Psoriasis and Emotional Dysregulation: A Multicenter Analysis of Psychodermatology Outcomes

Introduction: Psychological symptoms associated with psoriasis include depression, anxiety, and social phobia, often exacerbated by high rates of alexithymia. Treatment decisions should consider not only clinical severity but also patient characteristics and quality of life. However, the psychosocial burden of psoriasis may not always align with clinical severity. Objectives: This study aimed to assess emotional regulation difficulties in outpatients with psoriasis, comparing these difficulties to those of the general population and examining associations with sociodemographic factors, comorbidities, and treatment options. Methods: A cross-sectional, multicenter study enrolled 107 consecutive patients with psoriasis from dermatological centers in Lazio, Italy. For every patient the Psoriasis Area Severity Index (PASI), Investigator’s Global Assessment (IGA), and Difficulties in Emotional Regulation scale (DERS) were recorded. Results: Analysis revealed that patients with psoriasis reported significantly higher emotional regulation difficulties compared to the general Italian population, even those with mild disease. A significant association was found between psoriasis severity and emotional regulation difficulties, particularly in patients with higher PASI scores. Biological treatments were associated with lower levels of emotional regulation difficulties. Conclusions: This study corroborates the existing literature on the association between psoriasis severity and emotional regulation difficulties. However, it diverges from prior findings regarding the association between body mass index (BMI) and emotional dysregulation. Assessing emotional regulation difficulties may aid clinicians in identifying vulnerable patients and optimizing treatment decisions to improve overall quality of life and treatment adherence. Further research is needed to validate these findings and to explore longitudinal associations between emotional regulation and psoriasis outcomes.