Quality of life in persons living with psoriasis patients

doi:10.1016/j.jaad.2014.03.039

Journal of the American Academy of Dermatology

Volume 71, Issue 2, August 2014, Pages 302-307

https://doi.org/10.1016/j.jaad.2014.03.039 Get rights and content

Background

Numerous studies have analyzed the influence of psoriasis on the quality of life and psychosocial health of patients. However, few studies have addressed the effect of this disease on individuals living with these patients (cohabitants).

Objective

To analyze the influence of psoriasis on the levels of anxiety, depression, and quality of life of the cohabitants of psoriatic patients.

Methods

The study included patients, cohabitants, and controls, a total of 130 participants. Their quality of life was measured with the Dermatology Life Quality Index (DLQI) and Family Dermatology Life Quality Index (FDLQI), and their psychological state with the Hospital Anxiety and Depression Scale (HADS). Demographic data of participants and clinical characteristics of patients were also gathered.

Results

The presence of psoriasis impaired the quality of life of 87.8% of the cohabitants. FDLQI scores of cohabitants were significantly associated with the DLQI scores of the patients (r_s = 0.554; P < .001). Anxiety and depression levels did not differ between patients and cohabitants, but were significantly higher than in the controls (P < .001).

Limitations

Additional studies with larger numbers of patients and cohabitants are required to analyze differences between groups according to psoriasis severity.

Conclusion

Psoriasis markedly worsens the global well-being of patients and their cohabitants, who experienced an impairment of their quality of life and higher levels of anxiety and depression.

Section snippets

Subject selection

We analyzed 3 groups: patients consecutively selected from the Psoriasis Unit, their cohabitants, and healthy controls. Patients were eligible for the study if they met ≥1 of the following criteria: psoriasis vulgaris with a Psoriasis Area and Severity Index (PASI) score of >5.0, genital psoriasis, or severe scalp psoriasis. Study exclusion criteria for all participants were: age <18 years, the presence of a severe disease (eg, inflammatory or metabolic disease, cancer, etc), another

Results

The study included 130 individuals: 34 patients with psoriasis, 49 patient cohabitants, and 47 healthy controls. The patient group included 17 men and 17 women with a mean age of 43 years (range, 19-82 years). Their mean BSA (%) was 23 (standard deviation, 19.73), and the mean PASI score was 9.15 (standard deviation, 7.55), with a mean time since onset of 15.6 years. More than half (55%) of patients presented with scalp disease; 15% had genital lesions. The PASI score was significantly

Discussion

Numerous authors have shown that the impact of psoriasis extends beyond cutaneous symptoms. Studies have yielded evidence of an association between psoriasis and increased cardiovascular risk,20, 21, 22, 23, 24, 25 a higher incidence of severe infections,²⁶ and a greater risk of developing autoimmune diseases,²⁷ among other comorbidities. In addition, an increasing number of studies have reported that psoriasis produces a major impairment of QOL1, 2 and an increased risk of psychiatric

References (27)

L. Misery
Depression and psoriasis
Ann Dermatol Venereol
(2012)
I. Bjelland et al.
The validity of the Hospital Anxiety and Depression Scale: an updated literature review
J Psychosom Res
(2002)
Y. Hongbo et al.
Translating the science of quality of life into practice: what do dermatology life quality index scores mean?
J Invest Dermatol
(2005)
J. Shapiro et al.
Psoriasis and cardiovascular risk factors: a case-control study on inpatients comparing psoriasis to dermatitis
J Am Acad Dermatol
(2012)
A.B. Kimball et al.
Underdiagnosis and undertreatment of cardiovascular risk factors in patients with moderate to severe psoriasis
J Am Acad Dermatol
(2012)
L. Mallbris et al.
Psoriasis is associated with lipid abnormalities at the onset of skin disease
J Am Acad Dermatol
(2006)
S. Bremmer et al.
Obesity and psoriasis: from the Medical Board of the National Psoriasis Foundation
J Am Acad Dermatol
(2010)
A.W. Armstrong et al.
Psoriasis and metabolic syndrome: a systematic review and meta-analysis of observational studies
J Am Acad Dermatol
(2013)
M. Wakkee et al.
Increased risk of infectious disease requiring hospitalization among patients with psoriasis: a population-based cohort
J Am Acad Dermatol
(2011)
J.J. Wu et al.
The association of psoriasis with autoimmune diseases
J Am Acad Dermatol
(2012)

M.K. Basra et al.

The Family Dermatology Life Quality Index: measuring the secondary impact of skin diseases

Br J Dermatol

(2007)

H.L. Richards et al.

The Greater Patient concept

Br J Dermatol

(2008)

A.B. Kimball et al.

