Stress and Quality of Life in Psoriasis

R. Kaur, Sunita Sharma, K. Das, T. Narang
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Abstract

Introduction Psoriasis is a common dermatological disorder characterized by silvery-white, scaly, and erythematous plaques with or without pruritus. It is an immensely stressful condition, hampering the quality of life with significant psychological morbidity. Objective To assess the level of stress and quality of life among the patients with psoriasis. Methods A nonexperimental descriptive study design was used. Sixty participants were enrolled from Dermatology OPD, PGIMER, Chandigarh, by a purposive sampling technique during October to January 2021. An interview schedule, comprising (a) sociodemographic and clinical profile, (b) Perceived Stress Scale (PSS), (c) Patient Health Questionnaire-4 to assess anxiety (PHQ-4), (d) Patient Health Questionnaire-9 to assess depression (PHQ-9), (e) Patient Global Assessment (PtGA) Scale to assess severity of illness (PtGA), and (f) Dermatology Life Quality Index (DLQI), was used for data collection. Data were collected by a telephonic interview as per the interview schedule. At the end of the interview, patients were asked to send the pictures of affected body parts, which were then assessed by the dermatologist using the Investigator’s Global Assessment (IGA) Scale. Data analysis was done with descriptive and inferential statistics using the Statistical Package for Social Sciences (SPSS version 23). Results Most of (86.7%) the participants reported a moderate level of stress (PSS) and 65% described moderate effect on the quality of life. The assessment of the severity of illness on IGA depicted that 36.7% of participants had mild, 28.3% had moderate, and 26.7% had severe psoriasis. Mild to moderate depression (PHQ-9) was screened in about 25% of the participants. A significant correlation was found between stress, quality of life, anxiety, and depression (<0.001). The severity of psoriasis was significantly correlated with quality of life, anxiety, and depression. Conclusion The study results concluded that the presence of a significant level of stress has a considerable effect on the quality of life among the patients with psoriasis. Thus, it is recommended to assess and address the psychological issues along with medical management for the comprehensive management of patients with psoriasis.
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牛皮癣患者的压力与生活质量
银屑病是一种常见的皮肤病,其特征是银白色、鳞状、红斑斑块伴或不伴瘙痒。这是一个巨大的压力条件,阻碍生活质量与显著的心理疾病。目的了解银屑病患者的应激水平和生活质量。方法采用非实验描述性研究设计。在2021年10月至1月期间,通过有目的的抽样技术,从昌迪加尔的PGIMER皮肤科OPD招募了60名参与者。访谈时间表包括(a)社会人口学和临床概况,(b)感知压力量表(PSS), (c)患者健康问卷-4评估焦虑(PHQ-4), (d)患者健康问卷-9评估抑郁(PHQ-9), (e)患者整体评估(PtGA)量表评估疾病严重程度(PtGA), (f)皮肤病生活质量指数(DLQI),用于数据收集。根据访谈时间表,采用电话访谈的方式收集数据。在访谈结束时,患者被要求发送受影响身体部位的照片,然后由皮肤科医生使用研究者的整体评估(IGA)量表进行评估。数据分析使用社会科学统计软件包(SPSS version 23)进行描述性和推断性统计。结果大多数(86.7%)的参与者报告了中等水平的压力(PSS), 65%的参与者描述了对生活质量的中等影响。IGA对疾病严重程度的评估显示,36.7%的参与者患有轻度牛皮癣,28.3%患有中度牛皮癣,26.7%患有重度牛皮癣。在大约25%的参与者中筛选了轻度至中度抑郁症(PHQ-9)。压力、生活质量、焦虑和抑郁之间存在显著相关性(<0.001)。牛皮癣的严重程度与生活质量、焦虑和抑郁显著相关。结论压力的存在对银屑病患者的生活质量有相当大的影响。因此,建议在医疗管理的同时评估和解决心理问题,以实现银屑病患者的综合管理。
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