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Sengupta A, Wagani R. Mindful self-compassion for psychological distress -associated with skin conditions: An online intervention study. Indian J Dermatol Venereol Leprol 2024; 0:1-5. [PMID: 38314971 DOI: 10.25259/ijdvl_451_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/14/2023] [Indexed: 02/07/2024]
Abstract
Background Chronic skin conditions are different from internal illnesses since they are often immediately visible to others. Patients feel self-conscious and often go through depression, anxiety, fear of stigma and a substantial psychological, social and economic impact. It is crucial for healthcare professionals to gather information about various strategies and psychosocial interventions that can be used to manage psychological distress associated with skin conditions and avoid it from being neglected amidst other health conditions. Mindful Self-Compassion (MSC) can be used for this. It is a resource-building mindfulness-based self-compassion training programme that uses a combination of personal development training and psychotherapy designed to enhance one's capacity for self-compassion by cultivating spacious awareness as a basis for compassionate action. Aims This study examined the impact of mindful self-compassion on depression, anxiety, stress, dermatology-specific quality of life, self-esteem and well-being in a sample of 88 adults aged 18-55 years suffering from chronic skin conditions. Methods This study used an experimental waitlist control design. Participants were recruited from two skin clinics using purposive sampling in Mumbai, Maharashtra. Pre-test data was collected through self-reported questionnaires on psychological distress, dermatology-specific quality of life, self-esteem and well-being. Participants who were experiencing psychological distress were randomly assigned to either the experimental or waitlist control group. The intervention named 'mindful self-compassion' was delivered through an online platform, twice a week, over a period of 4 weeks. Post-test data was collected later on all variables. Results ANCOVA was utilised where pre-test scores were used as covariates. Differences in pre-test and post-test scores between the intervention group and waitlist control group for depression, anxiety, stress, dermatology-specific quality of life, self-esteem and well-being were analysed. Participants in the intervention group were found to have lower levels of depression, anxiety and stress as compared to the waitlist control group and also had enhanced levels of self-esteem, well-being and dermatological quality of life. These differences were found to be statistically significant (p < 0.001). Limitations The sample reflected heterogenous skin conditions, not a specific skin condition. The study was quantitative in nature, and we could not use any qualitative methods to assess the subjective experience of participants. Due to time constraints, follow-up data could not be gathered from participants to assess long-term effects on participants. Conclusion Mindful self-compassion can be effectively used to manage psychological distress in skin conditions. Dermatologists can become acquainted with basic signs of mental distress and the importance of psychological interventions. By collaborating with mental health professionals, patients can be given holistic treatment.
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Affiliation(s)
- Aparna Sengupta
- Amity University, Amity Institute of Behavioral and Allied Sciences, Mumbai - Pune Expressway Bhatan, Somathne, Panvel, Mumbai, Maharashtra, India
| | - Rekha Wagani
- Amity University, Amity Institute of Behavioral and Allied Sciences, Mumbai - Pune Expressway Bhatan, Somathne, Panvel, Mumbai, Maharashtra, India
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Wu CL, Chang YC, Yao WT, Chiang TI. Exploring the Effectiveness of Biological Therapy in Patients with Psoriasis: Body Image and Quality of Life. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:160. [PMID: 38256420 PMCID: PMC10819774 DOI: 10.3390/medicina60010160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Psoriasis is a chronic, long-term, incurable skin inflammatory disease characterized by the excessive proliferation of epidermal keratinocytes, dilation of blood vessels, thickening of the skin, and the formation of visible red patches of variable sizes. The impact on patients differs with the severity of the disease, leading to physiological discomfort and psychological distress, which significantly affect the quality of life. The etiology of psoriasis is not completely clear, but immune cells, including type 1 and type 17 cytokine-producing cells modulated by regulatory T cells (Tregs), play a critical role in driving the disease pathogenesis. With the ability to specifically target inflammatory markers, biologics can efficiently inhibit the spread of inflammation to achieve therapeutic effects. The goal was to explore the changes in body image and quality of life in psoriasis patients undertaking therapies with biologic agents. Materials and Methods: This study employed a quasi-experimental, single-sample, pretest-posttest design. Forty-four psoriasis patients were recruited from the dermatology outpatient clinics at two medical centers in northern Taiwan. A structured questionnaire, including demographic information, the Body Image Scale (BIS), and the Dermatology Life Quality Index (DLQI), was used as a research tool. Questionnaire assessments were conducted both before and three months after the biologic agent intervention. Statistical analyses were performed using SPSS version 22.0. Results: Our results indicated a significant difference in body image between psoriasis patients before and after intervention with biologic agents. In addition, overall quality of life (QoL) also showed significant improvements before and after biologic agent intervention. There was a positive correlation between body image and quality of life in psoriasis patients. Conclusions: The treatment for psoriasis has evolved rapidly in recent years, and biologic agents have proven to be effective therapies to improve the quality of life for psoriasis patients. Our study suggests that health-related education and psychological support can further benefit psoriasis patients to willingly and positively undertake treatment and therefore improve their positive body image and quality of life.
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Affiliation(s)
- Chia-Lien Wu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan; (C.-L.W.); (Y.-C.C.)
| | - Ya-Ching Chang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan; (C.-L.W.); (Y.-C.C.)
| | - Wen-Teng Yao
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 104, Taiwan;
- Department of Materials Science and Engineering, National Taiwan University, Taipei 106, Taiwan
| | - Tsay-I Chiang
- Department of Nursing, Hungkuang University, Taichung 403, Taiwan
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Frede N, Hiestand S, Schauer F, Endres D, Tebartz van Elst L, Zeisbrich M, Craig-Mueller N, Finzel S, Thiel J, Voll RE, Schempp C, Venhoff N. Psoriasis and Psoriatic Arthritis Have a Major Impact on Quality of Life and Depressive Symptoms: A Cross-Sectional Study of 300 Patients. Rheumatol Ther 2023; 10:1655-1668. [PMID: 37843747 PMCID: PMC10654309 DOI: 10.1007/s40744-023-00602-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/20/2023] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION Psoriasis (Pso) and psoriatic arthritis (PsA) can reduce the quality of life (QoL) and are known to be associated with depression. Within this study, we aimed to assess the burden of disease, functional capacity, quality of life, and depressive symptoms and identify factors predicting functional impairment and depression in patients with psoriatic disease. METHODS A cross-sectional survey was conducted in a cohort of 300 patients with psoriatic disease including 150 patients from a university hospital dermatology outpatient clinic and 150 patients from a university hospital rheumatology outpatient clinic. Questionnaire-based assessment of signs of arthritis (Psoriasis Epidemiology Screening Tool; PEST), functional status (Functional Questionnaire Hannover; FFbH), quality of life (World Health Organization Quality of Life Brief Version; WHOQOL-BREF), and depressive symptoms (Patient health questionnaire 9; PHQ-9) and retrospective medical chart analysis were performed. RESULTS Despite treatment, burden of disease was high. Joint pain was reported in multiple regions in patients with Pso (n = 111) and patients with PsA (n = 189), but with differences in frequency and distribution patterns of symptoms. Functional impairment in everyday life was independently associated with diagnosis of PsA (odds ratio [OR] 9.56, p = 0.005), depressive symptoms (OR 5.44, p < 0.001) and age (OR 1.04, p = 0.033). At least mild depressive symptoms were demonstrated in 54% and 69% of patients with Pso and PsA, respectively. In a logistic regression model, depressive symptoms were independently associated with functional impairment (OR 4.50, p = 0.003), axial complaints (OR 2.80, p = 0.030), diagnosis of psoriatic arthritis (OR 2.69, p = 0.046), and number of joint regions with complaints (OR 1.10, p = 0.032). CONCLUSION Functional impairment, QoL, and depressive symptoms are mutually interdependent. Early diagnosis of PsA and initiation of anti-inflammatory therapy are essential to avoid long-term damage, disability, and mental health complications. However, despite therapy many patients with PsA, and especially female patients, report a substantial residual disease burden due to their psoriatic disease which will need to be addressed by a more patient-centered approach.
