The impact of psoriasis disease severity and perceived social support on social appearance anxiety

Introduction and Aim: Psoriasis is a chronic inflammatory disease associated with psychosocial comorbidities. Patients with psoriasis often experience shame, poor self-esteem and a social avoidance, which can lead to increased levels of social anxiety. Patients may also experience anxiety about social interactions, which affects their quality of life. The aim of this study was to determine the severity of psoriasis disease and the level of perceived social support and to evaluate the effect of these two variables on social appearance anxiety. In line with the data to be obtained, with the preventive medicine role of primary care and biopsychosocial approach; it is aimed to plan educational studies and initiatives to improve health services to repair/prevent problematic areas, thus reducing the negative effects of the disease on the person, facilitating the disease process, directing the patient to the right centers when necessary, evaluating the effects of non-disease factors on social support, disease severity and appearance anxiety with socio-demographic data and contributing to the literature in this field. Materials and Methods: This descriptive, cross-sectional, quantitative and prospective study was conducted with 140 patients diagnosed with psoriasis who met the inclusion criteria and applied to the Dermatology and Family Medicine outpatient clinics of Hitit University Faculty of Medicine Erol Olçok Training and Research Hospital. In the study, in addition to the PASI (Psoriasis Area Severity Index) score calculated for the measurement of psoriasis disease severity, the Socio-Demographic Data Form, Multidimensional Scale of Perceived Social Support (MSPSS) and Social Appearance Anxiety Scale (SAAS) were administered by face-to-face interview method. The collected data were analyzed with SPSS 25 (Statistical Package for the Social Sciences, version 25) package program using appropriate statistical methods. Results: The mean age of the patients included in the study was 34,11 years and 55% were female. The mean duration of the disease was 9,17 years and the mean age at disease onset was 24,95 years. The PASI score was higher in males than females, in patients with high school degree or below than those with university degree or above, and in married patients than single patients (p<0.05). MSPSS Family subscale score of married patients was higher than single patients (p<0.01). The MSPSS Friends subscale score of patients living with friends was higher than those living alone (p<0.05). The MSPSS total score of patients who were employed in the public sector was higher than those who were students, housewives, employed in the private sector and freelancers (p<0.01). There was a low/moderate positive correlation between MSPSS total score and age at onset of illness and a low/moderate negative correlation between MSPSS total score and PASI score. Discussion-Conclusion: The negative correlation between perceived social support and disease severity emphasizes the importance of social support systems in the management of chronic diseases such as psoriasis. Personalized social support programs for patients can play a critical role in reducing the effects of illness and improving patient quality of life. The lack of a significant relationship between perceived social support and social appearance anxiety may suggest that these variables may be independent. That is, even if a person perceives high levels of social support, this may not automatically reduce their anxiety about their appearance. Social support can be provided from different sources and the quality of these supports may have different effects on social appearance anxiety. Personal characteristics, self-confidence levels and other psychological factors may play a role in the relationship between perception of social support and social appearance anxiety. The fact that no significant correlation was found between psoriasis severity and social appearance anxiety emphasizes the importance of a patient-centered approach and how people perceive the change in their bodies, regardless of the extent and severity of the disease, is important for effective treatment approaches. The socio-demographic characteristics examined in this study were not found to play a decisive role in social appearance anxiety, but more extensive research may be needed to better understand other factors underlying this anxiety. Keywords: Psoriasis, Perceived Social Support, Social Appearance Anxiety