The effect of personal mastery on depression and anxiety in patients with psoriasis: The mediating role of social support and acceptance of illness

Psoriasis is a chronic skin disease with heterogeneous manifestations and patients frequently experience comorbid depression and anxiety. The purpose of this study is to investigate the influencing factors of comorbid depression and anxiety in patients with psoriasis and analyze the interrelationships between these factors. The study employed a cross-sectional design with a sample size of 235. We used the general information questionnaire compiled by authors and 4 standardized psychometric scales: Hospital Anxiety and Depression Scale, Social Support Rate Scale, Acceptance of Illness Scale, and Personal Mastery Scale. Multivariate logistic regression analysis revealed that personal mastery, social support, and acceptance of illness were the influencing factors of depression and anxiety in patients with psoriasis. In addition, these 3 factors are positively correlated with each other (P < .01). Mediation analysis indicated that personal mastery had a direct effect of -0.028 (95% confidence interval [CI]: -0.037 to -0.019) on depression and anxiety. The indirect effect mediated by social support and acceptance of illness were -0.009 (95% CI: -0.017 to -0.002) and -0.017 (95% CI: -0.025 to -0.010), respectively. The chain mediation effect involving both social support and acceptance of illness was -0.012 (95% CI: -0.018 to -0.007). Personal mastery, social support, and acceptance of illness can influence depression and anxiety in patients with psoriasis in direct or indirect ways, with social support and acceptance of illness acting as mediators between personal mastery and the levels of depression and anxiety.