Risks of developing psychiatric disorders in pediatric patients with psoriasis

J Am Acad Dermatol

(2012)

Cited by (77)

Associations of polysocial risk score, lifestyle and genetic factors with incident psoriasis: a larger-scale prospective cohort study
2023, Public Health
The impact of polysocial risk score (PsRS), a composite measure of multiple social risk factors, on the development of psoriasis remains unclear. Moreover, the potential modifying effects of lifestyle and genetic susceptibility on the relationship between PsRS and psoriasis risk require further exploration.
This was a prospective cohort study conducted among UK Biobank.
In this study, we analyzed 331,631 participants enrolled in the UK Biobank cohort. To derive the PsRS, we utilized a summative strategy, amalgamating six social determinants of health derived from three domains: socio-economic status, psychosocial factors, and neighborhood and living environment consistently linked to incident psoriasis. Cox proportional hazard models were used to assess the associations between PsRS and psoriasis incidence. Furthermore, we constructed a lifestyle score and a genetic risk score to explore the potential modifying effects of these factors on the relationship between PsRS and psoriasis risk.
Compared with individuals with a low PsRS (≤1), those with intermediate PsRS (2–4) and high PsRS (≥5) had 1.20 (95% confidence interval [CI], 1.06–1.36) and 1.53 (95% CI, 1.31–1.78) times higher risks of developing psoriasis, respectively. Our findings revealed an additive interaction between PsRS and genetic susceptibility. Moreover, it was found that individuals with high PsRS and unhealthier lifestyles had a 2.60 times higher risk of developing psoriasis than those with lower PsRS and healthier ones.
Our study results imply that an elevated PsRS is linked to a heightened risk of psoriasis, which is further influenced by genetic factors. Our results also indicate that greater social vulnerability and unhealthier lifestyle may synergistically contribute to the additional risk of psoriasis.
[Translated article] What Do Medical Students Think About Dermatology? A Prospective Observational Study
2023, Actas Dermo-Sifiliograficas
Correlation between anxiety and depression risk and atopic dermatitis severity in Taiwan: A cross-sectional study
2022, JAAD International
Citation Excerpt :
A few studies have assessed anxiety and depression in patients with AD using the Hospital Anxiety and Depression Scale (HADS).14-16 Moreover, in previous studies in patients with non-AD diseases using HADS, patients with characteristics including female gender and an education level of high school or lower tended to have higher Hospital Anxiety and Depression Scale–anxiety (HADS-A) subscores,17,18 whereas these 2 possible confounders were not controlled in previous studies in patients with AD using HADS. In addition, there is no discussion on the most affected dimensions of HADS in patients with AD.
Limited studies on atopic dermatitis (AD) have investigated the possible covariance of sociodemographic factors with the Hospital Anxiety and Depression Scale (HADS).
This study aimed to examine the possible covariance between AD severity and HADS scores of patients in Taiwan.
Patients with AD from a medical center and 2 regional hospitals in Taiwan were enrolled in this cross-sectional study from April 2018 to April 2019. AD severity was measured using the “scoring atopic dermatitis” index, and anxiety and depression were screened based on HADS.
A total of 200 patients were included. After correcting for sociodemographic variables, significantly more borderline (≥8) and abnormal (≥11) cases of anxiety/depression (P < .05) were noted in patients with moderate-to-severe AD.
First, the cross-sectional study design cannot show causality. Second, baseline data, including a history of underlying cancer or previous psychiatric disorder, were not obtained in the questionnaire and may confound the HADS scores. Finally, a standardized psychiatric clinical interviews study design should be used for higher accuracy in the assessment of psycho-comorbidities.
Higher anxiety and depression risks were noted in patients with moderate-to-severe AD. Except for psychosomatic symptoms, all kinds of anxiety and depression symptoms occurred more frequently in patients with moderate-to-severe AD.
Quality of life in mothers of children with psoriasis
2023, Journal of Cosmetic Dermatology
Psoriasis and sexuality: Patients express their feelings
2023, Skin Health and Disease
Quality of Life Among Family of Patients with Atopic Dermatitis and Psoriasis
2023, International Journal of Behavioral Medicine

View all citing articles on Scopus

: Funding sources: None.

: Conflicts of interest: None declared.

View full text

Original articleQuality of life in persons living with psoriasis patients

Background

Objective

Methods

Results

Limitations

Conclusion

Section snippets

Subject selection

Results

Discussion

Ann Dermatol Venereol

J Psychosom Res

J Invest Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

The Family Dermatology Life Quality Index: measuring the secondary impact of skin diseases

Br J Dermatol

The Greater Patient concept

Br J Dermatol

Risks of developing psychiatric disorders in pediatric patients with psoriasis

J Am Acad Dermatol

Original article
Quality of life in persons living with psoriasis patients