Perceived stress, stress attributions and psychological distress in psoriasis.

OBJECTIVE: The objective of this study was to measure causal beliefs in individuals with psoriasis and to explore their relationship with perceived stress, quality of life, psychological well-being and psoriasis severity. METHODS: This study was cross-sectional in design, and patients were required to complete validated questionnaires assessing perceptions of illness, quality of life, psoriasis severity, perceived stress and psychological mood. A total of 141 individuals were recruited from two settings: an outpatient skin clinic at King's College Hospital and the Psoriasis Association. RESULTS: A strong belief in stress/psychological attributes as a causal factor was found in 61% of the sample. This belief was significantly associated with higher levels of anxiety, depression and perceived stress (r > or = .38; P < or = .0001). Perceived stress in this sample was significantly associated with a poorer level of quality of life, higher levels of anxiety and depression (r > or = .27; P < or = .002) but not with psoriasis severity. CONCLUSIONS: The belief that stress is causal was associated with lower levels of psychological well-being. However, there was no association between perceived stress and more objective measures of psoriasis severity.