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Affiliation(s)
- Natalie Frede
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Sonja Hiestand
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Franziska Schauer
- Department of Dermatology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Markus Zeisbrich
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Nils Craig-Mueller
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Stephanie Finzel
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Jens Thiel
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
- Division of Rheumatology and Clinical Immunology, Medical University Graz, Graz, Austria
| | - Reinhard E Voll
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Christoph Schempp
- Department of Dermatology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Nils Venhoff
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
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Kędra K, Reich A. Skin-Related Sexual Life Questionnaire (SRSLQ): Creation and Validation of the Questionnaire. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2023. [PMID: 38004072 PMCID: PMC10673023 DOI: 10.3390/medicina59112023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/08/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The assessment of sexual dysfunction among psoriatic patients still remains a great diagnostic difficulty due to its subjective and embarrassing character. Various questionnaires have been used to assess sexual dysfunctions associated with skin conditions; however, none of them have been approved as a gold standard. The aim of our study was to create and validate the Skin-Related Sexual Life Questionnaire (SRSLQ) for the assessment of possible sexual dysfunction and related psychological burdens in patients with skin diseases. Materials and Methods: A total of 109 patients, including 45 women and 64 men (1:1.4) suffering from psoriasis and aged between 18 and 73 years (mean 48.0 ± 13.4 years), were included in the study. All subjects completed the 11-item SRSLQ and the Dermatology Life Quality Index (DLQI). In addition, all men were asked to fulfil the five-item version of the International Index of Erectile Dysfunction (IIEF-5) at the time of examination and 7 days after enrollment. The disease severity was assessed via the PASI scale. Results: The statistical analysis of internal consistency of SRSLQ showed very good integrity, with a Cronbach α coefficient of 0.94. The reproducibility level assessed with intraclass correlation coefficient (ICC) amounted to 0.96. A significant correlation between the total score of the 11-item SRSDQ and the DLQI (r = 0.39; p < 0.001) was found, confirming congruent validity. Conclusions: The validated 11-item Skin-Related Sexual Life Questionnaire can be successfully implemented in daily clinical practice as well as in clinical research.
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Affiliation(s)
- Kamila Kędra
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszow, Poland;
- Doctoral School, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszow, Poland;
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Zhang XJ, Lin JR, Ou MX, Yan HW, Liu SN, Dai L, Gong FQ. Factors associated with quality of life in Chinese people with psoriasis: a cross-sectional study. BMC Public Health 2023; 23:1860. [PMID: 37749489 PMCID: PMC10521450 DOI: 10.1186/s12889-023-16758-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The ultimate goal of medical care is to eradicate disease and restore normality to a person's life. Quality of life (QOL) is a concern as dermatologists and researchers strive to find better drug treatments. However, there have been few reports on the factors associated with QOL among Chinese people with psoriasis. METHODS A total of 185 people with psoriasis were surveyed to assess their sociodemographic status, disease-related information, psychosocial status, and QOL. The questionnaires included a sociodemographic questionnaire, the Athens Insomnia Scale, the Hospital Anxiety and Depression Scale, the Perceived Social Support Scale, the Psychosocial Adaptation Questionnaire of Chronic Skin Disease and the Dermatology Life Quality Index. Multiple stepwise regression and path analysis were used to study the factors associated with QOL among Chinese people with psoriasis and to analyse the relationship between them. RESULTS The results showed that the presence of anxiety/depression, lesion area, sleep disorders, psychosocial adaptation, and sex could jointly predict 62.1% of the variance in QOL among Chinese people with psoriasis. According to previous theories and the literature, a path model was established for five variables. Four internal variables could be effectively explained. The values of the explanatory variables were 62.1% (F(1056) = 61.020, p = 0.000) for QOL, 71.8% (F(2433) = 117.370, p = 0.000) for anxiety/depression, 44.0% (F(660) = 36.935, p = 0.000) for sleep disorders, and 66.9% (F(6886) = 93.556, p = 0.000) for psychosocial adaptation. The path analysis confirmed that 9 paths were consistent with the predicted path, and 3 paths were not confirmed. CONCLUSION To improve QOL among Chinese people with psoriasis, attention should be given to the presence of anxiety/depression, lesion area, sleep disorders, psychosocial adaptation and sex differences. Therefore, health care programs for psoriasis should include physical, psychological and social aspects.
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Affiliation(s)
- Xiu-Jie Zhang
- School of Public Health, China Medical University, Shenyang, China
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jing-Rong Lin
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Min-Xing Ou
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hong-Wei Yan
- Department of Dermatology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Sheng-Nan Liu
- Department of Dermatology, Dalian Dermatology Hospital, Dalian, China
| | - Lu Dai
- Department of Dermatology, Shenyang Dermatology Hospital, Shenyang, China
| | - Fu-Qing Gong
- School of Public Health, China Medical University, Shenyang, China.
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Lee LL, Huo AP, Chen SL. Experiences and coping behaviours of patients with psoriasis: a qualitative study. J DERMATOL TREAT 2023; 34:2193661. [PMID: 36942918 DOI: 10.1080/09546634.2023.2193661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Psoriasis is a complex, chronic, lifelong inflammatory skin disease characterized by the development of erythematous, indurated, scaly, pruritic and often painful skin plaques, and it is currently incurable. It profoundly affects psychological wellbeing and social functioning and has significant associated co-morbidities. To improve clinical approaches, understanding of the experiences of patients with psoriasis is needed. OBJECTIVE To explore the experiences and coping behaviours of patients with psoriasis. METHODS A qualitative study approach was conducted. Through semi-structured interviews, 20 patients with psoriasis were recruited from general practices and specialist dermatology practices in a regional teaching hospital in Taiwan. Recorded interviews were transcribed and analysed by content analysis. RESULTS Three themes and nine subthemes were identified: 1. Symptoms distress: (a) trouble with scaling, (b) bothersome itching, and (c) complex pain experiences; 2. Psychological distress: (a) encountering discrimination and (b) feeling stigmatised; 3. Managing psoriasis: (a) coping with symptoms, (b) seeking alternative methods, (c) using biologic agents, and (d) changing thinking and coexisting with the disease. CONCLUSION The experience of patients with psoriasis has significant negative impacts on their lives. The findings of this study can provide healthcare professionals with a reference for the care of patients with psoriasis.
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Affiliation(s)
- Lin-Lin Lee
- Department of Nursing, Hungkuang University, Taichung 433304, Taiwan
| | - An-Ping Huo
- Department of Internal Medicine, Jen-Ai Hospital, Dali, Taichung 412224, Taiwan
| | - Shu-Ling Chen
- Department of Nursing, Hungkuang University, Taichung 433304, Taiwan
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Liang H, Kirk B, Polinski JM, Yue X, Kilpatrick RD, Gelfand JM. Impact of Season and Other Factors on Initiation, Discontinuation, and Switching of Systemic Drug Therapy in Patients with Psoriasis: A Retrospective Study. JID INNOVATIONS 2023; 3:100171. [PMID: 36876219 PMCID: PMC9982330 DOI: 10.1016/j.xjidi.2022.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/12/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022] Open
Abstract
This study investigated whether systemic drug prescribing for psoriasis varies by season and other exacerbating factors. Eligible patients with psoriasis were assessed for each season for initiation, discontinuation, and switching of systemic drugs. A total of 360,787 patients were at risk of initiating any systemic drugs in 2016‒2019; 39,572 patients and 35,388 patients were at risk of drug discontinuation or switching to a biologic and a nonbiologic systemic drug, respectively. The initiation of biologic therapy in 2016‒2019 peaked in spring (1.28%), followed by summer (1.11%), fall (1.08%), and winter (1.01%). Nonbiologic systemic drugs followed a similar pattern. Those aged 30‒39 years, male, those with psoriatic arthritis, those who live in the South region, those who live in areas with lower altitudes, and those who live in areas with lower humidity had higher initiation with the same seasonality pattern. Discontinuation of biologic drugs peaked in summer, and switching of biologics was highest in spring. Season is associated with initiation, discontinuation, and switching, although seasonality pattern is less clear for nonbiologic systemic drugs. Approximately 14,280 more patients with psoriasis in the United States are estimated to initiate a biologic in spring than in other seasons, and over 840 more biologic users switched in spring than in winter. The findings may provide evidence for healthcare resource planning in psoriasis management.
