Comparative Psychometric and Psychopathological Analysis of Stress Factors in the Manifestation of Chronic Dermatoses

Background: psychogenic stress is one of the key modifying factors in the pathogenesis of chronic dermatoses. Contemporary research data indicate a bidirectional relationship between stress and skin diseases, mediated through neuro-immuno-endocrine mechanisms in which the skin functions as a peripheral stress-reactive organ. Despite numerous observations, factors determining patients' vulnerability to various types of stressogenic triggers of chronic dermatoses remain insufficiently investigated.

The aim was to identify personality vulnerability factors in patients with stress-induced dermatoses in order to determine potential targets for psychocorrective interventions.

Patients and Methods: a single-center cross-sectional study was conducted involving 115 patients (76 women, 39 men; mean age 47 years) with dermatoses that had manifested within three months following a stressogenic event. The examination included dermatological and psychopathological assessments, as well as psychometric and statistical tools: GAD-7, PHQ-9, PSS-10, DLQI, PID-5-BF, and IBM SPSS v.27.

Results:  dermatosis manifestation was associated with subjectively significant stressors in 72.9% of cases, while in 27.1% it was linked to objectively significant ones. Subjective triggers were most frequently reported in lichen planus (92.6%), eczema (86.2%), and rosacea (80%). Patients exposed to subjectively significant stressors demonstrated higher levels of anxiety and depression (GAD-7: 7.5 ± 5.4 vs. 6.5 ± 4.6; PHQ-9: 8.2 ± 4.7 vs. 5.4 ± 3.5, p < 0.05), perceived stress (PSS-10: 36.5 ± 8.8 vs. 27.3 ± 6.7, p < 0.05), pathological personality traits (PID5-BF: 42.7 ± 12.6 vs. 29.6 ± 11.4, p < 0.05), and a greater negative impact of the dermatosis on quality of life (DLQI: 18.4 ± 7.4 vs. 14.1 ± 8.2, p < 0.05).

Conclusion: the findings demonstrate the predominance of subjective psychogenic determinants in the structure of stress-induced dermatosis manifestations. Among the identified stress vulnerability factors were features of the premorbid personality and somatoperceptive accentuation. These results underscore the need for integrating comprehensive clinical and psychometric assessment, along with psychocorrective approaches, into the standard management of patients with stress-induced forms of chronic dermatoses.

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