Association of the attachment styles with depression, anxiety, and quality of life in patients with psoriasis

Abstract

Objectives: This is a cross-sectional study to investigate the attachment styles and their impact on depression, anxiety, and quality of life in people with psoriasis. Methods: All participants completed socio-demographic and illness specific questionnaires along with Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS) and Adult Attachment Style Scale (AASS). 100 individuals with psoriasis and 130 individuals with no dermatological problems participated in the study. Results: HADS scores for depression (38% versus 15.4%, P < .001) and anxiety (28% versus 6.9%, P < .001) were higher in participants with psoriasis compared to the healthy participants in the control group. AASS scores of participants for anxious/ambivalent attachment (13.7±4.0 versus 13.3±3.9, P = .465), secure attachment (15.8±4.4 versus 16.2±3.9, p = .510), and avoidant attachment (11.0±3.6 versus 11.3±3.6, P = .598) did not differ significantly in two groups. There was a significant correlation between DLQI scores and anxious/ambivalent attachment scores of participants with psoriasis (P < .05, r = .222). HADS scores of participants with psoriasis were also found significantly correlated with insecure attachment styles; anxious/ambivalent attachment (depression, P < .001/ anxiety, P < .001), avoidant attachment (depression, p < .001/ anxiety, p < .01). Conclusion: This study demonstrates that there is a relationship between the insecure attachment styles and depression, anxiety and reduced quality of life in people with psoriasis and also support the idea that attachment insecurities can impair the physiological stress response by increasing the perceived stress in these patients.