Treatment Adherence: Connecting Psychology with Immune Treatment

Psychological issues such as depression, anxietyAnxiety, and stress can worsen inflammatory skin disease. Psychoneuroimmunology (PNI) presents the brain-immune system-skin axis as an explanation for the skin’s association with psychological factors. However, psychological factors may indirectly influence disease outcomes through changes in adherenceAdherence behavior. Even small changes in adherenceAdherence to highly effective treatmentsTreatment could cause the changes in disease severity associated with psychological issues. In this article, we describe the relationships between psychological states and skin disease, between psychological states and adherence, and between adherenceAdherence and skin disease severity. Adherence may need to be considered as a mediator in PNI studies. Addressing treatment adherenceAdherence in patients with psychological distress may be of utmost value in mitigating the effects of psychological issues on inflammatory diseases.