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Affiliation(s)
- Huifang Liang
- Global Epidemiology, Pharmacovigilance and Patient Safety, AbbVie, North Chicago, Illinois, USA
| | | | | | - Xiaomeng Yue
- Global Epidemiology, Pharmacovigilance and Patient Safety, AbbVie, North Chicago, Illinois, USA
| | - Ryan D Kilpatrick
- Global Epidemiology, Pharmacovigilance and Patient Safety, AbbVie, North Chicago, Illinois, USA
| | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.,Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Komine M, Kim H, Yi J, Zhong Y, Sakai Y, Crawford B, Habiro K, Hikichi Y, Feldman SR. A discrete choice experiment on oral and injection treatment preferences among moderate-to-severe psoriasis patients in Japan. J Dermatol 2023. [PMID: 36808765 DOI: 10.1111/1346-8138.16746] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/05/2023] [Accepted: 01/25/2023] [Indexed: 02/22/2023]
Abstract
Long-term psoriasis (PsO) management remains challenging. With growing variation in treatment efficacy, cost, and modes of administration, patient preferences for different treatment characteristics are not well understood. A discrete choice experiment (DCE), informed by qualitative patient interviews, was conducted to assess patient preferences for different attributes of PsO treatments; 222 adult patients with moderate-to-severe PsO receiving systemic therapy participated in the DCE web survey. Better long-term efficacy and lower cost were preferred (preference weights p < 0.05). Long-term efficacy had the highest relative importance (RI) and mode of administration was as important as the outcome attributes (efficacy and safety). Patients also preferred oral to injectable administration. In subgroup analyses by disease severity, residence, psoriatic arthritis as a comorbidity, and gender, the trends for each subgroup were the same as the overall population although the extent of RI for administration mode varied. Mode of administration was more important for patients with moderate versus severe disease, or rural versus urban residence. This DCE utilized attributes related to both oral and injectable treatment as well as a broad study population of systemic treatment users. Preferences were further stratified by patient characteristics to explore trends in different subgroups. Understanding the RI of treatment attributes and the attribute trade-offs acceptable to patients helps inform moderate-to-severe PsO systemic treatments decisions.
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Affiliation(s)
- Mayumi Komine
- Jichi Medical University Hospital, Tochigi, Shimotsuke, Japan
| | | | | | | | | | | | | | | | - Steven R Feldman
- Atrium Health Wake Forest Baptist, North Carolina, Winston-Salem, USA
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Pavlova NT, Ramasawmy C, Picariello F, Smith C, Moss‐Morris R. ‘I don't know which is the chicken and which is the egg’: A qualitative study of weight loss‐related beliefs and behaviours among adults with psoriasis and comorbid obesity. Br J Health Psychol 2022; 28:532-551. [PMID: 36484107 DOI: 10.1111/bjhp.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/12/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Obesity is a common (30%-40%) comorbidity of psoriasis. Weight loss is shown to improve the severity of psoriasis; however, little is known about the factors that may influence successful weight loss in the context of obesity and psoriasis. The current qualitative study aimed to explore the obesity-associated beliefs, perceptions, and behaviours related to weight loss in psoriasis. Preferences for a weight loss intervention were also explored. DESIGN Qualitative in-depth semi-structured interviews were conducted with 24 adults (62.5% male) with moderate-to-severe psoriasis and obesity (mean body mass index = 35.2 kg/m2 , SD = 4.1), recruited through a patient organization website in the UK. Data were analysed using inductive thematic analysis. RESULTS Most participants viewed psoriasis as unrelated to obesity. A well-controlled psoriasis and improvements in psoriasis symptoms were considered as major motivators for engaging in a weight loss program by individuals who viewed psoriasis and obesity as related conditions. Comfort eating was perceived as an escape strategy from the psoriasis-induced negative emotions. Participants shared their dissatisfaction with current weight loss recommendations which were too generic. They suggested that a desirable weight loss program would require both emotional and behavioural support, with an emphasis on psoriasis' burden. CONCLUSION The findings accentuate the importance of (1) clinicians discussing the link between obesity and psoriasis with patients, (2) weight loss advice to include both behavioural and emotional support, and (3) a weight loss advice to consider the psoriasis burden and the perceived barriers which may potentially lead to improved outcomes to obesity management in psoriasis.
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Affiliation(s)
- Neli T. Pavlova
- Health Psychology Section, Psychology Department, Institute of Psychiatry Psychology and Neuroscience King's College London London UK
| | - Celeny Ramasawmy
- Health Psychology Section, Psychology Department, Institute of Psychiatry Psychology and Neuroscience King's College London London UK
| | - Federica Picariello
- Health Psychology Section, Psychology Department, Institute of Psychiatry Psychology and Neuroscience King's College London London UK
| | - Catherine Smith
- Health Psychology Section, Psychology Department, Institute of Psychiatry Psychology and Neuroscience King's College London London UK
- St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust London UK
| | - Rona Moss‐Morris
- Health Psychology Section, Psychology Department, Institute of Psychiatry Psychology and Neuroscience King's College London London UK
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Bulut S, Karakaya J, Oksuz S, Kalyoncu U, Unal E. The reliability, validity, and responsiveness of Cognitive Exercise Therapy Approach: Biopsychosocial Questionnaire for patients with psoriatic arthritis. Rheumatol Int 2022; 42:1973-1981. [PMID: 35831716 DOI: 10.1007/s00296-022-05170-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
Although the importance of the biopsychosocial model that aims the optimum treatment is emphasized in the literature, there is a lack of scales that evaluate individuals with PsA in a multi-dimensional way, including all areas of influence. This study aimed to determine the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in individuals diagnosed with Psoriatic Arthritis (PsA). Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL), Health Assessment Questionnaire, Hospital Anxiety and Depression Scale, and Short Form-36 were used for the validity of the BETY-BQ. For scale reliability, the test-retest method was performed, Intraclass Correlation Coefficient (ICC) was calculated, and Cronbach's alpha (α) coefficient was checked for internal consistency. For the responsiveness of the scale, all scales were re-applied with 3 months intervals. The correlations of BETY-BQ with the other scales were found medium to very high. ICC was analyzed to compare the reliability of the test-retest results and it was found to be excellent. Cronbach's α value was found to be 0.940 which showed an excellent internal consistency. The time-dependent change sensitivity of BETY-BQ was found to be highly correlated with the PsA-specific scale, the PsAQoL questionnaire. BETY-BQ was determined as a valid, reliable, and sensitive assessment tool that health professionals can use in individuals with PsA diagnosis. In this study, a scale that will reveal the biopsychosocial responses of individuals with PsA to pharmacological and non-pharmacological treatments was presented to the literature.
