Association of psoriasis severity degree with self-esteem, depression and dermatology life quality index
Keywords:
Psoriasis Vulgaris, PASI Score, Self Esteem, Depression, DLQI, Dermatology Life Quality IndexAbstract
Background Psoriasis is a chronic inflammatory skin disease that affects physical health as well as self-esteem, depression, and quality of life. Objective We aimed to evaluate the association of psoriasis severity with self-esteem, depression, and dermatology life of quality index (DLQI) on outpatient and inpatient unit at Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia. Materials and Methods This study included 37 patients that fulfilled the inclusion and denied exclusion criteria. Sociodemographic characteristics of the patients were assessed, the Psoriasis Area Severity Index (PASI) were scored to determine psoriasis severity, as well as self-esteem (Rosenberg Self-Esteem Scale), depression (Hamilton Rating Scale for Depression), and Dermatology Life Quality Index. Results Our study showed there were no subjects with high self esteem, 73% subjects had standard self esteem, 27% subjects had low self esteem, and there was a significant negative association between psoriasis severity with self-esteem (p=0,035, r=-0,215). Eighty nine point one percent of patients got depression (35.1% mild depression; 27% moderate depression; 16.2% severe depression, and 10.8% very severe depression. Positive association between psoriasis severity with depression degree, however, was not statistically significant (p=0,107, r=0,124). Ninety seven point two percent patients got impaired DLQI. Positive association between psoriasis severity with DLQI, however, was not statistically significant (p=0,315, r=0,256). Conclusion Psoriasis is associated with low self-esteem, depression, and decrease in DLQI, although not statistically significant association between psoriasis severity (PASI) with depression and DLQI. Therefore, comprehensive treatment with psychiatrist for psoriasis patients is recommended. All patients with psoriasis without regards to its severity have to be screened for self-esteem, depression, and QOL. It is necessary to assess patients with low psoriasis severity to psychiatrist.References
Gudjonsson, JE Elder J. Psoriasis. In: Wolff, Klaus Goldsmith, LA Katz S, editor. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York: McGraw Hill; 2013. p. 197–231.
WHO. Global Report on Psoriasis. WHO Library Cataloguing-in-Publication data. Switzerland; 2017.
Boham, MP Suling, PL Pandaleke H. Profil psoriasis di poliklinik kulit dan kelamin RSUP Prof.Dr. R. D. Kandoi Manado periode Januari 2013- Desember 2015. J e-Clinic. 2016;4(2):24–8.
U AA V, Thaha A, Devi M. Angka Kejadian Psoriasis Vulgaris di Poliklinik Ilmu Kesehatan Kulit dan Kelamin RSUP dr . Mohammad Hoesin Palembang Periode Agustus 2008 – Juni 2012. 2014;(4):253–8.
Karimi M, Brazier J. Health, Health-Related Quality of Life, and Quality of Life: What is the Difference? Pharmacoeconomics. 2016;34(7):645–9.
Garcia-Sanchez L, Montiel-Jarquin AJ, Vazquez-Cruz E, May-Salazar A, Gutierrez-Gabriel I, Loria-Castellanoso J. [Quality of life in patients with psoriasis]. Gac Med Mex. 2017;153(2):185–9.
Baumeister, R. F., Campbell, J. D., Krueger, J. I., & Vohs KD. Rosenberg Self-Esteem Scale. New York. 1965;?
Boehncke W-H. Etiology and Pathogenesis of Psoriasis. Rheum Dis Clin North Am [Internet]. 2015;41(4):665–75. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0889857X15000642
Engler D, Pharmacology B, Pharmacy MC. No Title. 2017;84(5):38–42.
Kojanova M, Fialova J, Cetkovska P, Gkalpakiotis S, Jircikova J, Dolezal T, et al. Characteristics and risk profile of psoriasis patients included in the Czech national registry BIOREP and a comparison with other registries. Int J Dermatol. 2017;56(4):428–34.
Parisi R, Symmons DPM, Griffiths CEM, Ashcroft DM. Global epidemiology of psoriasis: A systematic review of incidence and prevalence. J Invest Dermatol [Internet]. 2013;133(2):377–85. Available from: http://dx.doi.org/10.1038/jid.2012.339
Gurer, MA Adisen E. Psoriasis, Genel Bilgiler, Epidemiyoloji. J Am Acad Dermatol. 2015;72:599–605.
Ginsburg, IH Link B. Feeling of stigmatization in patients with psoriasis. J Am Acad Dermatol. 1989;20:53–63.
Ermertcan A, Bilac D, Deveci A, Horasan G, Bilac C. The relationship between symptoms and patient characteristics among psoriasis patients. Indian J Dermatol Venereol Leprol [Internet]. 2009;75(5):551. Available from: http://www.ijdvl.com/text.asp?2009/75/5/551/55426
Moon, HS Mizara, A McBride S. Psoriasis and Psycho-dermatology. Dermatol Ther. 2013;3(2):117–30.
