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MINDFULNESS AND UVB IN THE TREATMENT OF MODERATE PSORIASIS 8 & Kupper, 2012). The distinction for responding to stress was examined in Massachusetts health care system with 4576 subjects with a quantity of different diagnoses such as psoriasis (Koo, Do, & Lee, 2000). The subjects reported the time between the emotional trigger of stress and the clinical change of the disease. The psoriasis population reported days between the distress and the aggravating of the condition (Koo et al., 2000). A review divides the stress of psoriasis, into the distress of the disease itself, consequences of the disease on quality of life and other psychosocial comorbidities like depression, anxiety, and suicidality. They suggest that Psychosocial comorbidities may increase the psychosocial stress and thus be an important factor in aggravating psoriasis (Hunter, Griffiths, & Kleyn, 2013). A recent cross-sectional study of 13 European countries examined the psychological burden of living with a skin disease (Dalgard et al., 2015). The interesting results regarding psychosocial comorbidities was a significant clinical anxiety on 17 % among people with psoriasis, and only this skin disease group reported suicidal thoughts (Dalgard et al., 2015). People with psoriasis report having higher levels of anxiety, depression, suicidal thoughts, and reduced quality of life compared to healthy populations (Olivier et al., 2010). The reactions to stress depend on how the stressor is perceived by the individual. Patients who have high disease worry are less expected to clear the skin from symptoms than those with low-worry (Hunter, Griffiths, & Kleyn, 2013). Fortune and colleagues summarized that light therapy improved psoriasis specific factors such as disability and disease-related stress, but didn’t influence the psychological well-being (Fortune et al., 2004). Feelings of shame or embarrassment may well result in avoiding public places or locations where the skin is visible, therefore decreasing social activity, and even employment opportunities (Ginsburg & Link, 1993; Kimball, Jacobson, Weiss, Vreeland, & Wu, 2012) (Hrehorów, Salomon, Matusiak, Reich, & Szepietowski, 2012)The exact mechanism how stress influence psoriasis is unclear, but there seem to be an increased body of research on the effects of stress on psoriasis both within the dermatology and interdisciplinary fields (B. Fordham, Griffiths, & Bundy, 2015; Hunter et al., 2013; Kabat-Zinn et al., 1998) Appraisals of Psychological stress The tension of stress may be physical or psychological. The physical stressors to the skin is cold, heat, infections, or any harmful substances. Psychological stressors are eventsPDF Image | Combining Mindfulness and Ultraviolet Phototherapy (UVB
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