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Affiliation(s)
- Senem Bulut
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Faculty of Medicine, Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | - Sevim Oksuz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eastern Mediterranean University, North Cyprus via Mersin 10, 99628, Famagusta, Turkey
| | - Umut Kalyoncu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Edibe Unal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
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Psychopathology and Alexithymia in Patients with Moderate-to-Severe Psoriasis: Development of a Novel Index with Prognostic Value. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074029. [PMID: 35409713 PMCID: PMC8998217 DOI: 10.3390/ijerph19074029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/20/2022] [Accepted: 03/24/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Psoriasis is a chronic, relapsing, inflammatory disease with a high risk of developing mental health difficulties. OBJECTIVE The purposes of the study were to evaluate in moderate-to-severe psoriasis (a) the prevalence of depression and psychopathology, (b) the relationship between depression, psychopathology symptoms, and alexithymia, including its three dimensions, difficulty in identifying feelings (DIF), difficulty in describing feelings (DDF), and externally oriented thinking (EOT), and (c) to establish a novel index for the development of depression according to patients' psychopathological profile. METHODS In 104 patients, alexithymia was evaluated with the Toronto Alexithymia Scale (TAS-20), depression with the Beck Depression Inventory (BDI), and psychopathology with the Brief Symptom Inventory SCL-90 (SCL90). A psychopathology index that combines information from the BDI and SCL90 scales was constructed and the performance of the index with alexithymia was examined. RESULTS Female patients and active smokers score higher on BDI and SCL90 scales. Overweight patients tend to score arithmetically higher. The psychopathology index developed correlates significantly with age, DIF, DDF, and TAS-20. DIF, DDF, and TAS-20 are significant predictors of the psychopathology index. Patients with alexithymia/possible alexithymia are six times as likely to score higher in one of the psychopathology scales. CONCLUSIONS Alexithymia is a significant factor in the development of psychopathology in psoriasis patients. The use of the proposed novel psychopathology index could be essential in order to identify patients with moderate-to-severe psoriasis who are more likely to experience depression and psychopathology. This could have an impact on the decision-making of psoriasis treatment and monitoring of the patient.
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Kowalewska B, Krajewska-Kułak E, Sobolewski M. The Impact of Stress-Coping Strategies and the Severity of Psoriasis on Self-Esteem, Illness Acceptance and Life Satisfaction. Dermatol Ther (Heidelb) 2022; 12:529-543. [PMID: 35041156 PMCID: PMC8764316 DOI: 10.1007/s13555-021-00669-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/16/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction The visibility of skin lesions is a significant burden for patients with psoriasis, who experience social hostility as well as many emotional and psychological problems. The recurrent nature of cutaneous manifestations and their location are also a source of emotional distress, which in turn is one of the main factors that intensifies skin lesions in these patients. The aim of the study was to assess the impact of the severity of psoriasis and stress-coping strategies on general psychometric measures in the affected patients. Methods The study used a short demographic questionnaire, Psoriasis Area and Severity Index (PASI), and four standardised general psychometric tools: Rosenberg Self-Esteem Scale (SES), Satisfaction With Life Scale (SWLS), Coping Inventory for Stressful Situations (CISS) and Acceptance of Illness Scale (AIS). A total of 111 patients participated in the study. Results The mean PASI score was 14.0 (12.1–15.9). The mean SWLS score was below average, i.e., 18.5 (17.3–19.7), and the SES score—26.8 points (26.1–27.5)—indicated self-esteem slightly above average among patients with psoriasis. The mean stress-coping level measured with CISS was 53.6 (51.9–55.2) for the task-oriented strategy (TOS), 46.2 (43.8–48.6) for the emotion-oriented strategy (EOS) and 50.1 (48.5–51.8) for the avoidance-oriented strategy (AOS). Higher PASI was associated with lower illness acceptance among men (r = 0.48) and lower self-esteem among women (r = 0.44). The level of life satisfaction was lower in respondents with higher PASI scores (mainly in the group of women, r = 0.44). Conclusions Higher severity of psoriasis (PASI) and greater frequency of emotion-oriented stress-coping mechanisms (CISS) are factors that negatively affect the overall psychophysical condition of respondents.
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Affiliation(s)
- Beata Kowalewska
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland.
| | - Elżbieta Krajewska-Kułak
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland
| | - Marek Sobolewski
- Faculty of Management, Rzeszow University of Technology, Rzeszow, Poland
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Kowalewska B, Jankowiak B, Krajewska-Kułak E, Milewski R, Sobolewski M. Skin-Disease Specific and Generic Psychometric Measures in Patients with Psoriasis. Dermatol Ther (Heidelb) 2021; 11:1999-2015. [PMID: 34585342 PMCID: PMC8478271 DOI: 10.1007/s13555-021-00609-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/08/2021] [Indexed: 01/19/2023] Open
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).
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Affiliation(s)
- Beata Kowalewska
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland.
| | - Barbara Jankowiak
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland
| | - Elżbieta Krajewska-Kułak
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland
| | - Rafał Milewski
- Doctoral Studies at Faculty of Health Sciences, Department of Primary Healthcare, Medical University of Bialystok, Białystok, Poland
| | - Marek Sobolewski
- Faculty of Management, Rzeszow University of Technology, Rzeszów, Poland
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Skin Disease in Children: Effects on Quality of Life, Stigmatization, Bullying, and Suicide Risk in Pediatric Acne, Atopic Dermatitis, and Psoriasis Patients. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111057. [PMID: 34828770 PMCID: PMC8619705 DOI: 10.3390/children8111057] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 12/23/2022]
Abstract
Acne, atopic dermatitis (AD), and psoriasis are all chronic dermatologic conditions that greatly impact the lives of pediatric patients and their caregivers. The visible nature of these diseases negatively affects the self-image of children early in life as well as their relationships with their families and peers. Physicians recognize the importance of addressing both the physical and mental symptoms of their patients but are currently not equipped with clear guidelines to manage long-term psychosocial comorbidities in pediatric dermatologic patients. A PubMed and Google Scholar search of key words was conducted to explore self-image in pediatric patients with acne, AD, and psoriasis. Chronic skin diseases put pediatric patients at risk for strained family relationships, poor self-image, psychiatric comorbidities, stigmatization, and eventual suicidal behavior. A limitation of this study is a lack of a validated measure of quality of life in the pediatric population that fulfills enough criteria to evaluate long term quality of life in children and adults. Possible management options, including connecting patients with the same diagnosis and allocating resources to parents and teachers to better understand these chronic skin conditions, may provide pediatric patients with the support they need to develop resilience in the face of these challenges.
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Gisondi P, Geat D, Ferrazzi A, Bellinato F, Girolomoni G. Hypochondriasis and Personality Traits of Patients with Chronic Plaque Psoriasis. Dermatology 2021; 238:276-282. [PMID: 34325430 DOI: 10.1159/000517018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/24/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Plaque psoriasis has been associated with anxiety, depression, suicidal ideation and various personality traits. However, studies on hypochondriasis, i.e. the belief of serious illness despite having no or only mild symptoms, are currently scarce. OBJECTIVE The aim of this study was to assess hypochondriasis and personality traits in psoriasis patients using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). METHODS We conducted an observational study on patients with plaque psoriasis who underwent MMPI-2 testing. Demographic and clinical data, including comorbidities, alcohol consumption, and smoking, were collected. RESULTS A total of 136 consecutive psoriatic patients were included. The mean age (±SD) was 53.7 (±13.5), mean PASI (Psoriasis Area Severity Index) was 12.4 (±9.9), and mean disease duration was 23.3 (±15.7) years. Pathologically elevated scores in the Hypochondriasis scale were observed in 27.9% of patients. Furthermore, in a few other MMPI-2 scales (Anxiety, Fears and Negative Treatment Indicators) ≥25% of patients obtained pathologically elevated scores. Conversely, the scales that had the highest proportion of low scorers were Ego Strength and Dominance. At regression analysis, higher psoriasis severity and female gender were associated with higher scores in the Hypochondriasis scale (p = 0.03 and 0.001). Finally, 72.8% reported any alcohol consumption and 8.1% heavy alcohol consumption. CONCLUSION About one third of patients with psoriasis have high scores in the MMPI-2 hypochondriasis evaluation scale. Poor individual coping resources also appeared to be distinctive psychological features in a significant proportion of psoriatic patients.
