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Dermatology and Therapy

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Open Access 01-12-2021 | Vulgar Psoriasis | Original Research

Skin-Disease Specific and Generic Psychometric Measures in Patients with Psoriasis

Authors: Beata Kowalewska, Barbara Jankowiak, Elżbieta Krajewska-Kułak, Rafał Milewski, Marek Sobolewski

Published in: Dermatology and Therapy | Issue 6/2021

Abstract

Introduction

Psychosocial problems of patients with chronic dermatoses, such as psoriasis, add to their somatic ailments, which results in the lack of illness acceptance, lowered self-esteem, deteriorated quality of life, and an array of somatic comorbidities. The aim of this study was to analyze the effect of psoriasis on the quality of life, sense of stigmatization, self-esteem, and satisfaction with life in patients with psoriasis.

Methods

The study was based on a short survey prepared by the authors and five validated scales: Dermatology Life Quality Index (DLQI), 6-Item Stigmatization Scale, 33-Item Feelings of Stigmatization Questionnaire, Rosenberg Self-Esteem Scale (SES), and Satisfaction With Life Scale (SWLS). The study included 111 patients with psoriasis (46.8% women and 53.2% men). The inclusion criteria of the study were the diagnosis of plaque psoriasis and written informed consent to participate.

Results

DLQI scores ranged between 0 and 28 points (pts) (mean 10.8 pts). Mean stigmatization scores determined with the 33- and 6-Item Stigmatization Scale were 81.6 pts and 7.5 pts, respectively. The mean SWLS score for the study group (18.5 pts) was slightly below the average. The mean score SES of 27 pts implies that the study respondents’ self-esteem level was slightly above the average.

Conclusions

Satisfaction with life turned out to be significantly modulated by overall stigmatization level on the 33-Item Stigmatization Scale (the stronger the sense of stigmatization, the lower the satisfaction with life) and education (respondents with higher education presented with higher satisfaction with life than those with non-higher education).

Hong J, Koo B, Koo J. The psychosocial and occupational impact of chronic skin disease. Dermatol Ther. 2008;21:54–9. https://doi.org/10.1111/j.1529-8019.2008.00170.x.CrossRefPubMed

Inanir I, Aydemir O, Gündüz K, Danaci AE, Türel A. Developing a quality of life instrument in patients with psoriasis: the Psoriasis Quality of Life Questionnaire (PQLQ). Int J Dermatol. 2006;45:234–8. https://doi.org/10.1111/j.1365-4632.2005.02448.x.CrossRefPubMed

Jensen P, Skov L. Psoriasis and obesity. Dermatology. 2016;232(6):633–9. https://doi.org/10.1159/000455840.CrossRefPubMed

Kunz M, Simon JC, Saalbach A. Psoriasis: obesity and fatty acids. Front Immunol. 2019;10: 1807. https://doi.org/10.3389/fimmu.2019.01807.CrossRefPubMedPubMedCentral

Owczarczyk-Saczonek A, Placek W. Compounds of psoriasis with obesity and overweight. Postepy Hig Med Dosw (Online). 2017;71(1):761–72. https://doi.org/10.5604/01.3001.0010.3854.CrossRef

Kong Y, Zhang S, Wu R, et al. New insights into different adipokines in linking the pathophysiology of obesity and psoriasis. Lipids Health Dis. 2019;18(1):171. https://doi.org/10.1186/s12944-019-1115-3.CrossRefPubMedPubMedCentral

Rendon A, Schäkel K. Psoriasis pathogenesis and treatment. Int J Mol Sci. 2019;20(6):1475. https://doi.org/10.3390/ijms20061475.CrossRefPubMedCentral

Frischknecht L, Vecellio M, Selmi C. The role of epigenetics and immunological imbalance in the etiopathogenesis of psoriasis and psoriatic arthritis. Ther Adv Musculoskelet Dis. 2019;11:17–59. https://doi.org/10.1177/1759720X19886505.CrossRef

Drvar DL, Vlahinić T, Maleš Ž, Turčić P, Čeović R. A modern approach to the treatment of plaque psoriasis. Acta Pharm. 2019;69(4):511–23. https://doi.org/10.2478/acph-2019-0047.CrossRefPubMed

10.

Langley RG, Krueger GG, Griffiths CE. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64(Suppl 2):ii18–23. https://doi.org/10.1136/ard.2004.033217.CrossRefPubMedPubMedCentral

11.

