Adverse childhood experiences in patients with psoriasis

Abstract

INTRODUCTION: Adverse childhood experiences (ACEs) have been linked to occurrence of autoimmune diseases in adults, including psoriasis. OBJECTIVES: To study the prevalence of ACEs in psoriasis patients, comparing them with a sample from the general population. METHODS: Three hundred and eighteen individuals were included (104 psoriasis patients and 214 controls). Patients and controls answered questions on an ACE study questionnaire about experiences of childhood abuse, negligence, domestic violence, and household dysfunction. Questionnaire scores range from zero (best result) to 8 (worst scenario). Psoriasis patients' charts were reviewed for epidemiological, clinical, and treatment data. A Psoriasis Area Severity Index (PASI) was calculated from measurements taken when the questionnaire was administered. RESULTS: Psoriasis patients reported a median of 4 ACEs (interquartile range [IQR] = 3-5) while controls had a median of 3 (IQR = 2-4) with p < 0.0001. The number of ACEs was not associated with PASI, age of disease onset, or presence of associated arthritis (all p > 0.5). Female psoriasis patients had more ACEs than males (p = 0.04). CONCLUSION: Patients with psoriasis have more ACEs than controls and ACEs were more common in female patients.