{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:33:29Z","timestamp":1790382809585,"version":"4.1.0"},"reference-count":69,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T00:00:00Z","timestamp":1685145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Stress and Health"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Psoriasis is a chronic\u2010inflammatory, immune\u2010mediated disease leading to a state of increased systemic inflammation. Mental comorbidities often occur in the patients and may additionally affect the therapy outcome. Currently, it is unknown whether the disease severity, psychosocial stress or health\u2010related quality of life determines the manifestation of anxiety\/depression, or vice versa, in psoriasis. The interplay between these variables during the dermatological treatment of psoriasis remains to be elucidated in order to initiate appropriate psychological interventions and to identify patients at risk for comorbid anxiety\/depression. In a prospective cohort study, the impact of disease severity, health\u2010related quality of life and psychosocial stress on anxiety\/depression were examined during the dermatological treatment in patients with moderate to severe psoriasis (patients with psoriasis\u00a0=\u00a0PSO). Patients were examined before (T1) and about 3\u00a0months after (T2) the beginning of a new treatment episode, in most cases by means of systemic therapy. Data were analysed, exploratory, using Bivariate Latent Change Score Models and mediator analyses. Assessments included patient\u2010reported outcomes (Hospital Anxiety and Depression Scale\/HADS, Perceived Stress Scale\/PSS, Childhood Trauma Questionnaire\/CTQ, Dermatology Life Quality Index\u2010DLQI, Body Surface Area\u2010BSA), at both T1 and T2. 83 PSO patients (37.3% women, median age 53.7, IQR 37.8\u201362.5, median BSA 18.0, IQR 9.0\u201340.0) with complete data of HADS and DLQI were included. In the total group, a higher anxiety\/depression at T1 was associated with a lower improvement in psoriasis severity in the course of the dermatological treatment (<jats:italic>\u03b3<\/jats:italic><jats:sub>BSA<\/jats:sub>\u00a0=\u00a00.50, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). In subgroups of PSO with low\/high CTQ scores, anxiety\/depression at T1 had no impact on the change in psoriasis severity. Only by tendency, in CTQ subgroups, a higher psoriasis severity at T1 was linked with a higher improvement in anxiety\/depression at T2 (low\/high CTQ, <jats:italic>\u03b3<\/jats:italic><jats:sub>HADS<\/jats:sub>\u00a0=\u00a0\u22120.16\/\u22120.15, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.08). An improvement in the health\u2010related quality of life was positively associated with an improvement in anxiety\/depression (Pearson's <jats:italic>r<\/jats:italic>\u00a0=\u00a00.49, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). Here, the reduction of acute psychosocial stress seems to be a decisive factor, mediating this association (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a00.20, <jats:italic>t<\/jats:italic> [2,60]\u00a0=\u00a01.87; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.07, 95% CI \u22120.01, 0.41). The results allude, that the initial severity of anxiety\/depression may presumably have an impact on the treatment outcome in the total group. In contrast, analysing subgroups of patients with high\/low childhood trauma, the impact of the initial disease severity on the course of anxiety\/depression after a switch to a new dermatological treatment could not be conclusively ruled out. The latter results from the latent change score modelling should be treated cautiously because of the small sample size. A common aetiopathological mechanism for psoriasis and anxiety\/depression might be assumed with impact of dermatological treatment on both. The change in perceived stress seems to play an important role in the manifestation of anxiety\/depression, substantiating the need for adequate stress management in patients with increased psychosocial stress during their dermatological treatment.<\/jats:p>","DOI":"10.1002\/smi.3263","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T10:15:09Z","timestamp":1685182509000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Psychosocial stress affects the change of mental distress under dermatological treatment\u2014A prospective cohort study in patients with psoriasis"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6292-0852","authenticated-orcid":false,"given":"Gloria\u2010Beatrice","family":"Wintermann","sequence":"first","affiliation":[{"name":"Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonie Louise","family":"Bierling","sequence":"additional","affiliation":[{"name":"Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"Department of Clinical Psychology Friedrich\u2010Schiller\u2010Universit\u00e4t  Jena Germany"},{"name":"Institute for Materials Science Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva M. J.","family":"Peters","sequence":"additional","affiliation":[{"name":"Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy Justus\u2010Liebig University Giessen  Giessen Germany"},{"name":"Department of Psychosomatic Medicine and Psychotherapy Charit\u00e9 Center 12 Internal Medicine and Dermatology, Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Beissert","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Weidner","sequence":"additional","affiliation":[{"name":"Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359105311423863"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102133.1994.tb02900.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737167.2014.914437"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2020.3275"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107525\u20104\u201035"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.880201"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.04.063"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2307\/2136404"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/15248371003699969"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2014.530"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/24750573.2018.1452521"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523\u20101747.ep12329912"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102230.1994.tb01167.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1348\/014466502163949"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1348\/014466504772812977"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102133.2002.04622.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2020.1398"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010017\u20100721\u2010x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2013.11.001"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128071\u2010200304120\u201000003"},{"key":"e_1_2_8_22_1","volume-title":"Introduction to mediation, moderation, and conditional process analysis: A regression\u2010based approach. 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