Abstract
Background
Despite evidence suggesting a bidirectional relationship between psychological factors and skin disease, psychological distress and personality traits remain underexplored in dermatological care.
Objective
This study aimed to compare psychopathological symptoms and personality traits between female outpatients with dermatological conditions and healthy controls.
Methods
In total, 159 outpatients with dermatological conditions and 160 healthy controls (all female) completed the Symptom Check List-90-Revised (SCL-90-R), and a shortened version of the NEO-Personality Inventory-Revised. Between-group comparisons were conducted using t-tests, and stepwise regression analysis was used to identify the psychopathological predictors of neuroticism.
Results
Compared with controls, the dermatology outpatient group demonstrated significantly higher SCL-90-R scores for all nine clinical scales and neuroticism, scoring lower in extraversion, openness, and agreeableness. Within the dermatology outpatient group, neuroticism was positively associated with all psychopathological dimensions (r=0.265–0.583; p<0.01). Depression, somatization, and obsessive-compulsive symptoms were significant predictors of neuroticism (F=33.969; p<0.001).
Conclusion
Female outpatients with dermatological conditions may experience considerable psychological distress and elevated neuroticism, even in the absence of clinical psychiatric diagnoses. Screening for psychological symptoms—including neuroticism, depression, somatization, and obsessive-compulsive features—should be considered in dermatological settings to better address patients’ emotional well-being and optimize care outcomes.
Keywords: Dermatology, Neuroticism, Outpatients, Personality, Psychological distress
INTRODUCTION
Dermatological diseases are often associated with psychological difficulties and psychiatric disorders1,2. Since Wittkower and Russell3 first reported on the role of emotional factors in skin diseases, clinicians have increasingly recognized the bidirectional relationship between emotional states and dermatological conditions. Psychological factors are known to contribute to the onset, progression, and persistence of various skin diseases4. Stress has frequently been linked to their exacerbation5.
Among psychiatric comorbidities, depression2,6,7 and anxiety7,8 are the most reported. These conditions are frequently associated with dermatological diseases, such as psoriasis1,9,10, acne1,9, and atopic eczema6,8,9. Additionally, the social stigma, humiliation, embarrassment, and lack of self-confidence about one’s appearance associated with dermatological diseases can impact one’s personality traits, even if it does not lead to psychological morbidity11.
Accordingly, many studies have investigated general dermatological diseases, as well as those that visibly affect appearance—including psoriasis12, atopic dermatitis13, and alopecia areata14—to identify associated personality traits. However, findings have been inconsistent, with no significant differences reported between patients with general dermatological diseases that those had a major influence on appearance. Moreover, their personality characteristics were often comparable to those of healthy individuals15,16.
This study aimed to examine the psychopathology and personality traits of female outpatients with dermatological conditions compared with healthy controls and identify the specific psychopathological symptoms that predict personality features.
MATERIALS AND METHODS
Ethics statement
The study protocol was approved by the Institutional Review Board (IRB) of the Chungnam National University Hospital (IRB No. 2016-10-013). All procedures were conducted in accordance with the ethical standards of the institutional research committee and with the 1975 Declaration of Helsinki, as revised in 2013. All participants provided written informed consent after receiving a full explanation of the study procedure. The purpose and procedures of this study were explained to all eligible patients, regardless of diagnosis.
Study participants
Patients who received outpatient treatment for dermatological conditions at the Department of Dermatology, Chungnam National University Hospital were recruited between October 2017 and March 2018. A total of 159 female patients participated in the study. Survey questionnaires were distributed at the time of their initial dermatological examination and were collected within 1 month. Participants presented with a variety of dermatological diagnoses.
For the control group, 200 female participants without diagnosed skin conditions were recruited through promotional leaflets. Among them, 160 who completed the questionnaires were included in the final control group. None of the participants in either group had a history of psychiatric or psychological treatment. In the dermatology outpatient group, psychiatric history was obtained from self-report and medical record review, whereas in the control group, it was assessed using self-report and a psychiatrist-conducted interview.
Only female participants were included in the study to reduce the potential confounding effects of sex on psychopathological and personality trait assessments, as well as to enhance the internal validity of group comparisons.
