Psychodermatologic Dimensions of Psoriasis: Perceived Burden, Help-Seeking Behavior and Openness to Supportive Care

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Abstract
Background/Objectives: Psoriasis is a chronic immune-mediated dermatosis with an important psychodermatologic burden, in which psychological stress, perceived disease impact, stigma, and attitudes toward mental health care may influence patient support needs. Although psychological and psychiatric interventions are increasingly discussed in dermatology, patient openness to different forms of supportive care, including music therapy, remains insufficiently characterized. This study aimed to characterize psychodermatologic burden and support-related attitudes among patients with psoriasis, with particular emphasis on openness to psychological counseling, psychiatric care, and music therapy-based support, and to explore the factors associated with these attitudes. Methods: In this single-center cross-sectional study, 102 adults with cutaneous or nail psoriasis completed an original self-administered questionnaire between July 2023 and January 2025. Results: Most participants perceived stress as related to psoriasis onset or worsening (86.3%) and considered dermatologist guidance toward psychological or psychiatric support beneficial (80.4%). Psychological counseling was the most accepted supportive intervention (75.5%), followed by music therapy (54.9%) and psychiatric consultation (48.0%), while previous psychological or psychiatric care was reported by 22.5%. Willingness to seek psychological support was independently associated with perceived psoriasis impact, whereas willingness to seek psychiatric support was associated with perceived stress impact. Awareness of music therapy was associated with higher educational level. Willingness to try music therapy was associated with high perceived stress impact, higher educational level, music listening, and awareness of music therapy. Conclusions: Patients with psoriasis frequently perceive stress as relevant to their disease and show variable openness to supportive care. These findings support an individualized psychodermatologic approach in which dermatologists may help identify patients receptive to psychological, psychiatric, or music therapy-based interventions.

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