The Mediating Role of Body Image in the Relationship Between Psoriasis Severity and Sexual Dysfunction

Psoriasis is a chronic inflammatory skin disease associated with significant sexual health burdens. Sexual dysfunction in patients with psoriasis is closely linked to psychological factors. This study aimed to examine the mediating roles of anxiety, depression, self-esteem, and body image in the relationship between psoriasis severity and sexual dysfunction. A cross-sectional study was conducted with 160 patients with psoriasis and 183 healthy controls. Psoriasis severity was assessed using the Psoriasis Area Severity Index (PASI), and participants completed self-report measures, including the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (RSES), and Body Image Scale (BIS). The results revealed that body image significantly mediated the relationship between psoriasis severity and sexual dysfunction (B = -0.177, p = .002), while anxiety, depression, and self-esteem did not. Compared to controls, patients with psoriasis reported significantly lower body image satisfaction (p < .001) and self-esteem (p < .001), as well as greater sexual dysfunction (p < .001). Sexual dysfunction was more pronounced in patients with moderate to severe psoriasis. These findings highlight the importance of incorporating body image-focused psychological interventions into the comprehensive management of psoriasis to improve sexual health.