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Affiliation(s)
- Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Davide Geat
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Anna Ferrazzi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
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Social Support and Appearance Satisfaction Can Predict Changes in the Psychopathology Levels of Patients with Acne, Psoriasis and Eczema, before Dermatological Treatment and in a Six-Month Follow-up Phase. PSYCH 2021. [DOI: 10.3390/psych3030020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This was a cross-sectional study which assessed the factors that predicted changes in the levels of psychopathological symptomatology of patients with acne, psoriasis and eczema both before dermatological treatment and in a six-month follow-up phase. One hundred and eight dermatological patients (18–35 years) participated in the study; 54 with visible facial cystic acne (Group A), and 54 with non-visible psoriasis/eczema (Group B). A battery of self-report questionnaires were administered to all patients before their dermatological treatment and in a six-month follow-up phase and included: the Symptom Checklist-90 Revised (SCL-90-R), the Interpersonal Support Evaluation List (ISEL-40), the Multidimensional Body–Self Relations Questionnaire (MBSRQ–AS) and the Rosenberg Self-Esteem Scale. Multiple regression analyses revealed that patients’ overall perceived social support and overall appearance satisfaction appeared to be strong predictors of the maintenance of patients’ psychopathology levels, even six months after they began their dermatological treatment. Psychosocial factors such as patients’ social support and appearance satisfaction could influence their psychopathology levels and the way they experienced their skin condition, before treatment and after a six-month period of time. The psychological assessment of the aforementioned factors could detect patients who would benefit from psychotherapeutic interventions in order to help them adapt to the extra burden which accompanies dermatological disorders.
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DI Altobrando A, Vara G, Filippi F, Sacchelli L, Patrizi A, Bardazzi F. The impact of psoriasis on marriage. Ital J Dermatol Venerol 2021; 157:235-239. [PMID: 34044508 DOI: 10.23736/s2784-8671.21.06974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Psoriasis frequently affects partners and intimacy and sometimes leads to a break in relationships. The aim of this study was to evaluate the possible negative impact of psoriasis on married life through the use of the Quality Marriage Index (QMI), a score used to assess marital satisfaction. METHODS In this prospective case-control study married or divorced patients with moderate-to-severe plaque psoriasis were compared to a control group made up of married or divorced healthy patients without psoriasis. Each patient enrolled in the study was given the questionnaire to assess the QMI. RESULTS 201 patients were included in the study sample: 100 suffered from moderate-tosevere plaque psoriasis and the other 101 did not. A significantly higher number of psoriatic patients was divorced than patients without psoriasis. By analyzing the QMI questionnaire, patients with psoriasis scored lower than patients without psoriasis in all single questions and in the total QMI value. By assessing how much each question weighed in the QMI final score, a significant difference between the two groups of patients was found in questions 3 and 6: the first one regarding the strength of marriage weighed more in psoriatic patients, while the second one regarding the happiness of marriage weighed more in non-psoriasis patients. CONCLUSIONS Psoriasis can contribute to marriage breakdown in affected patients. The concept of happiness seems to be greatly affected by the repercussions of psoriasis, while the strength of marriage plays a fundamental role in these patients.
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Affiliation(s)
| | - Giulio Vara
- Radiology Unit, S.Orsola-Malpighi Bologna University Hospital, Bologna, Italy
| | - Federica Filippi
- Department of Experimental, Diagnostic and Specialty Medicine, Dermatology, IRCCS Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Lidia Sacchelli
- Department of Experimental, Diagnostic and Specialty Medicine, Dermatology, IRCCS Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Department of Experimental, Diagnostic and Specialty Medicine, Dermatology, IRCCS Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Federico Bardazzi
- Department of Experimental, Diagnostic and Specialty Medicine, Dermatology, IRCCS Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
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The Relationship between Spiritual Well-Being and Resilience in Patients with Psoriasis. Dermatol Res Pract 2021; 2021:8852730. [PMID: 33854545 PMCID: PMC8019391 DOI: 10.1155/2021/8852730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 02/02/2021] [Accepted: 03/18/2021] [Indexed: 11/30/2022] Open
Abstract
Psoriasis skin disease affects the patients' health and quality of life to a great extent. Given the chronic nature of the disease, identifying the factors affecting adaptation to the disease can provide guidelines required for helping these patients deal with their problems. This study was conducted with the purpose of investigating the relationship between spiritual well-being and resilience in patients suffering from psoriasis. The present study is a descriptive-analytical work conducted in the largest city in the south of Iran in 2019. 150 patients diagnosed with psoriasis completed Ellison and Paloutzian's Spiritual Well-Being Scale and Connor and Davidson's Resiliency Scale. Data were analyzed using SPSS v. 20, descriptive (frequency distribution, mean, and standard deviation) and inferential statistics (Pearson, regression, and t-test). The significance level was set at 0.05. The obtained mean scores were 54.84 ± 13.25 for resilience and 73.22 ± 11.13 for spiritual health. Spiritual health predicted 43% of the variance of resilience, and all resilience-related factors had a significant positive relationship with spiritual well-being-related factors (P > 0.05). An analysis of the relationship between demographic variables on the one hand and resilience and spiritual well-being on the other indicated that an increase in the patients' academic status, duration of the disease, and age correlated with an increase in their resilience and spiritual well-being. Also, male patients and married patients were found to possess higher levels of resilience and spiritual well-being. According to the findings of the present study, spiritual well-being correlates with resilience in patients with psoriasis. Considering the chronic nature of the disease, it is recommended that more attention be paid to promoting spiritual health in the care plans of these patients.
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Brihan I, Ianoși 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; 20:202. [PMID: 33123231 DOI: 10.3892/etm.2020.9332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/26/2020] [Indexed: 01/22/2023] Open
Abstract
Skin has an integrative role in daily life, being a communication organ between the patient and the world. Skin affection in psoriasis has consequences on the patient's self-esteem, with direct implications on the quality of life. This study focused on the impairment of self-esteem in a group of 110 patients: Patients with severe cutaneous and psoriasis arthritis and patients with mild types of psoriasis, using the Rosenberg Self-Esteem Scale. Patients with severe cutaneous and psoriasis arthritis have a lower self-esteem compared with patients with mild psoriasis. The statistical data of two groups regarding the degree of education (secondary and higher education), in the male patients with severe cutaneous and psoriasis arthritis with higher education showed a lower self-esteem, compared with male patients with severe cutaneous and psoriasis arthritis with secondary education. In mild forms of psoriasis, the self-esteem of women and men is relatively equal, but below the general population average. Male patients with psoriasis arthritis have a much lower self-esteem compared with that of women, looking at life prospects more negatively. Psoriasis has a major impact on self-esteem, which correlates with quality of life in patients with psoriasis arthritis, depending on the skin condition that creates a major visual impact in society.
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Affiliation(s)
- Ilarie Brihan
- Dermatology Department, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Simona Laura Ianoși
- Dermatology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Daniel Boda
- Dermatologic Research Laboratory - 'N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Angelica Hălmăjan
- Psychology Department, Faculty of Social Humanistic Sciences, University of Oradea, 410073 Oradea, Romania
| | - Mihaela Zdrîncă
- Preclinical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - László Gyula Fekete
- Department of Dermatology, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Targu Mures, Romania
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Almeida V, Leite Â, Constante D, Correia R, Almeida IF, Teixeira M, Vidal DG, Sousa HFPE, Dinis MAP, Teixeira A. The Mediator Role of Body Image-Related Cognitive Fusion in the Relationship between Disease Severity Perception, Acceptance and Psoriasis Disability. Behav Sci (Basel) 2020; 10:E142. [PMID: 32961792 PMCID: PMC7551398 DOI: 10.3390/bs10090142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/01/2020] [Accepted: 09/16/2020] [Indexed: 02/03/2023] Open
Abstract
Psoriasis is a long-term skin disorder without a cure, whose patients are particularly susceptible to mental health diseases. Using a sample of patients diagnosed with psoriasis, this study aimed to: (1) identify the clinical and positive psychological variables that contribute the most to psoriasis disability and (2) assess the mediator role of body image-related cognitive fusion in the relation between disease severity perception and acceptance and self-compassion, on one hand, and psoriasis disability on the other. This is an initial cross-sectional exploratory study, with 75 patients diagnosed with psoriasis (males 52%; mean age 54.99 ± 13.72) answering a sociodemographic and a clinical questionnaire, the Psoriasis Disability Index (PDI), the Cognitive Fusion Questionnaire-Body Image (CFQ-BI), the Acceptance and Action Questionnaire-II (AAQ-II), and the Self-Compassion Scale (SCS). Descriptive and inferential statistics were used to characterize and assess the measures and the final model used. Through path analysis and a hierarchical multiple linear regression, it was found that the variables that significantly contributed to psoriasis disability were years of education, impact on social life and body image, explaining 70% of the variance. Body image-related cognitive fusion was a significant mediator in the relationship between disease severity and acceptance, and psoriasis disability. The implications of this study are considered to be extremely relevant, since it will allow additional information to be provided to psoriasis patients, appropriated to their educational level, aiming to reduce distorted perceptions of disease severity and intervene in the ability to accept this specific and important chronic health condition.
