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Cited by 96Psoriasis: Treatment and PathogenesisDermatology and Skin DiseasesPsychosomatic Disorders and Their Treatments

Core beliefs and psychological distress in patients with psoriasis and atopic eczema attending secondary care: the role of schemas in chronic skin disease

Mizara, A., Papadopoulos, L., McBride, S.R.·2012·British Journal of Dermatology
DOI 10.1111/j.1365-2133.2011.10799.x
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Abstract

BACKGROUND: The role of ingrained cognitive and emotional patterns (schemas) in patients with psoriasis and eczema has not previously been investigated. High levels of psychiatric morbidity and psychological distress observed in these populations suggest the presence of maladaptive schemas and therefore a possible target for future successful psychological intervention. OBJECTIVES: To investigate the presence of early maladaptive schemas (EMS) in patients with psoriasis and eczema and to explore their links with psychological distress. METHODS: A sample of 185 adults (psoriasis n = 55, atopic eczema n = 54, chronic disease control n = 23, normal control n = 53) completed validated, self-administered questionnaires. RESULTS: Differences were found between dermatology patients and control groups. Patients with psoriasis differed on seven EMS from the normal control group: emotional deprivation (P = 0·011), social isolation (P < 0·001), defectiveness (P < 0·001), failure (P < 0·001), vulnerability to harm (P < 0·001), subjugation (P = 0·009) and emotional inhibition (P = 0·002). They differed from the chronic disease group on vulnerability to harm (P = 0·002) only. Patients with eczema differed from the normal control group on eight EMS: emotional deprivation (P < 0·001), social isolation (P < 0·001), defectiveness (P < 0·001), failure (P < 0·001), dependence (P = 0·010), vulnerability to harm (P = 0·002), subjugation (P = 0·006) and insufficient self-control (P = 0·010). EMS were strongly positively related to psychological distress experienced by dermatology patients. Hierarchical regressions demonstrated two schemas, vulnerability to harm (P < 0·001) and defectiveness (P = 0·029), to be predictive of anxiety, and social isolation (P = 0·012) and vulnerability to harm (P = 0·018) to be predictive of depression, irrespective of age and years of coping for dermatology patients. CONCLUSIONS: The findings have important theoretical and clinical implications for psychological management of patients with psoriasis and eczema. Treatment protocols may benefit by targeting schemas. Further studies are needed to investigate the benefits of schema-focused therapy in patients with skin disease.

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  • The quality of life of patients with ROD is lower than for the general population in three key areas: physical limitations, social isolation and stigmatization, and emotional distress.

    “The quality of life of patients with ROD is lower than for the general population in three key areas: physical limitations (movements, pain, sleep problems, attention or concentration problems that affect daily life), [3–9], social isolation and stigmatization [3, 7, 9–13], and emotional distress (anger, depression, anxiety, hopelessness, loss, lack of control, abandonment) [3, 5, 8, 14–17].”

    From Connect-ROD – development and qualitative evaluation of a community-based group intervention to support well-being in patients with a rare or orphan disease (2024) · cites this paper as [12]

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Authors
Mizara, A., Papadopoulos, L., & McBride, S. R.
Affiliations
  • Royal Free London NHS Foundation Trust (GB)
  • London Metropolitan University (GB)
Corresponding author
Mizara, A.
ORCID
McBride, S.R.
Venue
British Journal of Dermatology
Publisher
Oxford University Press (OUP)
Published
2012-04-23
Volume
166
Issue
5
Pages
986-993
ISSN
  • 0007-0963 (ISSN-L)
  • 1365-2133
DOI
10.1111/j.1365-2133.2011.10799.x
OpenAlex
W1940302081
Cited by
96
References
42
Citations by year
2026: 2 · 2025: 12 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 9 · 2020: 3 · 2019: 3 · 2018: 9 · 2017: 9 · 2016: 10 · 2015: 5 · 2014: 6 · 2013: 6 · 2012: 1
FWCI
1.84
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • British Journal of Dermatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
early maladaptive schemas, psychological distress, psoriasis, atopic dermatitis, chronic skin disease, vulnerability to harm, defectivity, social isolation, emotional deprivation, anxiety, depression, maladaptive schemas, psychiatric morbidity, psychological intervention, secondary care patients, self-control, subjugation, emotional inhibition, dependency, failure, chronic disease control, dermatology patients
MeSH terms
Adult, Aged, Anxiety, Attitude to Health, Chronic Disease, Cross-Sectional Studies, Depression, Dermatitis, Atopic, Emotions, Female, Humans, Male, Middle Aged, Psoriasis, Surveys and Questionnaires, Stress, Psychological, Case-Control Studies, Young Adult

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