Factors Influencing Major Life-Changing Decisions in Patients with Psoriasis: A Cross-sectional Study
DOI:
https://doi.org/10.2340/actadv.v103.11640Keywords:
Psoriasis, Quality of life, Life-Changing decisionAbstract
Psoriasis is a chronic inflammatory disease associated with significant impairment in quality of life. Although quality of life in patients with psoriasis has been widely studied, there is little evidence regarding the impact of psoriasis on major life-changing decisions (MLCD). The aims of this study are to describe the impact of psoriasis on MLCD and to explore the potential clinical factors associated with MLCD. This cross-sectional study included 113 patients with psoriasis, regardless of disease severity, duration, or current treatment. The impact of the disease on different MLCD, including those related to professional career, decision of having children, choice of clothing, and leisure activities, was explored using Likert scales. Mean age was 51 years old and female to male ratio was 1.08 (54/50). The mean Psoriasis Area Severity Index was 3.75, and 30% (35/113) of the patients had psoriatic arthropathy. The most affected MLCD were career choice (median (interquartile range) score 3 (2–4)), social relationships (2 (1–3)), choice of clothing (2 (1–3)), job performance, absenteeism, and choice of holiday destination (1 (0–2)). Female sex, early age of onset and psoriatic arthropathy were associated with a greater impact of the disease on MLCD (p < 0.05). The results showed that a range of MLCD are affected in patients with psoriasis, such as career choice, job performance, absenteeism, or choice of clothing. Female sex, psoriatic arthritis and early age of onset are factors associated with a greater impact on MLCD. In order to limit the long-term negative effects of psoriasis on patients, special attention should be paid to detection of psoriatic arthritis, and to patients with early disease onset.
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Langley RGB, Krueger GG, Griffiths CEM. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis 2005; 64: 18-25.
https://doi.org/10.1136/ard.2004.033217 DOI: https://doi.org/10.1136/ard.2004.033217
Oliveira M de FSP de, Rocha B de O, Duarte GV. Psoriasis: classical and emerging comorbidities. An Bras Dermatol 2015; 90: 9-20.
https://doi.org/10.1590/abd1806-4841.20153038 DOI: https://doi.org/10.1590/abd1806-4841.20153038
Jensen P, Skov L. Psoriasis and obesity. Dermatology 2016; 232: 633-639.
https://doi.org/10.1159/000455840 DOI: https://doi.org/10.1159/000455840
Gao N, Kong M, Li X, Zhu X, Wei D, Ni M, et al. The association between psoriasis and risk of cardiovascular disease: a mendelian randomization analysis. Front Immunol 2022; 13: 918224.
https://doi.org/10.3389/fimmu.2022.918224 DOI: https://doi.org/10.3389/fimmu.2022.918224
Aguayo-Carreras P, Ruiz-Carrascosa JC, Molina-Leyva A. Type D personality is associated with poor quality of life, social performance, and psychological impairment in patients with moderate to severe psoriasis: a cross-sectional study of 130 patients. Indian J Dermatol Venereol Leprol 2020; 86: 375-381.
https://doi.org/10.4103/ijdvl.IJDVL_114_19 DOI: https://doi.org/10.4103/ijdvl.IJDVL_114_19
Lim DS, Bewley A, Oon HH. Psychological profile of patients with psoriasis. Ann Acad Med Singapore 2018; 47: 516-522.
https://doi.org/10.47102/annals-acadmedsg.V47N12p516 DOI: https://doi.org/10.47102/annals-acadmedsg.V47N12p516
Randa H, Todberg T, Skov L, Larsen LS, Zachariae R. Health-related quality of life in children and adolescents with psoriasis: a systematic review and meta-analysis. Acta Derm Venereol 2017; 97: 555-563.
https://doi.org/10.2340/00015555-2600 DOI: https://doi.org/10.2340/00015555-2600
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: 302-307.
https://doi.org/10.1016/j.jaad.2014.03.039 DOI: https://doi.org/10.1016/j.jaad.2014.03.039
Bhatti ZU, Finlay AY, Bolton CE, George L, Halcox JP, Jones SM, et al. Chronic disease influences over 40 major life-changing decisions (MLCDs): a qualitative study in dermatology and general medicine. J Eur Acad Dermatol Venereol 2014; 28: 1344-1355.