Diagnostic classification
Dermatological diagnoses were assigned according to the primary diagnosis recorded in the electronic medical records by dermatologists. Patients with dermatological conditions were classified into four categories according to the clinical similarity of diagnoses and reference to the International Classification of Diseases, 10th Revision (ICD-10): acne (n=39), alopecia (n=24), atopic/eczema/allergic disorders (n=48), and other dermatological conditions (n=48). Psychiatric evaluation focused on assessing psychopathological symptoms and personality characteristics, without limiting analyses to specific psychiatric diagnoses.
Evaluation tools
1) Personality traits test
A shortened version of the NEO-Personality Inventory-Revised (NEO-PI-R) was used to assess the Big Five personality traits: neuroticism, extraversion, openness, agreeableness, and conscientiousness17. The Korean version18 of this instrument is a validated and standardized adaptation of the original 240-item NEO-PI-R19. The shortened version comprises 60 items, with 12 items for each personality dimension. Items are rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), with higher scores reflecting greater expression of the respective personality trait.
2) Evaluation of psychopathology
General psychopathology was assessed using the Korean version of the Symptom Check List-90-Revised (SCL-90-R)20, a multidimensional inventory that is used to evaluate a broad spectrum of psychological and psychopathological symptoms21. The instrument includes 90 items, organized into nine clinical scales and three summary indices. Participants rated the severity of their symptoms over the past week using a 5-point Likert scale, ranging from 0 (“not at all”) to 4 (“extremely severe”). The nine clinical scales included somatization, obsessive-compulsive (OC), interpersonal sensitivity, depression, anxiety, phobic anxiety, hostility, paranoid ideation, and psychoticism. The three summary indices were the Global Severity Index, Positive Symptom Total, and Positive Symptom Distress Index. Higher scores indicated greater psychological symptom severity.
Statistical analysis
The normality of the data was assessed prior to conducting parametric analyses. Differences in the nine clinical scales of the SCL-90-R and five personality trait scales of the NEO-PI-R were examined between groups using the independent samples t-test. In addition, one-way analysis of variance (ANOVA) was performed to compare psychopathological symptoms and personality traits among the four dermatological diagnostic groups. Pearson’s correlation analysis was conducted within the dermatology outpatient group to examine the relationship between psychopathological symptoms and personality traits.
Based on the correlation results, four NEO-PI-R personality traits that showed significant associations with psychopathological symptoms were selected as dependent variables. To identify which psychopathological domains predicted each personality trait, stepwise multiple regression analyses were conducted. The nine clinical scales of the SCL-90-R were entered as independent variables, and separate regression models were constructed for each of the four selected personality traits. All statistical analyses were performed using SPSS version 24.0 (IBM, Armonk, NY, USA), with a two-tailed significance level of p<0.05.
RESULTS
Group characteristics and comparisons
A total of 159 female outpatients with dermatological conditions and 160 controls were included in the analysis. No missing values were detected across the primary outcome variables (SCL-90-R and NEO-PI-R scores) among participants included in the final analysis. The mean ages were 34.96±9.22 years and 33.20±2.58 years in the dermatology outpatient and control groups, respectively, with no significant difference (p=0.192). All participants scored below the clinical cutoff point of 70 on all nine SCL-90-R subscales, suggesting that while between-group differences were observed, the overall level of reported psychopathological symptoms did not reach the range typically indicative of clinical severity.
Independent samples t-tests revealed significantly higher scores in the dermatology outpatient than control group for all nine SCL-90-R clinical scales. Regarding personality traits assessed by the NEO-PI-R, the dermatology outpatient group reported significantly higher levels of neuroticism (p=0.035), and significantly lower levels of extraversion (p=0.002), openness (p=0.001), and agreeableness (p=0.046) than the control group. No significant between-group difference was observed for conscientiousness (p=0.383; Table 1).