Oji V, Luger TA. The skin in psoriasis: assessment and challenges. Clin Exp Rheumatol. 2015;33(5 Suppl 93):S14–9.PubMed

12.

Petraškienė R, Valiukevičienė S, Macijauskienė J. Associations of the quality of life and psychoemotional state with sociodemographic factors in patients with psoriasis. Medicina. 2016;52(4):238–43. https://doi.org/10.1016/j.medici.2016.07.001.CrossRefPubMed

13.

Boehncke WH, Schön MP. Psoriasis. Lancet. 2015;386(9997):983–94. https://doi.org/10.1016/S0140-6736(14)61909-7.CrossRefPubMed

14.

Czykwin E. Stygmat społeczny. Warszawa: Wydawnictwo Naukowe PWN; 2020.

15.

Dimitrov D, Matusiak Ł, Szepietowski JC. Stigmatization in Arabic psoriatic patients in the United Arab Emirates—a cross sectional study. Adv Dermatol Allergol. 2019;36(4):425–30. https://doi.org/10.5114/ada.2018.80271.CrossRef

16.

Zięciak T, Rzepa T, Król J, Żaba R. Stigmatization feelings and depression symptoms in psoriasis patients. Psychiatr Pol. 2017;51:1153–63. https://doi.org/10.12740/PP/68848.CrossRefPubMed

17.

Schmid-Ott G, Schallmayer S, Calliess IT. Quality of life in patients with psoriasis and psoriasis arthritis with a special focus on stigmatization experience. Clin Dermatol. 2007;25:547–54. https://doi.org/10.1016/j.clindermatol.2007.08.008.CrossRefPubMed

18.

Hawro T, Janusz I, Zalewska A, Miniszewska J. Jakość życia i stygmatyzacja a nasilenie zmian skórnych i świądu u osób chorych na łuszczycę. W Rzepa T, Szepietowski J, Żaba R. Psychologiczne i medyczne aspekty chorób skóry. Wrocław Poland, Cornetis; 2011. p. 42–51.

19.

Hrehorów E, Salomon J, Matusiak Ł, Reich A, Szepietowski JC. Patients with psoriasis feel stigmatized. Acta Derm Venereol. 2012;92:67–72. https://doi.org/10.2340/00015555-1193.CrossRefPubMed

20.

Zill JM, Dirmaier J, Augustin M, et al. Psychosocial distress of patients with psoriasis: protocol for an assessment of care needs and the development of a supportive intervention. JMIR Res Protoc. 2018;7: e22. https://doi.org/10.2196/resprot.8490.CrossRefPubMedPubMedCentral

21.

Kostyła M, Tabała K, Kocur J. Illness acceptance degree versus intensity of psychopathological symptoms in patients with psoriasis. Adv Dermatol Allergol. 2013;30:134–9. https://doi.org/10.5114/pdia.2013.35613.CrossRef

22.

Hrehorów E, Reich A, Szepietowski J. Jakość życia chorych na łuszczycę: zależność od świądu, stresu i objawów depresyjnych. Dermatol Klin. 2007;9:19–23.

23.

Martínez-Ortega JM, Nogueras P, Muñoz-Negro JE, Gutiérrez-Rojas L, González-Domenech P, Gurpegui M. Quality of life, anxiety and depressive symptoms in patients with psoriasis: a case–control study. J Psychosom Res. 2019. https://doi.org/10.1016/j.jpsychores.2019.109780.CrossRefPubMed

24.

Gupta MA, Gupta AK. Psychiatric and psychological comorbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol. 2003;4(12):833–42. https://doi.org/10.2165/00128071-200304120-00003.CrossRefPubMed

25.

Miękoś-Zydek B, Ryglewska A, Lassota-Falczewska M, Czyż P, Kaszuta A. Quality of life in psoriatic patients. Adv Dermatol Allergol. 2006;23(6):273–7.

26.

Rapp DA, Brenes GA, Felman SR, et al. Anger and acne: implications for quality of life, patient satisfaction and clinical care. Br J Dermatol. 2004;151(1):183–9. https://doi.org/10.1111/j.1365-2133.2004.06078.x.CrossRefPubMed

27.

Zacharie R, Zacharie C, Ibsen H, Morternsen JT, Wulf HC. Dermatology life quality idem: data Danish inpatients and outpatients. Acta Derm Venerol. 2003;suppl 2:78–86. https://doi.org/10.1080/000155500750012153.CrossRef

28.

