Presentation (CTI)

OBJECTIVES: People with psoriasis face psychological and interpersonal impacts that can be underrecognized in clinical care and research. Qualitative analysis of social media is an emerging approach for understanding patient experiences, as individuals may be more likely to reveal personal impacts of disease in anonymous online narratives than in other settings. This approach has not been taken previously to explore psychological and interpersonal impacts of plaque psoriasis. Here, we examine how psoriasis symptoms impact mental health and intimate relationships using patient-generated social media narratives.
METHODS: A qualitative analysis was conducted using Reddit posts published between 2020-2025 by individuals with psoriasis. Eligible posts described the impact of psoriasis symptoms on mental health and interpersonal relationships; posts mentioning mild or non-plaque psoriasis were excluded. Themes were identified through content analysis, with quotations used to illustrate findings.
RESULTS: Across 263 threads, individuals described how psoriasis symptoms limited enjoyable activities and self-expression. Narratives highlighted cascading and cyclical psychological impacts, where stress and anxiety exacerbated symptoms, worsening mental health. Physical symptoms and psychological burden negatively affected interpersonal relationships, contributing to feelings of isolation and loneliness. Low self-esteem can impede initiating new intimate relationships and negatively impacted sexual intimacy in existing relationships. Effective treatment reduced psychological burden and relationship barriers, for some allowing renewed engagement in daily life.
CONCLUSIONS: Psoriasis exerts a profound impact on self-expression, mental health, and intimate relationships. These findings underscore the importance of effective psoriasis treatments not only for symptom control but also for improving emotional well-being and relationship engagement.