Psychopathological parameters and dexamethasone Evangelos Karanikas, Faidon Harsoulis, Ioannis Giouzepas, Ioannis Griveas, Fotis Chrysomallis Departments of Dermatology, Psychiatry and Endocrinology of Medical School of Aristotelian University of Thessaloniki, Greece logical development.1 Numerous studies have attempted toidentify a specific personality profile of a representative psori- Introduction
atic patient but it remains unclear whether different psycho- The literature dealing either with the psychological impact of logical features precede and precipitate psoriatic flare-ups, or psoriasis on the patients or the vulnerability of psoriatics to they are a consequence of having a chronic, symptomatic, dis- stressful life events is extensive whereas, so far, only few stud- ies have actually tried to investigate the role of neuroendocrine Furthermore, many studies have focused on the relationship parameters within the aforementioned setting.
between stressful life events and the exacerbation of psoriaticdisease.7-14 According to one of them, psoriatic patients whose Objective
the cutaneous condition is closely connected to their exposure To investigate the correlation between psychopathological to stressful life events, were reported to be up to 80%.9 On the parameters and the neuroendocrine functional test of contrary, the research output dealing with the psychopatholo- Dexamethasone Suppression Test (DST) in psoriatic patients.
gy of psoriasis especially within the neuroendocrine frame-work, is minimal. In particular, the research into the literature about studies involving the application of the Dexamethasone 24 mostly outpatient psoriatics and the same number of Suppression Test (DST) in psoriatic patients, demonstrated matched controls underwent psychiatric evaluation for detec- only 2 studies.15,16 In no study has there been an attempt to track tion of psychopathological traits. All participants underwent down and investigate a possible interaction between psy- chopathological parameters and DST in psoriatic patients.
This has been our main motive for carrying out the present Psoriatic patients showed significantly higher levels of depres-sive and anxiety mood, with the latter being mostly related to recent stressful life events. In the DST, psoriatics exhibitedhigher mean cortisol serum levels although both groups pre- PATIENTS
sented suppressed cortisol levels under 5 ìg/dl. Hormonal The study involved (the participation) of 24 patients that visit- parameters did not correlate with psychopathological features, ed the A’ Clinic of Dermatological and Venereological the extent of cutaneous psoriatic lesions and the duration of Diseases of Aristotelian University of Thessaloniki on a pri- marily outpatient basis. They suffered from psoriasis which hadbeen diagnosed either on a clinical basis (the diagnosis had Conclusions
been made by two clinicians) or by histopathological findings.
Psoriasis is related to significant psychosocial morbidity The patient sample consisted of 24 subjects, 11 men(46%) and although no clear correlation with the DST has been replicat- 13 women(54%), with mean age 51.29 +- 3.59 years.
From the above mentioned patients 3 were admitted in the hospital (2 males and one female). The mean duration of the Key Words: Psoriasis, Stress, Psychopathology, Dexamethasone
disease was 6.29 1.90 years and according to the reports of the Suppression Test, Cortisol, Life Changes patients, the mean duration of the current psoriatic episodewas estimated in 6.28 1.61 months (n=18, 6 gave insufficient INTRODUCTION
Psoriasis serves as perhaps the most illustrative example, In the study, 24 healthy volunteers participated as control compared to any other psychocutaneous disorder, of the group. Eleven (46%) were males and 13 (54%) were females subtle interactions between genetic predisposition, envi- with mean age, 43.42 2.35 years. The groups under study were ronmental influences and psychosocial factors that take place before the disease manifests itself. Ïn the other hand, because The protocol of the study has been approved by the ethical the 60% of the patients suffering from psoriasis start having the committee of both the Aristotelian University and the Hospital first symptoms prior to the age of 30 years, the nature of the of Dermatological and Venereological Diseases of skin disease becomes a crucial factor in these persons' psycho- Thessaloniki. All the participants gave their written consentafter having been told the exact procedure.
The inclusion and exclusion criteria for both healthy volun- teers and psoriatics were 1) age between 18-60 years 2) partic- Address correspondence to: Evangelos Karanikas MD, PhD
ipation in at least 10-year federal educational system, 3) 10 Kleanthous st, 54642, Thessaloniki,GreeceTEL: 0030 6977313243, FAX: 0030 2310 381010 absense of severe concomitant diseases ( cardiopulmonary, renal failure, cancer, cerebrovascular episode etc), 4) absence

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