https://doi.org/10.1111/jdv.12289 DOI: https://doi.org/10.1111/jdv.12289
Warren RB, Kleyn CE, Gulliver WP. Cumulative life course impairment in psoriasis: patient perception of disease-related impairment throughout the life course. Br J Dermatol 2011; 164: 1-14.
https://doi.org/10.1111/j.1365-2133.2011.10280.x DOI: https://doi.org/10.1111/j.1365-2133.2011.10280.x
Bhatti ZU, Salek SS, Bolton CE, George L, Halcox JP, Jones SM, et al. The development and validation of the major life changing decision profile (MLCDP). Health Qual Life Outcomes 2013; 11: 78.
https://doi.org/10.1186/1477-7525-11-78 DOI: https://doi.org/10.1186/1477-7525-11-78
Wójcik E, Reszke R, Krajewski PK, Matusiak Ł, Madziarska K, Ali FM, et al. Major life changing decision profile: creation of the Polish language version. Dermatol Ther 2021; 34: e14568.
https://doi.org/10.1111/dth.14568 DOI: https://doi.org/10.1111/dth.14568
Jebb AT, Ng V, Tay L. A review of key likert scale development advances: 1995-2019. Front Psychol 2021; 12: 637547.
https://doi.org/10.3389/fpsyg.2021.637547 DOI: https://doi.org/10.3389/fpsyg.2021.637547
Golbari NM, van der Walt JM, Blauvelt A, Ryan C, van de Kerkhof P, Kimball AB. Psoriasis severity: commonly used clinical thresholds may not adequately convey patient impact. J Eur Acad Dermatol Venereol 2021; 35: 417-421.
https://doi.org/10.1111/jdv.16966 DOI: https://doi.org/10.1111/jdv.16966
Ogdie A, Shin DB, Love TJ, Gelfand JM. Body surface area affected by psoriasis and the risk for psoriatic arthritis: a prospective population-based cohort study. Rheumatology (Oxford) 2022; 61: 1877-1884.
https://doi.org/10.1093/rheumatology/keab622 DOI: https://doi.org/10.1093/rheumatology/keab622
Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54: 2665-2673.
https://doi.org/10.1002/art.21972 DOI: https://doi.org/10.1002/art.21972
Mabuchi T, Yamaoka H, Kojima T, Ikoma N, Akasaka E, Ozawa A. Psoriasis affects patient's quality of life more seriously in female than in male in Japan. Tokai J Exp Clin Med 2012; 37: 84-88.
von Stülpnagel CC, Augustin M, Düpmann L, da Silva N, Sommer R. Mapping risk factors for cumulative life course impairment in patients with chronic skin diseases - a systematic review. J Eur Acad Dermatol Venereol 2021; 35: 2166-2184.
https://doi.org/10.1111/jdv.17348 DOI: https://doi.org/10.1111/jdv.17348
Ciuluvica C, Fulcheri M, Amerio P. Expressive suppression and negative affect, pathways of emotional dysregulation in psoriasis patients. Front Psychol 2019; 10: 1907.
https://doi.org/10.3389/fpsyg.2019.01907 DOI: https://doi.org/10.3389/fpsyg.2019.01907
Moraes FA, da Silva MRR, Dos Santos JBR, Acurcio FA, Almeida AM, Kakehasi AM, et al. Health-related quality of life in psoriatic arthritis: findings and implications. Value Heal Reg issues 2021; 26: 135-141.
https://doi.org/10.1016/j.vhri.2021.06.003 DOI: https://doi.org/10.1016/j.vhri.2021.06.003
Kelly KA, Balogh EA, Kaplan SG, Feldman SR. Skin disease in children: effects on quality of life, stigmatization, bullying, and suicide risk in pediatric acne, atopic dermatitis, and psoriasis patients. Child (Basel) 2021; 8: 1057.
https://doi.org/10.3390/children8111057 DOI: https://doi.org/10.3390/children8111057
Griffiths CEM, Augustin M, Naldi L, Romiti R, Guevara-Sangines E, Howe T, et al. Patient-dermatologist agreement in psoriasis severity, symptoms and satisfaction: results from a real-world multinational survey. J Eur Acad Dermatol Venereol 2018; 32: 1523-1529.
https://doi.org/10.1111/jdv.14937 DOI: https://doi.org/10.1111/jdv.14937
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Copyright (c) 2023 Manuel Sanchez-Diaz, Pablo Díaz-Calvillo, Alberto Soto-Moreno, Alejandro Molina-Leyva, Salvador Arias-Santiago
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