Author Affiliations: Institut f ür Reha-Forschung Norderney, Abt Sozialmedizin Muenster, Muenster, Germany (Dr J. A. Bahmer); Derma am Diako, Bremen, Germany (Dr F. A. Bahmer).
In their prospective study in a recent issue of the Archives, Qureshi et al1 provide convincing evidence that intake of nonlight beer increases the risk of developing psoriasis. Since there are several other factors known to negatively influence psoriasis, such as obesity and smoking,2 it seems reasonable to counsel patients on lifestyle modification, as proposed by Shelling and Kirshner3 in a “Practice Gaps ” article in the same issue of the Archives. However, the effectiveness of such counseling is somewhat questionable because of personality traits rendering patients with psoriasis susceptible to addictive behavior concerning alcohol and food intake.4
In a comparative study of personality traits in patients with psoriasis, atopic dermatitis, and urticaria, our research team4 showed important differences in self-regulation, competence, and coping behavior. In contrast to patients with atopic dermatitis and urticaria, patients with psoriasis showed low scores for intrinsic positive affect and high scores for impulsive behavior. In these patients, alcohol may function as source of positive affect. Faced with negative life events or stressful situations, patients with psoriasis showed deficits in managing the situation appropriately and tended to avoid negative outcomes because of an overall lack of action-oriented behavior.
Because the risk behavior in patients with psoriasis is so closely linked to personality structure, an early and specific preventive intervention seems desirable to enhance self-efficacy and self-motivation, reduce helplessness, and aid in the development of coping strategies to enable the patient with psoriasis to generate intrinsic positive affect. Such psychotherapeutically oriented motivational counseling should help patients with psoriasis to overcome state orientation, depressive mood states, and nonadaptive coping strategies.
Correspondence: Dr F. A. Bahmer, Derma am Diako, Groepelinger Heerstrasse 406, 28239 Bremen, Germany (fbahmer@t-online.de).
Financial Disclosure: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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