Table 1. Comparison of psychopathological symptoms and personality traits between female patients with dermatological conditions and healthy controls.
| Variables | Patients (n=159) | Control (n=160) | p-value | |
|---|---|---|---|---|
| Age | 34.96±9.22 | 33.20±2.58 | 0.192 | |
| SCL-90-R | ||||
| SOM | 43.26±7.88 | 38.48±5.63 | 0.001 | |
| OC | 43.64±9.36 | 36.76±5.91 | 0.001 | |
| IS | 44.31±9.92 | 37.73±4.98 | 0.001 | |
| DEP | 43.16±9.69 | 36.72±4.87 | 0.001 | |
| ANX | 42.25±7.92 | 37.72±3.67 | 0.001 | |
| HOS | 45.54±9.14 | 40.16±3.83 | 0.001 | |
| PHOB | 44.04±7.36 | 40.98±2.83 | 0.001 | |
| PAR | 43.89±8.79 | 39.54±3.59 | 0.001 | |
| PSY | 42.84±7.39 | 39.02±2.35 | 0.001 | |
| NEO-PI-R | ||||
| Neuroticism | 33.31±6.89 | 31.90±4.83 | 0.035 | |
| Extraversion | 38.14±5.94 | 40.17±5.64 | 0.002 | |
| Openness | 36.24±4.61 | 38.94±5.38 | 0.001 | |
| Agreeable | 41.99±5.91 | 43.25±5.32 | 0.046 | |
| Conscientiousness | 42.25±6.24 | 42.81±5.19 | 0.383 | |
Values are presented as mean ± standard deviation.
For the SCL-90-R, a T-score ≥63 is commonly used to indicate clinically significant distress, but was not used for diagnostic classification in this study. The NEO-PI-R does not have formal clinical cut-off scores.
SCL-90-R: Symptom Check List-90-Revised, SOM: somatization, OC: obsessive-compulsive, IS: interpersonal sensitivity, DEP: depression, ANX: anxiety, HOS: hostility, PHOB: phobic anxiety, PAR: paranoid ideation, PSY: psychoticism, NEO-PI- R: NEO Personality Inventory-Revised.
ANOVA was performed to compare psychopathological symptoms and personality traits among the four diagnostic groups. No statistically significant differences were found in any of the measured variables across the groups (all p>0.05). These results suggest that psychological vulnerability in dermatology outpatients may be more strongly influenced by individual-level factors rather than specific dermatological diagnoses (Table 2).
Table 2. Subanalysis of psychopathological symptoms and personality traits according to subtypes of dermatological conditions in female patients.
| Variables | Acne (n=39) | Atopic/eczema/allergic dermatitis (n=48) | Alopecia (n=24) | Other dermatological conditions (n=48) | F | p-value | Post-hoc (Scheffé, p<0.05) | |
|---|---|---|---|---|---|---|---|---|
| SCL-90-R | ||||||||
| SOM | 42.05±5.87 | 43.58±8.90 | 43.5±6.67 | 43.81±8.86 | 0.414 | 0.743 | ns | |
| OC | 43.31±7.83 | 44.19±9.26 | 44.67±8.84 | 42.85±10.92 | 0.276 | 0.842 | ns | |
| IS | 42.64±7.12 | 44.67±10.67 | 45.92±10.77 | 44.52±10.77 | 0.601 | 0.615 | ns | |
| DEP | 41.67±7.30 | 43.67±9.35 | 43.67±9.93 | 43.63±11.60 | 0.407 | 0.748 | ns | |
| ANX | 41.72±8.07 | 41.94±7.22 | 41.54±6.45 | 43.33±9.17 | 0.442 | 0.723 | ns | |
| HOS | 44.82±7.55 | 45.42±8.62 | 44.75±7.92 | 46.65±11.31 | 0.373 | 0.773 | ns | |
| PHOB | 42.1±4.26 | 44.94±7.42 | 44.83±6.99 | 44.31±9.17 | 1.259 | 0.290 | ns | |
| PAR | 41.72±5.63 | 44.56±8.85 | 42.71±6.85 | 45.56±11.18 | 1.631 | 0.184 | ns | |
| PSY | 40.87±3.87 | 42.90±6.75 | 42.96±6.36 | 44.33±10.03 | 1.596 | 0.193 | ns | |
| NEO-PI-R | ||||||||
| Neuroticism | 33.67±7.52 | 33.0±6.99 | 33.58±7.35 | 33.19±6.18 | 0.083 | 0.969 | ns | |
| Extraversion | 39.69±6.37 | 38.29±4.99 | 35.96±6.13 | 37.82±6.17 | 2.065 | 0.107 | ns | |
| Openness | 36.05±4.83 | 36.48±5.22 | 35.67±3.95 | 36.44±4.17 | 0.215 | 0.886 | ns | |
| Agreeable | 42.05±6.43 | 41.19±6.41 | 43.04±5.47 | 42.21±5.19 | 0.567 | 0.638 | ns | |
| Conscientiousness | 41.67±5.45 | 42.52±6.66 | 41.88±6.87 | 42.63±6.24 | 0.227 | 0.878 | ns | |
Values are presented as mean ± standard deviation.