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Affiliation(s)
- Vera Almeida
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Rua Central de Gandra 1317, 4585-116 Gandra PRD, Portugal; (V.A.); (D.C.); (R.C.); (M.T.); (A.T.)
| | - Ângela Leite
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Rua Central de Gandra 1317, 4585-116 Gandra PRD, Portugal; (V.A.); (D.C.); (R.C.); (M.T.); (A.T.)
- Faculty of Philosophy and Social Sciences, Portuguese Catholic University, Rua de Camões 60, 4710-362 Braga, Portugal
| | - Diana Constante
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Rua Central de Gandra 1317, 4585-116 Gandra PRD, Portugal; (V.A.); (D.C.); (R.C.); (M.T.); (A.T.)
| | - Rita Correia
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Rua Central de Gandra 1317, 4585-116 Gandra PRD, Portugal; (V.A.); (D.C.); (R.C.); (M.T.); (A.T.)
| | - Isabel Filipa Almeida
- UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal;
| | - Maribel Teixeira
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Rua Central de Gandra 1317, 4585-116 Gandra PRD, Portugal; (V.A.); (D.C.); (R.C.); (M.T.); (A.T.)
| | - Diogo Guedes Vidal
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal;
| | - Hélder Fernando Pedrosa e Sousa
- Department of Mathematics (DM. UTAD), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal;
| | - Maria Alzira Pimenta Dinis
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal;
| | - Ana Teixeira
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Rua Central de Gandra 1317, 4585-116 Gandra PRD, Portugal; (V.A.); (D.C.); (R.C.); (M.T.); (A.T.)
- UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal;
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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 2020; 30:181-191. [PMID: 32888104 PMCID: PMC7847870 DOI: 10.1007/s11136-020-02621-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2020] [Indexed: 01/07/2023]
Abstract
Purpose The aim of the study was first to examine the heterogeneity of body image and resources, as described by the conservation of resources theory (COR), in a sample of psoriatic patients and explore whether heterogeneity within these variables explains the possible differences in levels of life satisfaction among the participants. Second, we aimed to investigate if life satisfaction level among the observed profiles of psoriatic patients, extracted on the basis of their body image and resources, differed from that of the healthy comparison group. Methods The sample consisted of 735 participants, including 355 adults with a medical diagnosis of psoriasis and 380 healthy adults recruited from a non-clinical general population. Participants filled the Satisfaction with Life Scale, the Multidimensional Body-Self Relations Questionnaire and the COR evaluation questionnaire. Results Latent profile analysis revealed four classes of psoriatic patients with different levels of resources and body image. The group with the highest level of resources and the most positive body image did not differ from the healthy comparison group regarding satisfaction with life. The group with the lowest level of resources and the most negative body image was characterized by the lowest satisfaction with life. Conclusions The results of our study may change the simplifying trend that highlights the traditionally very poor well-being of psoriatic patients. Moreover, the discovery of specific profiles of these patients, which differ with regard to psychological variables, can lead to rethinking contemporary forms of psychological counselling in psoriatic patients.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| | - Katarzyna Podkowa
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
| | - Małgorzata Pięta
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
| | - Daniel Pankowski
- Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Okopowa 59, 01-043, Warsaw, Poland
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Sex-related impairment and patient needs/benefits in anogenital psoriasis: Difficult-to-communicate topics and their impact on patient-centred care. PLoS One 2020; 15:e0235091. [PMID: 32609733 PMCID: PMC7329077 DOI: 10.1371/journal.pone.0235091] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 06/08/2020] [Indexed: 12/11/2022] Open
Abstract
Genital psoriasis affects 2-5% of psoriasis patients; generalised plaque or intertriginous psoriasis also affects the genital area in 29-40% of cases. Anogenital psoriasis has been associated with significant quality of life impairments, but little is known about specific patient needs/treatment goals. This study aimed to examine the overall and sex-related disease burden, patient needs and treatment benefits in patients with anogenital psoriasis, compared to patients with psoriasis not affecting the anal/genital areas. Within the cross-sectional nationwide survey, 2,009 participants were consecutively recruited in 157 randomly assigned German dermatology practices and clinics, according to the following inclusion criteria aged 18 years or over; diagnosis of psoriasis vulgaris; ability to answer the questionnaires; and written informed consent. Based on a high-resolution grid on the topical distribution of psoriasis, two groups were formed: anogenital psoriasis (n = 622) and comparison group (n = 1,303). Clinical severity was assessed by the Psoriasis Area and Severity Index (PASI). Patients completed the EuroQoL visual analogue scale (EQ VAS), the Dermatology Life Quality Index (DLQI), and the Patient Benefit Index (PBI). Patients with anogenital psoriasis had higher PASI (13.0±10.6 vs. 8.9±7.6, P < 0.001) and more DLQI impairments (8.9±6.9 vs. 7.0±6.2, P = 0.002) than controls. At the item-level, they also reported more sex-related DLQI impairments (DLQI-i9: 0.5±0.8 vs. 0.3±0.7, P < 0.001) and treatment needs (PBI-i17: 2.2±1.8 vs. 1.9±1.8, P = 0.001). A great percentage of missing/not-relevant responses was found for sex-related items (23.3-41.9%). These results suggest that the assessment of sex-related impairments and treatment needs should be prioritised in patients with anogenital psoriasis. Questionnaires may be used as a less uncomfortable way for patients to discuss their genital lesions and sexual function during healthcare visits. However, the great percentage of missing/not-relevant responses to sex-related items calls for in-depth assessments and effective patient-physician communication regarding these sensitive topics.
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Korman NJ, Malatestinic W, Goldblum OM, Murage MJ, Renda L, Lin CY, Lucas J, Middleton C, Lobosco S. Assessment of the benefit of achieving complete versus almost complete skin clearance in psoriasis: a patient's perspective. J DERMATOL TREAT 2020; 33:733-739. [PMID: 32432957 DOI: 10.1080/09546634.2020.1772454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Psoriasis is characterized by thick and scaly plaques. The Dermatology Life Quality Index (DLQI) and Physician Global Assessment (PGA) can be used to define its severity.Objective: To assess the impact of complete clearance of skin versus almost clear skin across various disease measures.Methods: Data were collected in a survey of US dermatologists and patients with psoriasis from November 2016-January 2017. Dermatologists completed a 6-point PGA (0 = clear skin, 1 = almost clear skin). Patients completed the DLQI and Work Productivity and Activity Impairment questionnaire (WPAI). Patients with clear and almost clear skin were compared using analysis of covariance for continuous variables, and multivariate logistic regression analysis for categorical variables.Results: Data for 99 and 160 patients with clear and almost clear skin, respectively, were included in the analyses. Patients with clear skin reported less frequent and lower intensity itching, lower total DLQI score (indicating better health-related quality of life), and less impairment of overall work productivity than patients with almost clear skin (all: p < 0.05).Limitations: Limitations relating to general survey methodology.Conclusion: Patients perceived a meaningful difference between clear and almost clear skin. Clear skin is now a realistic treatment target with newer biologics approved in psoriasis.
