[|I do believe this is an important part of psoriasis therapy, with many dermatologists using low dose antidepressants as part of their therapeutic regimen, particularly in times of crisis, ie significant flares of disease with quality of life issues in patients who frequently tend to withdraw from society under these circumstances.|auteur215]

With all chronic illness, it is invariably necessary to assess with the patient how his psychological suffering takes form, how he adjusts to it, and how he plans to manage it and emancipate himself from it. Even if this step does not result often in the patient undergoing psychological counselling, it is always an important step to consider and reconsider with him, in the hope to discover any reactive depression or psychological factors self-perpetuating or exacerbating the illness.

Moreover, the painful changes to the self-image may actually exacerbate some existing psychological frailty, which will then need to be managed by its own. However, in chronic illnesses more than in other fields of medicine, the patient needs to be considered as an indivisible entity, physical and mental. This comes to prove the importance of the collaboration between dermatologist and psychotherapist, each taking far too comfortable refuge in his sphere of competence these days rather than attempting to meet and concur on the questions posed by the patient.

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