Sociodemographic Factors Influence Outcomes Among Patients With Psoriasis

A patient’s sex, disease duration, and place of residence were the most common sociodemographic factors shown to affect illness acceptance, life satisfaction, sense of stigmatization, and quality of life (QOL) among those who have psoriasis, according to the results of a recent Polish study published in Dermatology and Therapy.

Psoriasis is a chronic disease of the skin, affecting approximately 2% of the world’s population. Its main characteristics include itchiness, pain, and the presence of thick red skin lesions that can develop anywhere on the body.

The authors note the disease may “distort self-image of an individual, lower self-esteem, and evoke feelings of shame and embarrassment. Often, patients have the impression of being unattractive to others.”

Sex was shown to play a role in illness acceptance, satisfaction of life, and QOL. Although men, on average, had significantly higher levels of illness acceptance compared with their female counterparts, they also showed a moderate deterioration in QOL twice as often as women, as well as lower levels of satisfaction with life.

Longer disease duration, or time since diagnoses, was found to significantly affect the degree of life satisfaction, sense of stigmatization, and QOL. Low and moderate levels of life satisfaction were most common in patients whose psoriasis had been diagnosed 6 to 19 years prior to the study. The highest stigmatization levels and most evident deterioration in QOL were also most common among these patients.

Place of residence had a significant effect on satisfaction with life and sense of stigmatization, which were both higher among countryside dwellers. Similarly, QOL was more severely deteriorated in patients who resided in cities or towns.

Additionally, correlations between scales used to assess emotional response to psoriasis were found, suggesting that levels of acceptance and satisfaction with life were positively correlated, whereas sense of stigmatization measured was negative correlated with level of disease acceptance and life satisfaction. More than half of respondents rated their satisfaction with life as low, with only 28.6% of those respondents having high levels of illness acceptance.

Overall, Acceptance of Illness Scores among all study participants ranged between 10 and 40 points, with a mean (SD) value of 24.02 (7.56) points, demonstrating that study participants showed moderate levels of illness acceptance. Also, nearly half of respondents were shown to have a severe deterioration in QOL, with Dermatology Life Quality Index (DLQI) values ranging between 0 and 30 points for all participants. The mean (SD) DLQI value came in at 17.81 (5.91), suggesting that overall, psoriasis has a “very large effect” on QOL.

“The results of this study might constitute a starting point for further research on the influence of sociodemographic variables on illness acceptance, satisfaction with life, stigmatization, and quality of life with psoriasis,” said the investigators.

Reference

Kowalewska B, Cybulski M, Jankowiak B,k 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 (Heidelb). 2020;10(3):413-430. doi: 10.1007/s13555-020-00368-w