Kowalewska B, Krajewska-Kułak E, Wrońska I, Niczyporuk W, Sobolewski M. Self-assessment of quality of life in patients with dermatological disorders. Dermatol Klin. 2010;12(2):106–13.

29.

Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210–6. https://doi.org/10.1111/j.1365-2230.1994.tb01167.x.CrossRefPubMed

30.

Gerdes S, Zahl VA, Weichenthal M, Mrowietz U. Smoking and alcohol intake in severely affected patients with psoriasis in Germany. Dermatology. 2010;220:38–43. https://doi.org/10.1159/000265557.CrossRefPubMed

31.

Fortes C, Mastroeni S, Leffondré K, et al. Relationship between smoking and the clinical severity of psoriasis. Arch Dermatol. 2005;141:1580–4. https://doi.org/10.1001/archderm.141.12.1580.CrossRefPubMed

32.

Kirby B, Richards HL, Mason DL, Fortune DG, Main CJ, Griffiths CE. Alcohol consumption and psychological distress in patients with psoriasis. Br J Dermatol. 2008;158:138–40. https://doi.org/10.1111/j.1365-2133.2007.08299.x.CrossRefPubMed

33.

Komorowska OR, Szczerkowska-Dobosz A, Purzycka-Bohdan D, Rawicz-Zegrzda D, Dudziak M. Łuszczyca jako czynnik ryzyka rozwoju chorób serca i naczyń. Przegl Dermatol. 2014;101:500–6. https://doi.org/10.5114/dr.2014.46953.CrossRef

34.

Türel Ermertcan A, Temeltaş G, Deveci A, et al. Sexual dysfunction in patients with psoriasis. J Dermatol. 2006;33:772–8. https://doi.org/10.1111/j.1346-8138.2006.00179.x.CrossRefPubMed

35.

Dauendorffer JN, Ly S, Beylot-Barry M. Psoriasis and male sexuality. Ann Dermatol Venereol. 2019;146(4):273–8. https://doi.org/10.1016/j.annder.2019.01.021.CrossRefPubMed

36.

Szepietowski J, Salomon J, Finlay AY, et al. Dermatology Life Quality Index (DLQI): Polish version. Dermatol Klin. 2004;6(2):63–70.

37.

Lu Y, Duller P, van der Valk PGM. Helplessness as predictor of perceived stigmatization in patients with psoriasis and atopic dermatitis. Dermatol Psychosom. 2003;4:146–50.CrossRef

38.

Hrehorów E, Szepietowski J, Reich A, Evers AWM, Ginsburg IH. Narzędzia do oceny stygmatyzacji u chorych na łuszczycę: polskie wersje językowe. Derm Klin. 2006;8:253–8.

39.

Ginsburg IH, Link BG. Feelings of stigmatization in patients with psoriasis. J Am Acad Dermatol. 1989;20:53–63. https://doi.org/10.1016/s0190-9622(89)70007-4.CrossRefPubMed

40.

Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985;49(1):71–5. https://doi.org/10.1207/s15327752jpa4901_13.CrossRef

41.

Juczyński Z. NPPPZ—Narzędzia Pomiaru w Promocji I Psychologii Zdrowia. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego, Warszawa (2012).

42.

Dzwonkowska I, Lachowicz-Tabaczek K, Łaguna M. Samoocena i jej pomiar. SES. Skala Samooceny Rosenberga. Warszawa: Pracownia Testów Psychologicznych; 2008.

43.

Stanisz A. Przystępny kurs statystyki z zastosowaniem STATISTICA PL na przykładach z medycyny. Tom 1. Wyd. Kraków: StatSoft Polska; 2007.

44.

Stanisz A. Przystępny kurs statystyki z zastosowaniem STATISTICA PL na przykładach z medycyny. Tom 2. Wyd. Kraków: StatSoft Polska; 2007.

45.

Wine-Lee L, Keller SC, Wilck MB, Gluckman SJ, Van Voorhees AS. From the Medical Board of the National Psoriasis Foundation: vaccination in adult patients on systemic therapy for psoriasis. J Am Acad Dermatol. 2013;69(6):1003–13. https://doi.org/10.1016/j.jaad.2013.06.046.CrossRefPubMed

46.

Kraśnicka J, Krajewska-Kułak E, Klimaszewska K, et al. Mandatory and recommended vaccinations in Poland in the views of parents. Hum Vaccin Immunother. 2018;14(12):2884–93. https://doi.org/10.1080/21645515.2018.1496766.CrossRefPubMedPubMedCentral

47.

