Stressful Family Changes in Early Childhood Could Increase Psoriasis Risk

Early childhood stressors such as divorce could increase the risk of a child developing psoriasis later in life, according to a study published last month in the Journal of Investigative Dermatology. Specifically, stressful changes before the age of 1 increased psoriasis risk by OR=4.19.

Co-authors Debojyoti Das and Johnny Ludvigsson, M.D., Ph.D., both of Linköping University in Sweden, identified more than 16,000 children in Sweden using the All Babies in Southeast Sweden study. Parents were given questionnaires about recent family changes, including death, illness, conflict at home or divorce. Psoriasis cases were identified using the Swedish National Patient Register.

Children were followed up with at ages 1, 3, 5 and 8. At the study’s end, 121 children were diagnosed with psoriasis. Stress was most associated with psoriasis development before age 1. When analyzed separately, follow-up data for years 3, 5 and 8 did not show any significant relation between early stress and psoriasis development.

“We have earlier published results showing that early nutrition plays a role in the later development of psoriasis,” Das and Ludvigsson write in the study. “We found that breastfeeding seems to protect against psoriasis many years later, and one of the mechanisms may be through psychological contact, creating security and less stress for the child, in addition to the more direct effect on the gut microbiome. This made it natural to study more deeply the possible effect of early psychological stress on the development of psoriasis later.”

One current hypothesis for the connection between psychosocial stress and psoriasis involves the body's stress response altering the function of immune cells, thus driving inflammatory processes throughout the body, such as in the gut or, in this case, the skin.

Psoriasis is an inflammatory, autoimmune disease in which the immune system attacks the skin.

There are multiple types of psoriasis, the most common being plaque psoriasis, which makes up 90% of cases. It is characterized by the overgrowth of skin cells, which appear as itchy, thick white and red skin patches, typically on the elbows, knees, scalp and face.

Other types of psoriasis include guttate psoriasis, which appears as small, red, scaly bumps on the arms, back and abdomen, and inverse psoriasis, which manifests in body creases such as between the buttocks or under the arms.

Psoriasis can also be comorbid with other conditions such as diabetes, heart disease and depression. Some psoriasis patients also have psoriatic arthritis, which one in three psoriasis patients will develop.

There is currently no cure for psoriasis, nor do experts know for certain what causes it. However, Das and Ludvigsson’s research results could provide the building blocks for future studies.

“Stressful life factors early in life influence immune balance and seem to be among the important factors for the development of psoriasis,” the authors conclude. “Everything that can be done should be done to protect young children from stressful life factors that threaten their security and emotional well-being.”