For the SCL-90-R, a T-score ≥63 is commonly used to indicate clinically significant distress, but was not used for diagnostic classification in this study. The NEO-PI-R does not have formal clinical cut-off scores.
SCL-90-R: Symptom Check List-90-Revised, SOM: somatization, ns: not significant, OC: obsessive-compulsive, IS: interpersonal sensitivity, DEP: depression, ANX: anxiety, HOS: hostility, PHOB: phobic anxiety, PAR: paranoid ideation, PSY: psychoticism, NEO-PI-R: NEO Personality Inventory-Revised.
Correlation between the SCL-90-R and NEO-PI-R in the dermatology outpatient group
Within the dermatology outpatient group, neuroticism was positively correlated with all nine SCL-90-R clinical scales (r=0.265–0.583; p<0.01). By contrast, extraversion, openness, agreeableness, and conscientiousness were negatively correlated with the SCL-90-R clinical scales (Fig. 1).
Fig. 1. Pearson correlation coefficients between psychopathological symptoms and personality traits in female patients with dermatological conditions.
SOM: somatization, OC: obsessive-compulsive, IS: interpersonal sensitivity, DEP: depression, ANX: anxiety, HOS: hostility, PHOB: phobic anxiety, PAR: paranoid ideation, PSY: psychoticism, NEU: Neuroticism, EXT: Extraversion, OPN: Openness, AGR: Agreeable, CON: Conscientiousness.
Regression analysis: predictors of personality traits in the dermatology outpatient group
Stepwise multiple regression analyses were conducted for the four NEO-PI-R personality traits that showed significant correlations with SCL-90-R variables. For neuroticism, depression (β=0.512; p=0.001), somatization (β=0.326; p=0.001), and OC symptoms (β=0.368; p=0.005) were significant predictors, with the model showing substantial explanatory power (F=33.969, adjusted R2=0.385; p<0.001).
For extraversion, OC symptoms were a significant negative predictor (β=–0.335, adjusted R2=0.112, p=0.003). Hostility negatively predicted agreeableness (β=–0.369, adjusted R2=0.131; p=0.001). For conscientiousness, OC symptoms also emerged as a significant negative predictor (β=–0.349, adjusted R2=0.116; p=0.001; Table 3).
Table 3. Stepwise regression analyses identifying psychopathological predictors of personality traits in the patient group.
| Variables | B | SE | β | t | p-value | Adjusted R2 | |
|---|---|---|---|---|---|---|---|
| Neuroticism | |||||||
| SCL-90-R DEP | 0.364 | 0.091 | 0.512 | 3.977 | 0.001 | 0.385 | |
| SCL-90-R SOM | 0.285 | 0.087 | 0.326 | 3.287 | 0.001 | ||
| SCL-90-R OC | 0.270 | 0.095 | 0.368 | 2.852 | 0.005 | ||
| Extraversion | |||||||
| SCL-90-R OC | −0.213 | 0.048 | −0.335 | −4.452 | 0.003 | 0.112 | |
| Agreeable | |||||||
| SCL-90-R HOS | −0.239 | 0.048 | −0.369 | −4.982 | 0.001 | 0.131 | |
| Conscientiousness | |||||||
| SCL-90-R OC | −0.233 | 0.050 | −0.349 | −4.664 | 0.001 | 0.116 | |
SCL-90-R: Symptom Check List-90-Revised, NEO-PI-R: NEO-Personality Inventory-Revised, DEP: depression, SOM: somatization, OC: obsessive-compulsive, HOS: hostility. Model 1 was adjusted for SCL-90-R scores: and Model 2 was adjusted for SCL-90-R scores and dermatological diagnosis.