Lin TY, See LC, Shen YM, Liang CY, Chang HN, Lin YK. Quality of life in patients with psoriasis in northern Taiwan. Chang Gung Med J. 2011;34:186–96.PubMed

48.

Moradi M, Rencz F, Brodszky V, Moradi A, Balogh O, Gulácsi L. Health status and quality of life in patients with psoriasis: an Iranian cross-sectional survey. Arch Iran Med. 2015;18:153–9. PubMed

49.

Rencz F, Gulácsi L, Péntek M, et al. DLQI-R scoring improves the discriminatory power of the Dermatology Life Quality Index in patients with psoriasis, pemphigus and morphea. Br J Dermatol. 2020;182:1167–75. https://doi.org/10.1111/bjd.18435.CrossRefPubMed

50.

Sendrasoa FA, Razanakoto NH, Ratovonjanahary V, et al. Quality of life in patients with psoriasis seen in the Department of Dermatology, Antananarivo, Madagascar. Biomed Res Int. 2020;2020(14):9292163. https://doi.org/10.1155/2020/9292163.CrossRefPubMedPubMedCentral

51.

An JG, Liu YT, Xiao SX, Wang JM, Geng SM, Dong YY. Quality of life of patients with neurodermatitis. Int J Med Sci. 2013;10:593–8. https://doi.org/10.7150/ijms.5624.CrossRefPubMedPubMedCentral

52.

Kowalewska B, Cybulski M, Jankowiak B, Krajewska-Kułak E. Acceptance of illness, satisfaction with life, sense of stigmatization, and quality of life among people with psoriasis: a cross-sectional study. Dermatol Ther. 2020;10:413–30. https://doi.org/10.1007/s13555-020-00368-w.CrossRef

53.

Martínez-García E, Arias-Santiago S, Valenzuela-Salas I, Garrido-Colmenero C, García-Mellado V, Buendía-Eisman A. Quality of life in persons living with psoriasis patients. J Am Acad Dermatol. 2014;71:302–7. https://doi.org/10.1016/j.jaad.2014.03.039.CrossRefPubMed

54.

Jung S, Lee M, Suh D, Shin HT, Suh DC. The association of socioeconomic and clinical characteristics with health-related quality of life in patients with psoriasis: a cross-sectional study. Health Qual Life Outcomes. 2018;16:180. https://doi.org/10.1186/s12955-018-1007-7.CrossRefPubMedPubMedCentral

55.

Kouris A, Christodoulou C, Stefanaki C, et al. Quality of life and psychosocial aspects in Greek patients with psoriasis: a cross-sectional study. An Bras Dermatol. 2015;90:841–5. https://doi.org/10.1590/abd1806-4841.20154147.CrossRefPubMedPubMedCentral

56.

Salaffi F, Carotti M, Gasparini S, Intorcia M, Grassi W. The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people. Health Qual Life Outcomes. 2009;7:25. https://doi.org/10.1186/1477-7525-7-25.CrossRefPubMedPubMedCentral

57.

Fortune DG, Main CJ, O’Sullivan TM, Griffiths CEM. Quality of life in patients with psoriasis: the contribution of clinical variables and psoriasis-specific stress. Br J Dermatol. 1997;137:755–60.CrossRef

58.

Rapp SR, Feldman SR, Excum ML, Fleischer AB, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999;41:401–6. https://doi.org/10.1016/s0190-9622(99)70112-x.CrossRefPubMed

59.

Rapp SR, Cottrell CA, Leary MR. Social coping strategies associated with quality of life decrements among psoriasis patients. Br J Dermatol. 2001;145:610–6. https://doi.org/10.1046/j.1365-2133.2001.04444.x.CrossRefPubMed

60.

Uttjek M, Dufaker M, Nygren L, Stenberg B. Determinants of quality of life in a psoriasis population in northern Sweden. Acta Derm Venereol. 2004;84:37–43. https://doi.org/10.1080/00015550310015833.CrossRefPubMed

61.

Al-Mazeedi K, El-Shazly M, Al-Ajmi HS. Impact of psoriasis on quality of life in Kuwait. Int J Dermatol. 2006;45(4):418–24. https://doi.org/10.1111/j.1365-4632.2006.02502.x.CrossRefPubMed

62.

