Ways of coping with stress in

patients with HPV infection

Cvitanovi H1, Lugovi Mihi L2, itum M2

1 Department of Dermatovenerology, General Hospital

Karlovac, Karlovac, Croatia
2 Clinical Department of Dermatovenerology, Sestre
Milosrdnice University Hospital Center, Zagreb, Croatia
 Stressful life events in response to
psychosocial trigger have been reported to
negatively affect the course of infections.
Patients with high stress levels report an
increased frequency of HPV infections when
compared to people with low stress levels.
Most people will experience cutaneous
warts at some stage of their lives and if
even a small proportion of affected
individuals experience psychological
distress then this may constitute a
significant public health issue.
 There is a connection between psychological stressors
and dermatoses (e.g. psoriasis, atopic dermatitis,
urticaria, warts, herpes simplex, vitiligo, acne,
alopecia, prurigo) and different cytokines and
mediators produced in the skin.
These systems react to stressogenic stimuli and can
cause clinical disease in an acute or chronic stress.
It is significant that stress resistance can be
enhanced by personal coping mechanisms, social
support, and favorable psychosocial constellations.
 Study is based on patients with clinical
manifestation of Human papillomavirus
(HPV) infection and control group psoriasis
patients who were admitted over a period
of one year to the Dermatology ward of
General Hospital Karlovac. In total of 122
patients with confirmed diagnosis of clinical
manifestation of HPV infection (n=66) and
psoriasis control group (n = 56).
 Aims of this study was to determine
which coping strategies are used in
patients with clinical manifestation of
HPV infection. We used Recent Life
Changes Questionnaire and Brief
COPE test for stress evaluation.
 Results: There were no statically significant difference
between adaptive and maladaptive coping strategies
comparing HPV patients and a control group.
Difference in specific coping strategies between HPV
and control group showed that self-blame and
planning strategies are statistically significantly more
used in HPV group.
HPV patients with genital warts used maladaptive
coping statistically significantly more than patients
with non-genital localization of HPV.
HPV patients who had higher score of life stress
events used maladaptive coping statistically
significant more than patients with lower life stress
events score.
Differences between adaptive and maladaptive coping according localisation
Differences between adaptive and maladaptive coping in HPV patients

according stress level (Life Change Unit score)

 Chronic skin diseases can exhaust
ability to cope and lead to extensive
social dysfunction and psychological
morbidity.
Use of adaptive coping strategy is
related to better social and
psychological functions of the patients
and with better clinical outcome.
 The results point to the need of HPV
patients with genital localization and high
numbers of stress events to learn how to
cope with stress, enabling them to take
action and change ways of coping.
There are needs for integrating
psychological intervention into standard
care protocol of dermatologic disease.