Interplay of Biological Treatment and Psychological Features in Patients with Psoriasis: A Real-Life Prospective Study

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Introduction: Emotional dysregulation (ED), common among patients with psoriasis, lead to psychopathology and impair treatment adherence. Objective: This study examines the changes in prevalence of ED in patients and its effects on illness perception, mental health, and quality of life (QoL) during one year of treatment with risankizumab. Method: ED, illness perception, general health and QoL were measured at baseline, and at 4, 16, and 52 weeks post-treatment in 58 patients with psoriasis. Results: Higher ED was associated with greater psychological distress and poorer QoL. Patients with higher levels of ED reported greater psychological distress, worse QoL, and higher symptom-related distress throughout treatment as compared to those with lower ones. Although both groups improved in illness perception and clinical severity outcomes, patients with high ED consistently experienced worse subjective outcomes. Conclusion: ED is frequent in psoriasis patients and negatively affects mental health and QoL, despite clinical improvements in skin symptoms. Targeted psychological interventions may be necessary for patients who exhibit higher levels of emotional dysregulation to ensure comprehensive care and better long-term outcomes.