Soliman MM. Feeling of stigmatization and satisfaction with life among Arabic psoriatic patients. Saudi Pharm J. 2020;28(12):1868–73. https://doi.org/10.1016/j.jsps.2020.11.013.CrossRefPubMedPubMedCentral

63.

Hawro M, Maurer M, Weller K, et al. Lesions on the back of hands and female gender predispose to stigmatization in patients with psoriasis. J Am Acad Dermatol. 2017;76(4):648-654.e2. https://doi.org/10.1016/j.jaad.2016.10.040.CrossRefPubMed

64.

Perrott SB, Murray AH, Lowe J, Mathieson CM. The psychosocial impact of psoriasis: physical severity, quality of life, and stigmatization. Physiol Behav. 2000;70(5):567–71. https://doi.org/10.1016/s0031-9384(00)00290-0.CrossRefPubMed

65.

Sommer R, Augustin M, Mrowietz U, Topp J, Schäfer I, von Spreckelsen R. Perception of stigmatization in people with psoriasis-qualitative analysis from the perspective of patients, relatives and healthcare professionals. Hautarzt. 2019;70(7):520–6. https://doi.org/10.1007/s00105-019-4411-y (German).CrossRefPubMed

66.

Basińska MA, Drozdowska M. Emotional intelligence as an indicator of satisfaction with life of patients with psoriasis. Postepy Dermatol Alergol. 2013;30(6):365–72. https://doi.org/10.5114/pdia.2013.39435.CrossRefPubMedPubMedCentral

67.

Solovan C, Marcu M, Chiticariu E. Life satisfaction and beliefs about self and the world in patients with psoriasis: a brief assessment. Eur J Dermatol. 2014;24(2):242–7. https://doi.org/10.1684/ejd.2014.2295.CrossRefPubMed

68.

Eskin M, Savk E, Uslu M, Küçükaydoğan N. Social problem-solving, perceived stress, negative life events, depression and life satisfaction in psoriasis. J Eur Acad Dermatol Venereol. 2014;28(11):1553–9. https://doi.org/10.1111/jdv.12355.CrossRefPubMed

69.

Rzeszutek M, Podkowa K, Pięta M, Pankowski D, Cyran-Stemplewska S. Comparative study of life satisfaction among patients with psoriasis versus healthy comparison group: the explanatory role of body image and resource profiles. Qual Life Res. 2021;30(1):181–91. https://doi.org/10.1007/s11136-020-02621-3.CrossRefPubMed

70.

Tzur Bitan D, Krieger I, Comaneshter D, Cohen AD, Feingold D. The association between the socioeconomic status and anxiety-depression comorbidity in patients with psoriasis: a nationwide population-based study. J Eur Acad Dermatol Venereol. 2019;33(8):1555–61. https://doi.org/10.1111/jdv.15651.CrossRefPubMed

71.

Brihan I, Ianoşi SL, Boda D, Hălmăjan A, Zdrîncă M, Fekete LG. Implications of self-esteem in the quality of life in patients with psoriasis. Exp Ther Med. 2020;20(6):202. https://doi.org/10.3892/etm.2020.9332.CrossRefPubMedPubMedCentral

72.

Nazik H, Nazik S, Gul FC. Body image, self-esteem, and quality of life in patients with psoriasis. Indian Dermatol Online J. 2017;8(5):343–6. https://doi.org/10.4103/idoj.IDOJ_503_15.CrossRefPubMedPubMedCentral

73.

Hassani F, Koraei A, Yaghoobi R, Zarea K. An evaluating of the relationship between body image, body satisfaction, depression, marital quality, and self-esteem in patients with psoriasis. Psychol Health Med. 2021;26(4):467–77. https://doi.org/10.1080/13548506.2020.1766093.CrossRefPubMed

74.

Alariny AF, Farid CI, Elweshahi HM, Abbood SS. Psychological and sexual consequences of psoriasis vulgaris on patients and their partners. J Sex Med. 2019;16(12):1900–11. https://doi.org/10.1016/j.jsxm.2019.08.017.CrossRefPubMed

Title: Skin-Disease Specific and Generic Psychometric Measures in Patients with Psoriasis
Authors: Beata Kowalewska
Barbara Jankowiak
Elżbieta Krajewska-Kułak
Rafał Milewski
Marek Sobolewski
Publication date: 01-12-2021
Publisher: Springer Healthcare
Keyword: Vulgar Psoriasis
Published in: Dermatology and Therapy / Issue 6/2021
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI: https://doi.org/10.1007/s13555-021-00609-6

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