E2 ModerateModerate confidencePEM not requiredCross-SectionalPeer-reviewedReviewed
Standard · 3 min
Patients' strategies for coping with psoriasis.
Fortune, D G, Richards, H L, Main, C J et al. · Clinical and experimental dermatology · 2002 · DOI
Quick Summary
This study looked at how people with psoriasis (a skin condition) cope with their illness by comparing their coping strategies to healthy people and those with other diseases. Researchers found that psoriasis patients most often use acceptance and planning to manage their condition, while least often turning to alcohol, drugs, or denial. Interestingly, people with psoriasis used fewer active coping strategies than healthy controls, but used similar coping approaches to patients with other conditions like chronic fatigue syndrome and cancer.
Why It Matters
While this study examines psoriasis rather than ME/CFS, it demonstrates that patients with invisible chronic illnesses (like chronic fatigue syndrome, which is explicitly mentioned) employ similar coping mechanisms across disease types. Understanding these generic coping patterns can inform interventions for ME/CFS patients and highlight that coping strategies may need individualization regardless of disease visibility or severity.
Observed Findings
Acceptance, planning, active coping, and positive reinterpretation were the most frequently used coping strategies in psoriasis patients.
Alcohol/drug use, religion, and denial were the least frequently used coping strategies.
Patients with severe psoriasis did not significantly differ from those with mild/moderate disease in coping strategy use despite reporting greater disability.
Psoriasis patients used significantly less active coping, planning, positive reinterpretation, and humor than healthy controls.
Similar coping strategy patterns were observed across psoriasis, chronic fatigue syndrome, atrial fibrillation, spinal cord injury, cancer, and myocardial infarction.
Inferred Conclusions
Chronic illness may produce a generic coping response pattern that is relatively consistent across different disease types, regardless of visibility or severity.
Coping strategies in chronic illness may require individualization based on specific disease demands rather than applying a one-size-fits-all approach.
Patients with chronic conditions as a group employ fewer active problem-focused coping strategies compared to the general healthy population.
Remaining Questions
Do certain coping strategies lead to better health outcomes, quality of life, or disease progression in psoriasis or other chronic illnesses?
What This Study Does Not Prove
This study does not prove that any particular coping strategy is more effective for managing psoriasis or other conditions—it only describes which strategies patients report using most frequently. The cross-sectional design cannot establish causality or determine whether certain coping strategies lead to better health outcomes. Additionally, findings about psoriasis may not directly translate to ME/CFS management without disease-specific research.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Contribute
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Why do chronic illness patients overall use fewer active coping strategies than healthy controls—is this adaptive or maladaptive?
How do coping strategies differ between early-stage and long-standing disease, and do they change over time?
Which specific adaptations to generic coping strategies are most effective for disease-specific challenges like psoriasis stigma versus ME/CFS post-exertional malaise?