DISCUSSION
Higher levels of psychopathological symptoms and neuroticism were reported among female dermatological outpatients than among healthy controls. In our subgroup analysis by dermatologic diagnosis, no significant differences were found in psychopathological or personality measures. This suggests that psychological vulnerability in dermatology outpatients may depend more on individual factors, such as personality traits and subjective distress, than on the specific diagnosis. Among the various symptoms, depression, somatization, and OC symptoms significantly predicted neuroticism, suggesting that these psychological factors may contribute to emotional vulnerability in this population.
Although none of the participants scored above the clinical threshold on the SCL-90-R, the dermatology outpatient group reported significantly higher levels of psychological distress across all clinical dimensions than the controls. This finding is consistent with prior study indicating that skin disease patients experience significant psychological burden, including depression and anxiety22. As participants with a history of psychiatric treatment were excluded, these findings likely reflect subclinical psychological distress within this group. Although depression and anxiety remain the most reported psychiatric concerns in dermatology, somatization, OC traits, and body-focused repetitive behaviors have also been observed23,24.
Consistent with our findings, studies using the NEO-FI in patients with dermatological conditions have demonstrated associations between personality traits and various forms of psychopathology. A study of patients with atopic dermatitis found that higher neuroticism was significantly associated with elevated anxiety levels, suggesting that emotion dysregulation may contribute to the heightened psychological burden25. In patients with vitiligo, increased neuroticism and decreased conscientiousness were shown to negatively influence treatment adherence, emphasizing the impact of personality on clinical outcomes26. In addition, patients with genodermatoses exhibited elevated neuroticism and reduced quality of life, further supporting its transdiagnostic role in dermatological distress27. Unlike prior studies focusing on specific skin conditions, our study involved a general outpatient sample. Although direct comparisons are limited, our findings are consistent with those of previous studies showing that dermatological conditions have high neuroticism and may affect psychiatric problems. These findings suggest that they may be the basis for psychological distress and health behavior in patients with skin disease.
Neuroticism has been consistently associated with lower subjective well-being, increased vulnerability to psychiatric disorders, and diminished quality of life in general and clinical populations28,29,30. Neuroticism has been associated with maladaptive emotion regulation strategies that are broadly linked to psychopathology31. Even in the absence of clinically diagnosable psychiatric conditions, elevated neurotic traits may negatively influence treatment adherence and psychological adjustment, particularly in patients with visible dermatological conditions.
From a clinical perspective, female dermatology outpatients may have substantial psychological vulnerability, characterized by elevated levels of depression, somatization, OC symptoms, and neuroticism. Such vulnerability can negatively impact treatment adherence, exacerbate distress related to dermatologic symptoms, and reduce overall quality of life. Recognizing these risks and, when needed, using brief, validated psychological tools or referring patients to psychiatrists may more effectively address their psychological needs. This multidisciplinary approach can strengthen the therapeutic alliance, enhance adherence, and ultimately improve both psychological well-being and patient-centered outcomes.
This study has notable strengths, including the use of a standardized and well-validated personality assessment (NEO-PI-R) in a relatively large, naturalistic outpatient sample. Furthermore, the inclusion of psychopathological and personality measures enabled a more integrated understanding of psychological vulnerability in patients with dermatological conditions.
However, certain limitations should be noted; first, the study did not account for the timing, severity, and specific types of dermatological conditions, making it difficult to evaluate condition-specific psychological problems. Although individual dermatological diagnoses were recorded, no significant psychological differences were observed across diagnostic categories; therefore, all patient data were analyzed as a single group. Second, the control group did not match patients with dermatological conditions in dermatological or psychosocial characteristics, and other demographic variables were not fully controlled, which may have introduced comparison bias. Third, socioeconomic status, including potentially important confounding factors such as education level, income, and occupation, was not assessed, which limited our opportunity to adjust for its potential influence on the relationship between dermatological conditions and psychological outcomes. Fourth, all psychological data were collected exclusively through standardized self-report questionnaires without clinical psychiatric interviews. The use of self-report measures may have led to reporting bias, especially when evaluating subclinical psychological distress. Fifth, only female participants were included, limiting generalizability. Finally, the cross-sectional and retrospective design restricts causal inference. Future research may benefit from examining condition-specific psychological patterns using larger samples. It should also consider disease status at the time psychological assessments are administered, including the use of standardized severity measures such as the Investigator’s Global Assessment or Dermatology Life Quality Index. In addition, future studies should also include more diverse populations, consider specific dermatological diagnoses, and employ longitudinal designs to better understand the interplay between psychopathology and personality traits in this context. Moreover, structured clinical interviews should be conducted to improve the validity of psychological assessments.