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Affiliation(s)
- Neil J Korman
- University Hospitals Case Medical Center, Cleveland, OH, USA
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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 2020; 26:467-477. [DOI: 10.1080/13548506.2020.1766093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Fatemeh Hassani
- Department of Counseling, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Amin Koraei
- Department of Counseling, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Reza Yaghoobi
- Dermatology Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Relationship between self-esteem and stigmatization in psoriasis patients. Postepy Dermatol Alergol 2020; 37:597-602. [PMID: 32994785 PMCID: PMC7507155 DOI: 10.5114/ada.2020.93242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 06/07/2019] [Indexed: 12/22/2022] Open
Abstract
Introduction Psoriasis is classified as a psychosomatic disease since its development and outcome may be modulated by various psychological factors. Due to the presence of clinical signs visible to others and poor social awareness of the disease, psoriasis patients are not infrequently classified as different or stigmatized, and their value as human beings tends to decrease. Aim To analyse the relationship between self-esteem and stigmatization in psoriasis patients. Material and methods The study included 120 patients with psoriasis vulgaris. The study participants completed Polish versions of the Rosenberg Self-Esteem Scale (RSES) and the 6-Item Stigmatization Scale developed by Evers et al., as well as an original survey containing questions about their sociodemographic characteristics. Results Mean RSES score of the study participants was 24.1 points. Mean RSES score for female patients was nearly 2 points lower than the mean score for men. Analysis of Spearman's rho coefficients showed that the higher the self-esteem in the study participants the less often they considered themselves unattractive to others (0.23), less often believed that people gaze at their skin lesions (0.23) or avoid them because of their condition (0.38). Conclusions Our findings demonstrate clearly that both self-esteem and stigmatization are significant components of psoriasis' influence on the patient life. Psoriasis should not be considered merely as a somatic problem, but also as a significant psychological and social burden.
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Almutairi S, Alotaibi A, Almohideb M. Perception and assessment of psoriasis in the general population of Riyadh, Saudi Arabia. SAUDI JOURNAL FOR HEALTH SCIENCES 2020. [DOI: 10.4103/sjhs.sjhs_180_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The psychosocial adaptation of patients with skin disease: a scoping review. BMC Public Health 2019; 19:1404. [PMID: 31664970 PMCID: PMC6819547 DOI: 10.1186/s12889-019-7775-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 10/14/2019] [Indexed: 02/08/2023] Open
Abstract
Background Skin disease is a global public health problem that often has physiological, psychological and social impacts. However, it is not very clear how to adapt to these impacts, especially psychosocial adaptation of patients with skin disease. Methods We searched EMBASE, PubMed, CINAHL and PsycINFO from 2009 to 2018. The following themes were extracted from the included articles: the concepts, related factors, and interventions for psychosocial adaptation of patients with skin disease. Two reviewers independently screened and analyzed. Results From 2261 initial records, 69 studies were identified and analyzed. The concept of psychosocial adaptation in patients with skin disease was referred to under an assortment of descriptions. The related factors for psychosocial adaptation in patients with skin disease included the following: demographic factors (sex, age, education level, ethnicity, BMI, sleep quality, marital status, exercise amount, family history, the use of topical treatment only, personality and history of smoking); disease-related factors (disease severity, clinical symptoms, localization and duration); psychological factors (anxiety/depression, self-esteem, body image, stigma and suicidal ideation); and social factors (social support, social interaction, sexual life, economic burden and social acceptance). Despite being limited in quantity, several studies have clarified the benefits of adjuvant care in the form of cognitive behavioral training, educational training and self-help programs, all of which have become common methods for dealing with the psychosocial impacts. Conclusions Based on the previous literatures, we constructed a protocol of care model for psychosocial adaptation in patients with skin disease. It not only provided the direction for developing new instruments that could assess psychosocial adaptation statue, but also a basis for helping patients adjust to changes in skin disease.
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Gündüz A, Topçuoğlu V, Usta Gündüz EB, Ergun T, Gençosmanoğlu DS, Sungur MZ. Significant Effects of Body Image on Sexual Functions and Satisfaction in Psoriasis Patients. JOURNAL OF SEX & MARITAL THERAPY 2019; 46:160-169. [PMID: 31997726 DOI: 10.1080/0092623x.2019.1654582] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Negative body image appraisals may effect the sexual functions, avoidance, and level of finding oneself sexually attractive. The aim of the study is to assess the levels of sexual dysfunction and sexual satisfaction in patients with psoriasis and the effect of the body image appraisal on sexual functions and satisfaction. In all, 216 individuals were included in the study, and 112 of them had psoriasis; 104 individuals who never experienced any skin problems participated in the study and answered questions that assess depression and anxiety levels, sexual problems and satisfaction, as well as body image appraisal. Psoriasis patients showed significantly higher levels of sexual impairments and less satisfaction with sexual life compared to controls. The psoriasis group had lower body image satisfaction compared to the controls. Depression and anxiety levels in the psoriasis group were higher than in the control group. The cognitive meaning of skin involvement as body image satisfaction was found to be the most significant risk factor that affected sexual functions in psoriasis patients. It also predicted sexual satisfaction in the patient group. However, the objective measure of the severity of the disease as Psoriasis Area and Severity Index (PASI) was not a determinant of sexual dysfunctions and satisfaction.
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Affiliation(s)
- Anıl Gündüz
- Department of Clinical Psychology, Istanbul Kent University, Universitesi, Istanbul, Turkey
| | - Volkan Topçuoğlu
- Psychiatry, Marmara Universitesi Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Elvan Başak Usta Gündüz
- Department of Child And Adolescent Psychiatry, Marmara Universitesi Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Tülin Ergun
- Dermatology, Marmara Universitesi Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | | | - Mehmet Z Sungur
- Department of Clinical Psychology, Istanbul Kent University, Universitesi, Istanbul, Turkey
- Department of Clinical Psychology, Istanbul Kent University, President of the Turkish Association for Cognitive Behaviour Psychotherapy, Istanbul, Turkey
- Former President of European Association of Behaviour and Cognitive Psychotherapy, Istanbul, Turkey
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He HY, Tian JL, Deng YQ, Xiong X, Xu Y, Liao YM, Fang J, Feng X, Ye X, Li CQ. Association of brain-derived neurotrophic factor levels and depressive symptoms in young adults with acne vulgaris. BMC Psychiatry 2019; 19:193. [PMID: 31234814 PMCID: PMC6591989 DOI: 10.1186/s12888-019-2182-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 06/13/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is one of the proteins that contributes to the survival, growth, maintenance of neurons, and plays important roles in the pathophysiology of depression. It has been reported that depression is closely associated with the pathogenesis of acne vulgaris disease. But, there is no report of serum BDNF levels in patients with acne vulgaris. The study aimed to determine the potential association between BDNF and depressive symptoms in young adults with acne vulgaris. METHODS In this analytical cross-sectional study, the serum BDNF levels were measured in peripheral blood samples of 20 consecutive acne vulgaris patients with depression and 98 consecutive acne vulgaris patients without depression and also compared it with a 59 healthy control group by using a ELISA. The potential correlation between the BDNF levels, interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), and depressive symptoms such as nine-item patient health questionnaire (PHQ-9) and Athens insomnia scale (AIS) were evaluated with multivariate logistic regression analysis. RESULTS Our results showed that levels of BDNF expression were lower in consecutive acne vulgaris patients when compared with healthy control (P < 0.05). There was a negative correlation between levels of BDNF and the PHQ-9 scores (r = - 0.486, P < 0.001). Furthermore, acne vulgaris patients with depression showed lower serum BDNF levels (10.96 ± 2.12 ng/ml) compared with acne vulgaris patients without depression (13.85 ± 2.47 ng/ml), as well as with healthy control (14.35 ± 2.70 ng/mg; both P < 0.05). No difference was found in serum BDNF levels between healthy control and acne vulgaris patients without depressive symptoms (z = 0.964, P > 0.05). Similarly, the overall area under the curve of receiver operating characteristic was 0.82, indicating the highly conserving of serum BDNF levels as an biomarker for screening of depression in young adults with acne vulgaris (72% sensitivity and 85% specificity). CONCLUSION Serum BDNF levels were decreased and negatively associated with depressive symptoms in young Chinese adults with acne vulgaris.
