Perceived Stigmatization among Dermatological Outpatients Compared with Controls: An Observational Multicentre Study in 17 European Countries

Authors

  • Sylvia van Beugen Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
  • Christina Schut Institute of Medical Psychology, Justus-Liebig-University Gießen, Gießen, Germany
  • Jörg Kupfer Institute of Medical Psychology, Justus-Liebig-University Gießen, Gießen, Germany
  • Antony P. Bewley Barts Health NHS Trust & Queen Mary University, London, UK
  • Andrew Y. Finlay Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
  • Uwe Gieler Department of Dermatology, Justus-Liebig- University Giessen and Vitos Klinik, Giessen, Germany
  • Andrew R. Thompson South Wales Clinical Psychology Programme, Cardiff & Vale University Health Board, & School of Psychology, Cardiff University, UK
  • Tamara Gracia-Cazaña Miguel Servet University Hospital, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
  • Flora Balieva Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
  • Bárbara R. Ferreira Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal
  • Gregor B. Jemec Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
  • Lars Lien Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
  • Laurent Misery Department of Dermatology, University Hospital of Brest, Brest, France
  • Servando E. Marron Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
  • Sonja Ständer Department of Dermatology, University Clinic Münster, Münster, Germany
  • Claudia Zeidler Department of Dermatology, University Clinic Münster, Münster, Germany
  • Csanád Szabó Institute of Psychology, University of Szeged, Szeged, Hungary
  • Jacek C. Szepietowski Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
  • Adam Reich Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
  • Amna Elyas Department of Dermatology and Venereology, Skåne University Hospital, Malmo, Sweden
  • Ilknur K. Altunay University of Health Sciences. Hamidiye Etfal Research and Training Hospital, Department of Dermatology and Venereology, Istanbul, Turkey
  • Franz J. Legat Department of Dermatology, Medical University of Graz, Graz, Austria
  • Vesna Grivcheva-Panovska University St Cyril and Methodius, School of Medicine, PHI University Clinic of Dermatology Skopje, N. Macedonia
  • Dmitry V. Romanov Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
  • Andrey N. Lvov Department of Dermatovenereology and Cosmetology, Central State Medical Academy of department of presidential affairs, Moscow, Russia
  • Géraldine Titeca Department of Dermatology/ Clinique Notre Dame de Grâce, Gosselies, Belgium
  • Francesca Sampogna Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
  • Nienke C. Vulink Department of Psychiatry, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
  • Lucia Tomás-Aragones Department of Psychology, University of Zaragoza, Zaragoza Spain
  • Andrea W.M. Evers Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
  • Florence J. Dalgard Department of Dermatology and Venereology, Skåne University Hospital, Malmo, Sweden

DOI:

https://doi.org/10.2340/actadv.v103.6485

Keywords:

social stigma, skin diseases, medical psychology, multicenter study

Abstract

Perceived stigmatization places a large psychosocial burden on patients with some skin conditions. Little is known about the experience of stigmatization across a wide range of skin diseases. This observational cross-sectional study aimed to quantify perceived stigmatization and identify its predictors among patients with a broad spectrum of skin diseases across 17 European countries. Self-report questionnaires assessing perceived stigmatization and its potential predictors were completed by 5,487 dermatology outpatients and 2,808 skin-healthy controls. Dermatological diagnosis, severity, and comorbidity were clinician-assessed. Patients experienced higher levels of perceived stigmatization than controls (p < 0.001, d   = 0.26); patients with psoriasis, atopic dermatitis, alopecia, and bullous disorders were particularly affected. Multivariate regression analyses showed that perceived stigmatization was related to sociodemographic (lower age, male sex, being single), general health-related (higher body mass index, lower overall health), disease-related (higher clinician-assessed disease severity, presence of itch, longer disease duration), and psychological (greater distress, presence of suicidal ideation, greater body dysmorphic concerns, lower appearance satisfaction) variables. To conclude, perceived stigmatization is common in patients with skin diseases. Factors have been identified that will help clinicians and policymakers to target vulnerable patient groups, offer adequate patient management, and to ultimately develop evidence-based interventions.

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Published

2023-06-22

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van Beugen, S., Schut, C., Kupfer, J., Bewley, A. P., Finlay, A. Y., Gieler, U., … Dalgard, F. J. (2023). Perceived Stigmatization among Dermatological Outpatients Compared with Controls: An Observational Multicentre Study in 17 European Countries. Acta Dermato-Venereologica, 103, adv6485. https://doi.org/10.2340/actadv.v103.6485

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Vol. 103 (2023)

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Copyright (c) 2023 Sylvia van Beugen, Christina Schut, Jörg Kupfer, Antony P. Bewley, Andrew Y. Finlay, Uwe Gieler, Andrew R. Thompson, Tamara Grazia-Cazaña, Flora Balieva, Bárbara R. Ferreira, Gregor B. Jemec, Lars Lien, Laurent Misery, Servando E. Marron, Sonja Ständer, Claudia Zeidler, Csanád Szabó, Jacek C. Szepietowski, Adam Reich, Amna Elyas, Ilknur K. Altunay, Franz J. Legat, Vesna Grivcheva-Panovska, Dmitry V. Romanov, Andrey N. Lvov, Géraldine Titeca, Francesca Sampogna, Nienke C. Vulink, Lucia Tomás-Aragones, Andrea W.M. Evers, Florence J. Dalgard

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