This study found that female outpatients with dermatological conditions exhibited greater levels of psychological distress and neuroticism than healthy controls. Symptoms, including depression, somatization, and OC features, were closely associated with neurotic traits. These results suggest that recognizing and addressing underlying psychological concerns in dermatology settings—especially those related to emotional regulation—could improve patient well-being and clinical outcomes. Future studies should explore these associations across diverse populations and specific skin conditions.
Footnotes
FUNDING SOURCE: This study was supported by the research fund of Chungnam National University in 2020.
CONFLICTS OF INTEREST: The authors have nothing to disclose.
DATA SHARING STATEMENT: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
- 1.Hughes JE, Barraclough BM, Hamblin LG, White JE. Psychiatric symptoms in dermatology patients. Br J Psychiatry. 1983;143:51–54. doi: 10.1192/bjp.143.1.51. [DOI] [PubMed] [Google Scholar]
- 2.Fried RG, Gupta MA, Gupta AK. Depression and skin disease. Dermatol Clin. 2005;23:657–664. doi: 10.1016/j.det.2005.05.014. [DOI] [PubMed] [Google Scholar]
- 3.Wittkower E, Russell B. Emotional factors in skin disease. New York: Hoeber; 1953. [Google Scholar]
- 4.Alexander EJ. Psychosomatic medicine—its principles and applications. Am J Psychiatry. 1951;108:301–318. [Google Scholar]
- 5.Kimyai-Asadi A, Usman A. The role of psychological stress in skin disease. J Cutan Med Surg. 2001;5:140–145. doi: 10.1007/BF02737869. [DOI] [PubMed] [Google Scholar]
- 6.Hashiro M, Okumura M. Anxiety, depression and psychosomatic symptoms in patients with atopic dermatitis: comparison with normal controls and among groups of different degrees of severity. J Dermatol Sci. 1997;14:63–67. doi: 10.1016/s0923-1811(96)00553-1. [DOI] [PubMed] [Google Scholar]
- 7.Kellett SC, Gawkrodger DJ. The psychological and emotional impact of acne and the effect of treatment with isotretinoin. Br J Dermatol. 1999;140:273–282. doi: 10.1046/j.1365-2133.1999.02662.x. [DOI] [PubMed] [Google Scholar]
- 8.Linnet J, Jemec GB. An assessment of anxiety and dermatology life quality in patients with atopic dermatitis. Br J Dermatol. 1999;140:268–272. doi: 10.1046/j.1365-2133.1999.02661.x. [DOI] [PubMed] [Google Scholar]
- 9.Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol. 1998;139:846–850. doi: 10.1046/j.1365-2133.1998.02511.x. [DOI] [PubMed] [Google Scholar]
- 10.Russo PA, Ilchef R, Cooper AJ. Psychiatric morbidity in psoriasis: a review. Australas J Dermatol. 2004;45:155–159. doi: 10.1111/j.1440-0960.2004.00078.x. [DOI] [PubMed] [Google Scholar]
- 11.Magin P, Adams J, Heading G, Pond D, Smith W. The psychological sequelae of psoriasis: results of a qualitative study. Psychol Health Med. 2009;14:150–161. doi: 10.1080/13548500802512294. [DOI] [PubMed] [Google Scholar]
- 12.Kiliç A, Güleç MY, Gül U, Güleç H. Temperament and character profile of patients with psoriasis. J Eur Acad Dermatol Venereol. 2008;22:537–542. doi: 10.1111/j.1468-3083.2007.02460.x. [DOI] [PubMed] [Google Scholar]
- 13.Kim TS, Pae CU, Jeong JT, Kim SD, Chung KI, Lee C. Temperament and character dimensions in patients with atopic dermatitis. J Dermatol. 2006;33:10–15. doi: 10.1111/j.1346-8138.2006.00002.x. [DOI] [PubMed] [Google Scholar]
- 14.Talaei A, Nahidi Y, Kardan G, Jarahi L, Aminzadeh B, Jahed Taherani H, et al. Temperament-character profile and psychopathologies in patients with alopecia areata. J Gen Psychol. 2017;144:206–217. doi: 10.1080/00221309.2017.1304889. [DOI] [PubMed] [Google Scholar]
