Physical and psychologic measures are necessary to assess overall psoriasis severity

Background: The assessment of psoriasis severity is complex and involves bo th the physical and psychologic assessment of the individual patient. Objective: We compared the Salford: Psoriasis Index and several other tools for assessing psoriasis severity for their abilities to assess both the ph ysical and psychologic effects of psoriasis. Methods: A total of 101 patients (44 women, 57 men) were assessed by means of the Salford Psoriasis Index (SPT), Psodasis Area and Severity Index (PAS I), Self-Administered PASI (SAPASI), Psoriasis Disability Index (PDI), Hosp ital Anxiety and Depression Scale (HADS), and illness Perception Questionai re (IPQ). Results: The "signs" score of SPI (which measures the clinical extent of ps oriasis), PASI, and SAPASI correlated well with each other (r = 0.69-0.99; P < .01). They also correlated significantly, but not as strongly, with sco res of psoriasis-induced disability the PDI and SPI "psychosocial disabilit y" score (r = 0.46-0.51: P < .01); bur not with general measures of psychol ogic distress. There nas no significant correlation between the historical treatment, "intervention," score in SPI and either the physical or the psyc hologic store in the SPI. The PDI and "psychosocial disability" score of SP I correlated well with each other (r = 0.69; P < .01) as well as with the d epression and anxiety subscale scores of HADS (r = 0.33 and r = 0.37; P <.0 1, respectively), the total number of symptoms suffered by the patient (r = 0.38; P <.01), and the belief that stress or worry were associated with ps oriasis (r = 0.33; P <.01). Conclusions: Physical scores of psoriasis severity such as PAST, SAPASI, an d the "signs" component of SPI give a partial indication of psychosocial di sability caused by psoriasis. In many patients, however, the physical score does not, reflect psychosocial disability. Patients should be assessed by a more holistic approach, which takes into account both physical and psycho logic measurements, such as used in SPT, when assessing the severity of pso riasis.