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Psychological (co)morbidity in patients with psoriasis: the impact of pruritus and anogenital involvement on symptoms of depression and anxiety and on body dysmorphic concerns – a cross-sectional study

N. da Silva1, M. Augustin1, C. Hilbring1, C.C. Braren-von Stülpnagel1, R. Sommer1

1 Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany

Objectives While stress plays a paramount role on the onset/exacerbation of psoriasis, via overactivation of the hypothalamic–pituitary–adrenal axis and increased release of pro-inflammatory cytokines, cutaneous inflammatory response induces, in turn, anxiety/depression symptoms, via body disfigurement and stigmatisation. The intensity of pruritus and anogenital involvement are additional risk factors for psychological comorbidity.Aims were to (1) examine the effects of intensity of pruritus and anogenital psoriasis on disease burden and psychological comorbidity and (2) identify the variables associated with the presence of clinically significant depression, anxiety, and dysmorphic concerns.

Design Cross-sectional study.

Setting Conducted at the University Medical Center Hamburg-Eppendorf (UKE).

Participants 107 patients with psoriasis (mean age = 46.3, SD = 14.6 years; 53.3% male): 64 with none/mild pruritus; 43 with moderate/severe pruritus; 31 with anogenital psoriasis; 76 not affected in the anogenital area.

Primary/secondary outcomes measures Disease severity was assessed with Psoriasis Area and Severity Index and intensity of pruritus was rated by patients. Patient-reported outcomes included the Dermatology Life Quality Index, ItchyQoL, Patient Benefit Index, Perceived Stigmatisation Questionnaire, and Relationship and Sexuality Scale. Psychological morbidity was assessed with the Patient Health Questionnaire, Generalised Anxiety Disorder, and Dysmorphic Concern Questionnaire.

Results Patients with moderate/severe pruritus reported more quality of life impairments, depression, anxiety and dysmorphic concerns, and less treatment benefits than those with none/mild pruritus. Moderate/severe pruritus had a deleterious effect on depression and stigmatisation for patients without anogenital involvement. Less patient benefits were associated with a higher likelihood of clinically significant depression/anxiety.

Conclusion Pruritus induces significant burden and psychological morbidity, particularly for patients without anogenital involvement. However, coping strategies used by patients with anogenital psoriasis might be dysfunctional for overall psychosocial adaptation. Patient-centred healthcare might be the best way to prevent psychological comorbidity.

PMID:
36153012
DOI:
10.1136/bmjopen-2021-055477

A Systematic Review and Meta-analysis of Factors Associated with Stigma of Dermatologic Disease Psychodermatology and quality of life

CFZ. Stuhlmann, S. Lysakova, C. Jordan, T. Revenson, R. Sommer, L. Wilhelm (2022, September)

ePoster presented at 31st European Academy of Dermatology and Venereology (EADV) Congress

Development of new measures to capture Cumulative Life Course Imairments (CLCI) in patients with chronic skin diseases

C. von Stülpnagel, M. Augustin, L. Westphal, R. Sommer (2022, September)

ePoster presented at 31st European Academy of Dermatology and Venereology (EADV) Congress

Disease burden and patient needs in women of childbearing age with psoriasis: retrospective analysis from the German PsoBest registries Psoriasis

N. da Silva, L. Westphal, M. Augustin, R. Sommer (2022, September)

ePoster presented at 31st European Academy of Dermatology and Venereology (EADV) Congress

Patients' and physicians' perspectives of shared decision making for psoriasis systemic treatment: associations with sources of information and health literacy

N. da Silva, M. Augustin, S. Pohl, J. Traxler, R. Sommer (2022, September)

ePoster presented at 31st European Academy of Dermatology and Venereology (EADV) Congress

Measuring wellbeing in psoriasis: Psychometric properties of the WHO-5 questionnaire

R. Sommer, L. Westphal, U. Mrowietz, S. Gerdes, M. Augustin (2022, September)

ePoster presented at 31st European Academy of Dermatology and Venereology (EADV) Congress

A comparative analysis of the predictors, extent and impact of self-stigma in people with psoriasis and atopic dermatitis Psychodermatology and quality of life

S. Schlachter, L. Westphal, M. Augustin, R. Sommer (2022, September)

ePoster presented at 31st European Academy of Dermatology and Venereology (EADV) Congress

Development and validation of an outcome instrument measuring dry skin - the Xerosis Area and Severity Index (XASI).

R. Sommer1, M. Augustin1, N. da Silva1, C.C. von Stülpnagel1

1Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany

J Eur Acad Dermatol Venereol. 2022 Jan;36(1):e70-e72

 

The aim of this study was the development and validation of a composite measuring instrument for the assessment of the extent (surface area affected) and severity of xerosis in clinical practice and research.

PMID:
Epub 2021 Sep 21. 34482583
DOI:
10.1111/jdv.17636

Parents with Asthmatic Children, Quality of Life

C. Crespo1, N. da Silva1,2 

1Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal

2 University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany

Encyclopedia entry: Encyclopedia of Quality of Life and Well-Being Research

DOI:
10.1007/978-3-319-69909-7_4019-2

Destigmatization of people with skin diseases in body care professions – a study protocol

J. Traxler, M. Augustin, M. Grosser, R. Sommer (2022, October)

Poster presented at the DKVF Conference, Potsdam, Germany 

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