- 15.Buske-Kirschbaum A, Ebrecht M, Kern S, Höllig H, Gierens A, Hellhammer D. Personality characteristics and their association with biological stress responses in patients with atopic dermatitis. Dermatol Psychosom. 2004;5:12–16. [Google Scholar]
- 16.Buske-Kirschbaum A, Ebrecht M, Kern S, Gierens A, Hellhammer DH. Personality characteristics in chronic and non-chronic allergic conditions. Brain Behav Immun. 2008;22:762–768. doi: 10.1016/j.bbi.2007.12.002. [DOI] [PubMed] [Google Scholar]
- 17.Costa PT, McCrae RR. Normal personality assessment in clinical practice: The NEO personality inventory. Psychol Assess. 1992;4:5–13. [Google Scholar]
- 18.Min BM, Lee KI, Jung JC. NEO-PI-R. Seoul: PSI Consulting; 1997. [Google Scholar]
- 19.Kim DY, Yoo TY. The relationships between the Big Five personality factors and contextual performance in work organizations. Korean J Ind Organ Psychol. 2002;15:1–24. [Google Scholar]
- 20.Kim JH, Kim KI. The standardization study of Symptom Checklist-90-revision in Korea III. Ment Health Res. 1984;2:278–311. [Google Scholar]
- 21.Derogatis LR. SCL-90-R: Administration, scoring & procedures: Manual-II. Baltimore: Clinical Psychometric Research; 1983. [Google Scholar]
- 22.Dalgard FJ, Gieler U, Tomas-Aragones L, Lien L, Poot F, Jemec GBE, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015;135:984–991. doi: 10.1038/jid.2014.530. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Raikhy S, Gautam S, Kanodia S. Pattern and prevalence of psychiatric disorders among patients attending dermatology OPD. Asian J Psychiatr. 2017;29:85–88. doi: 10.1016/j.ajp.2017.04.018. [DOI] [PubMed] [Google Scholar]
- 24.Woodruff PW, Higgins EM, du Vivier AW, Wessely S. Psychiatric illness in patients referred to a dermatology-psychiatry clinic. Gen Hosp Psychiatry. 1997;19:29–35. doi: 10.1016/s0163-8343(97)00155-2. [DOI] [PubMed] [Google Scholar]
- 25.Pinto LMF. Evaluating an anxiety scale and personality traits in atopic dermatitis and its relation with severity markers [master’s thesis] Porto: University of Porto; 2014. [Google Scholar]
- 26.Hedayati A, Mani A, Hamidizadeh N, Chohedri E, Moradi Khalaj H, Moshfeghinia R, et al. Association of personality traits with treatment adherence in vitiligo. J Iran Med Council. 2023;6:535–541. [Google Scholar]
- 27.Wawrzycki B, Fryze M, Mlak R, Pelc A, Wertheim-Tysarowska K, Bygum A, et al. The depressiveness, quality of life and NEO-FFI scale in patients with selected genodermatoses. J Clin Med. 2024;13:1624. doi: 10.3390/jcm13061624. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Costa PT, Jr, McCrae RR. Influence of extraversion and neuroticism on subjective well-being: happy and unhappy people. J Pers Soc Psychol. 1980;38:668–678. doi: 10.1037//0022-3514.38.4.668. [DOI] [PubMed] [Google Scholar]
- 29.Magnus K, Diener E, Fujita F, Pavot W. Extraversion and neuroticism as predictors of objective life events: a longitudinal analysis. J Pers Soc Psychol. 1993;65:1046–1053. doi: 10.1037//0022-3514.65.5.1046. [DOI] [PubMed] [Google Scholar]
- 30.Carr CW, Veledar E, Chen SC. Factors mediating the impact of chronic pruritus on quality of life. JAMA Dermatol. 2014;150:613–620. doi: 10.1001/jamadermatol.2013.7696. [DOI] [PubMed] [Google Scholar]
- 31.Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: a meta-analytic review. Clin Psychol Rev. 2010;30:217–237. doi: 10.1016/j.cpr.2009.11.004. [DOI] [PubMed] [Google Scholar]