Psychosocial care
Psoriatic arthritis is a long-term condition that
can have a significant psychological effect on the
patient’s life (Chang et al 2011).The fluctuating
nature and unpredictability of symptoms may
lead to the patient losing confidence in his or her
control over the disease. Psychological distress
may also be exacerbated by the visible nature of
the condition in terms of structural changes to
joints and the appearance of psoriasis (Mease
and Menter 2006). Frequently, patients describe
how they avoid certain social situations where
their bodies may be exposed, such as swimming
or other recreational activities, which can lead to
a degree of social isolation and increased levels
of depression. Previous studies have shown that
patients with rheumatoid arthritis are twice as
likely to experience depression than the general
population (Dickens and Creed 2001).
Although studies have not been done
specifically in patients with psoriatic arthritis,
the author’s experience from the clinic suggests
that patients with psoriatic arthritis may also be
at risk of developing depression. When patients
attend clinic, as well as assessing the levels of
disease activity, it is imperative to acknowledge
the psychosocial effect of the condition on quality
of life.
Effective psychological support can be
enhanced by ensuring the patient is taught
management strategies to overcome functional
disabilities. Assessment from physical and
occupational therapists at every stage throughout
the disease trajectory will support patients as
their physical needs change. Ensuring patients
have access to an advice line service will help
reduce feelings of isolation. Knowing there
is someone on the end of the telephone who
can offer practical and emotional support is
of benefit. However, the most effective way of
improving individuals’ sense of wellbeing and
self-efficacy is empowering them to become
actively involved in the management of their
disease, with an emphasis on the importance
of patient education.