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Affiliation(s)
- Hong-yi He
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Jin-lan Tian
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Yong-qiong Deng
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Xia Xiong
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Yang Xu
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Yong-mei Liao
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Jing Fang
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Xia Feng
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Xin Ye
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
| | - Chang-qiang Li
- grid.488387.8Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000 People’s Republic of China
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Al Qahtani NA, Deepthi A, Alhussain NM, Al Shahrani BAM, Alshehri H, Alhefzi A, Joseph B. Association of geographic tongue and fissured tongue with ABO blood group among adult psoriasis patients: a novel study from a tertiary care hospital in Saudi Arabia. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:490-497. [PMID: 30902460 DOI: 10.1016/j.oooo.2019.01.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/11/2019] [Accepted: 01/16/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE We aimed to determine if there was any association between geographic tongue (GT) and fissured tongue with ABO blood group among adult psoriasis patients in Saudi Arabia. STUDY DESIGN This hospital-based cross-sectional study included 100 consecutive new adult patients diagnosed with psoriasis and 100 case-matched participants in the control group (nonpsoriatic). Sociodemographic and dermatologic parameters, intraoral lesions (GT and fissured tongue), and ABO blood grouping and immunoglobulins were recorded and evaluated using χ2 or Fisher's exact test. RESULTS A total of 74% of patients had an early age of onset, and 48% of them reported this disease in their parents. A total of 76% of those with generalized psoriasis had plaque type, whereas 78% with the localized type had pustular lesions. A total of 70% of psoriatic patients had O Rh-positive blood; 63% of tongue lesions seen in these patients were GT, and it was most prominent in O Rh-positive (64.28%) and O Rh-negative (62.50%) blood types. GT was prevalent among women (75.6%). CONCLUSIONS This study found a positive association of both GT and fissured tongue in this population of adult patients with psoriasis compared with a case-matched control population without psoriasis.
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Affiliation(s)
- Nabeeh A Al Qahtani
- Associate Professor, Department of Periodontics and Community Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia.
| | - Angeline Deepthi
- Assistant Professor, Division of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia; Professor and Head, Department of Oral Medicine and Radiology, Rajas Dental College and Hospital, Tamil Nadu Dr. M.G.R Medical University, Chennai, India
| | - Nada Mohammed Alhussain
- Resident, Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | | | - Hamza Alshehri
- Consultant, Department of Dermatology, Aseer Central Hospital, Abha. Kingdom of Saudi Arabia
| | - Amal Alhefzi
- Resident, Department of Family Medicine, Aseer Central Hospital, Abha, Kingdom of Saudi Arabia
| | - Betsy Joseph
- Assistant Professor, Department of Periodontics and Community Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
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Ermis E, Celik SK, Solak N, Genc GC, Dursun A. The role of GNLY gene polymorphisms in psoriasis pathogenesis. An Bras Dermatol 2019; 94:198-203. [PMID: 31090825 PMCID: PMC6486070 DOI: 10.1590/abd1806-4841.20198188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/01/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Psoriasis is a systemic inflammatory disorder that involves complex pathogenic interactions between the innate and adaptive immune systems. The most accepted mechanism in the etiopathogenesis of psoriasis is the induction of inflammation with keratinocyte hyperproliferation. Granulysin (GNLY) is a cytolytic antimicrobial peptide (AMP) that is secreted together with granzyme and perforin from the granules of human cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells. It has been immunohistochemically proven that the expression of granulysin is increased in lesions of psoriasis. OBJECTIVE This study aimed to investigate the relationship between psoriasis disease and granulysin gene polymorphisms. METHODS GNLY rs7908 and rs10180391 polymorphisms were studied by PCR-RFLP in 100 psoriasis patients under treatment in the Dermatology Polyclinic of Bulent Ecevit University. In addition, 100 healthy individuals with similar age and sex distribution were used as a control group. RESULTS In the control group, GNLY rs7908 CC genotype was significantly higher than in psoriasis patients (P= 0.031; OR= 0.305; Cl= 0.305 (0.121 - 0.773). In our study, the genotype distributions in patients and control groups were GNLY rs7908 (SNP) GG (51%, 37%), GC (41%, 44%), CC (8%, 19%); GNLY rs10180391 (SNP) from the CC (41%, 44%), CT (42%, % 41), TT (17%, 15%). STUDY LIMITATIONS The study only included Turkish patients. CONCLUSION Our findings showed that GNLY rs7908 CC genotype and C allele had a protective effect against psoriasis and decreased the disease severity (according to PASI score), whereas rs10180391 SNP did not show any effective role in psoriasis pathogenesis.
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Affiliation(s)
- Esra Ermis
- Department of Molecular Biology and Genetics, Faculty of
Sciences and Arts, Bulent Ecevit University, Zonguldak, Turkey
| | - Sevim Karakas Celik
- Department of Molecular Biology and Genetics, Faculty of
Sciences and Arts, Bulent Ecevit University, Zonguldak, Turkey
| | - Nilgun Solak
- Department of Dermatology, Faculty of Medicine, Bulent
Ecevit University, Zonguldak, Turkey
| | - Gunes Cakmak Genc
- Department of Medical Genetics, Faculty of Medicine,
Bulent Ecevit University, Zonguldak, Turkey
| | - Ahmet Dursun
- Department of Medical Genetics, Faculty of Medicine,
Bulent Ecevit University, Zonguldak, Turkey
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High prevalence of erectile dysfunction in men with psoriasis: evidence from a systematic review and meta-analysis. Int J Impot Res 2018; 31:74-84. [DOI: 10.1038/s41443-018-0093-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/25/2018] [Accepted: 10/15/2018] [Indexed: 02/06/2023]
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Versteegh JJ, Dulfer K, Stuvel K, Pasmans SG, Utens EM. Netherton syndrome; neuropsychological and psychosocial functioning of child and adult patients and their parents. J Health Psychol 2018; 25:2296-2316. [PMID: 30129381 PMCID: PMC7583452 DOI: 10.1177/1359105318790052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Netherton syndrome is a rare severe skin disease. Clinical experience showed considerable psychosocial burdens among Netherton syndrome patients/families. Their (neuro)psychological functioning has never been investigated. Objective: To investigate neuropsychological/psychosocial functioning of Netherton syndrome patients and parents. Methods: A total of 12 Netherton syndrome patients and/or parents completed neuropsychological tests, semi-structured-interviews, and psychological-questionnaires. Results: Intelligence results showed disharmonic profiles, with below-average scores on processing speed. Neuropsychological problems and unfavorable outcomes on health-related quality of life, illness-appearance-related problems, and negative social consequences among patients/parents were found. Psychopathological (emotional) problems were reported; stigmatization, bullying was common among Netherton syndrome patients. Conclusion: Compared with normative data, Netherton syndrome patients showed neuropsychological and psychosocial problems. Standard follow-up is necessary to identify problems at early stage.
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Affiliation(s)
| | - Karolijn Dulfer
- Erasmus University Medical Center-Sophia Children's Hospital, The Netherlands
| | - Kira Stuvel
- Erasmus University Medical Center-Sophia Children's Hospital, The Netherlands
| | - Suzanne Gma Pasmans
- Erasmus University Medical Center-Sophia Children's Hospital, The Netherlands
| | - Elisabeth Mwj Utens
- Erasmus University Medical Center-Sophia Children's Hospital, The Netherlands.,University of Amsterdam, The Netherlands.,The Bascule - Academic Center for Child Psychiatry, The Netherlands.,Academic Medical Center, The Netherlands
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Ho P, Lin I, Yang X, Cho Y, Chu C. Using a novel scoring system for paronychia related to oncologic treatments (SPOT) for assessing paronychia severity and its correlation with pain index and quality of life. J Eur Acad Dermatol Venereol 2018; 33:204-212. [DOI: 10.1111/jdv.15121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 06/06/2018] [Indexed: 11/27/2022]
Affiliation(s)
- P.‐H. Ho
- Department of Dermatology National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - I.‐C. Lin
- Department of Dermatology National Cheng Kung University Hospital Tainan Taiwan
| | - X. Yang
- Department of Pharmacology Koo Foundation Sun Yat‐Sen Cancer Center Taipei Taiwan
| | - Y.‐T. Cho
- Department of Dermatology National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - C.‐Y. Chu
- Department of Dermatology National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
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