Leah, SS Carolyn, SD Elizabeth L. Education level, income level and mental health services use in Canada: associations and policy implications. Heal Policy. 2007;3(1):96–106.
Ustundag, H Demir, N Zengin N. Stomali Hastalarda beden imaji ve Benlik. Saygisi Turkiye Klin J Med Sci. 2007;27:522–7.
Kim, WH Cho, YS Yoo H. Quality of life in korean patients with inflammatory bowel diseases: ulcerative colitis, crohn disease and intestinal Behcet’s disease. Int J Color Dis. 1999;14:52–7.
Lorant V. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003;157:98–112.
Song HJ, Park CJ, Kim TY, Choe YB, Lee SJ, Kim NI, et al. The clinical profile of patients with psoriasis in Korea: A nationwide cross-sectional study (EPI-PSODE). Ann Dermatol. 2017;29(4):462–70.
Pakran, J Riyaz, N Nandakumar G. Determinants of quality of life in psoriasis patients: a cluster analysis of 50 patients. Indian J Dermatol. 2011;56(6):689–93.
Lee, YW Park, EJ Kwon I. Impact of psoriasis on quality of life: relationship between clinical response to therapy and change in healthrelated quality of life. Ann Dermatol. 2010;22(4):389–96.
Gelfand, JM Feldman, SR Stern R. Determinants of quality of life in patients with psoriasis: a study from the US population. J Am Acad Dermatol. 2004;51:704–8.
Monali, JB Amit, K Steven R. Quality of life in patietns with psoriasis. Heal Qual Life Outcomes. 2006;4:35.
Schwandt, A Bergis, D Dapp A. Psoriasis and Diabetes: a Multicenter Study in 222078 Type 2 Diabetes Patients Reveals High Levels of Depression. J Diabetes Res. 2015;(10):1–10.
Gyldenlove, M Storgaard, H Holst J. Patients with psoriasis are insulin resistant. J Am Acad Dermatol. 2015;72:599–605.
Ip, W Kirchhof M. Glycemic control in the treatment of psoriasis. Dermatology. 2017;233:23–9.
Singh, S Bhansali A. Randomized placebo control study of insulin sensitizers (Metformin and Pioglitazone) in psoriasis patients with metabolic syndrome (Topical Treatment Cohort). BMC Dermatol. 2016;16:12.
Wu, S Li, WQ Han J. Hypercholesterolemia and risko of incident psoriasis and psoriatic arthritis in US women. Arthritis Rheumatol. 2014;66:304–10.
Yilmaz E, Tamer E, Artüz F, Külcü Çakmak S, Köktürk F. Evaluation of serum uric acid levels in psoriasis vulgaris. Turkish J Med Sci. 2017;47(2):531–4.
Xin, L Xiao, M Hongshen W. association of serum uric acid levels in psoriasis. Med. 2016;95(19).
Vasili E, Vargu M, Burazeri G, Hysa K, Cano E, Bezati B. Psoriasis and Diabetes. In: Inflammatory Diseases - Immunopathology, Clinical and Pharmacological Bases [Internet]. InTech; 2012. Available from: http://www.intechopen.com/books/inflammatory-diseases-
immunopathology-clinical-and-pharmacological-bases/psoriasis-and-diabetes
Cohen, AD Weitzman, D Dreiher J. Psoriasis and hypertension: a case-control study. Acta Derm Venereol. 2010;(90):23–6.
Armstrong, AW Harskamp, CT Armstrong E. the association between psoriasis and hypertension: a systemic review and meta-analysis of observational studies. J Hypertens. 2013;31:433–42.
Takeshita, J Wang, S Shin D. Effect of psoriasis severity on hypertension control. A population-based study in the United Kingdom. JAMA Dermatol. 2015;151:161–9.
Kimball AB, Guerin A, Latremouille-Viau D, Yu AP, Gupta S, Bao Y, et al. Coronary Heart Disease and Stroke Risk in Patients with Psoriasis: Retrospective Analysis. Am J Med [Internet]. 2010;123(4):350–7. Available from: http://dx.doi.org/10.1016/j.amjmed.2009.08.022
Xu, T Zhang Y. Association of psoriasis with stroke and myocardial infarction: meta-analysis of cohort studies. Br J Dermatol. 2012;167(6):1345–50.
Karne, PP Pawar, SM Bargale A. Study of lipid profile in psoriasis patients. IJCBR. 2015;2(1):1–4.
Wu, CY Shieh, JJ Liu Y. Association between antidiabetic drugs and psoriasis risk in diabetic patients: results from a nationwide nested case controlstudy in Taiwan. J Am Acad Dermatol. 2014;72:123–30.
Cohen, AD Dreiher, J Shapiro, Y Vidavsky, L Vardy, DA Davidovici, B Meyerovitch J. Psoriasis and diabetes: a population based cross-sectional study 2008. J Eur Acad Dermatol Venerol. 2008;22(5):585–9.
Sivanesan AR, Daniel SJ. A Study of Psychiatric Morbidity Among Patients with Early-onset Psoriasis. Int J Sci Study. 2017;5(3):108–14.
Wahl AK, Robinson HS, Langeland E, Larsen MH, Krogstad AL, Moum T. Clinical characteristics associated with illness perception in psoriasis. Acta Derm Venereol. 2014;94(3):271–5.
Kurd, SK Troxel, AB Crits-Christoph P. The risk of depression, anxiety and suicidality in patients with psoriasis: A population-based cohort study. Arch Dermatol. 2010;146(8):891–5.
Sivanesan, AR Daniel S. A study of psychiatric morbidity among patients with early-onset psoriasis. IJSS. 2017;5(3):108–13.
Korman AM, Hill D, Alikhan A, Feldman SR. Impact and management of depression in psoriasis patients. Expert Opin Pharmacother [Internet]. 2016;17(2):147–52. Available from: http://www.tandfonline.com/doi/full/10.1517/14656566.2016.1128894
Ahmed, HU Mohammad, DH Afzal A. Suicide and depression in the World Health Organization South-East Asia Region: A systematic Review. WHO South East Asia J Public Heal. 2017;6(1):60–6.
Lakuta, P Basista H. Toward a better understanding of social anxiety and depression in psoriasis patients: The role of determinants, mediators and moderators. J Psychosom Res. 2017;(94):32–8.
Khawaja AR, Bokhari SMA, Rasheed T, Shahzad A, Hanif M, Qadeer F, et al. Disease Severity, Quality of Life, and Psychiatric Morbidity in Patients With Psoriasis With Reference to Sociodemographic, Lifestyle, and Clinical Variables. Prim Care Companion CNS Disord [Internet]. 2015;17(3):1–17. Available from: http://www.psychiatrist.com/PCC/article/Pages/2015/v17n03/14m01629.aspx
Heydendael VMR, De Borgie CAJM, Spuls PI, Bossuyt PMM, Bos JD, De Rie MA. The burden of psoriasis is not determined by disease severity only. J Investig Dermatology Symp Proc [Internet]. 2004;9(2):131–5. Available from: http://dx.doi.org/10.1111/j.1087-0024.2004.09115.x
Raddadi A Al, Jfri A, Samarghandi S, Matury N, Habibullah T, Alfarshoti M, et al. Psoriasis: Correlation between severity index (PASI) and quality of life index (DLQI) based on the type of treatment. J Dermatology Dermatologic Surg [Internet]. 2016;20(1):15–8. Available from: http://linkinghub.elsevier.com/retrieve/pii/S2352241015000456
Bhosle, MJ Kulkarni, A Feldman S. Quality of life in Patients with Psoriasis. Heal Qual Life Outcomes. 2006;4(35):1–7.
Nazik, H Nazik, S Gul F. Body Image, Self esteem and Quality of Life in Patients with Psoriasis. Indian Dermatol Online J. 2017;8(5):343–6.
Owczarek K, Jaworski M. Quality of life and severity of skin changes in the dynamics of Psoriasis. Postep Dermatologii i Alergol. 2016;33(2):102–8.
Mattei PL, Corey KC, Kimball AB. Psoriasis Area Severity Index (PASI) and the Dermatology Life Quality Index (DLQI): The correlation between disease severity and psychological burden in patients treated with biological therapies. J Eur Acad Dermatology Venereol. 2014;28(3):333–7.
Pujol RM, Puig L, Daudén E, Sánchez-Carazo JL, Toribio J, Vanaclocha F, et al. Mental health self-assessment in patients with moderate to severe psoriasis: An observational, multicenter study of 1164 patients in Spain (The VACAP study). Actas Dermosifiliogr [Internet]. 2013;104(10):897–903. Available from: http://dx.doi.org/10.1016/j.ad.2013.04.014
Judtih, AB Friedrich A. Psoriasis, Addiction, and personality. Arch Dermatol. 2011;147(8):988.
Kabat-Zinn J, Wheeler E, Light T, Skillings A, Scharf MJ, Cropley TG, et al. Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosom Med. 1998;60(5):625–32.
Fortune DG, Richards HL, Kirby B, Bowcock S, Main CJ, Griffiths CEM. A cognitive-behavioural symptom management programme as an adjunct in psoriasis therapy. Br J Dermatol. 2002;146(3):458–65.
