Psoriasis causes as much disability as other major medical diseases

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Abstract

Little is known about how the health-related quality of life (HRQL) associated with psoriasis compares with that of other patient populations. We describe HRQL associated with psoriasis and compare it with HRQL of patients with other major chronic health conditions. A second aim is to identify which specific aspects of psoriasis contribute most to HRQL. A total of 317 patients completed a non-disease-specific measure of HRQL. Responses were compared with those of patients with 10 other chronic health conditions. HRQL was regressed on ratings of 18 aspects of psoriasis. Patients with psoriasis reported reduction in physical functioning and mental functioning comparable to that seen in cancer, arthritis, hypertension, heart disease, diabetes, and depression. Six aspects of psoriasis predicted physical functioning, and 5 different disease aspects predicted mental functioning. The impact of psoriasis on HRQL is similar to that of other major medical diseases. Different aspects of psoriasis are related to the different dimensions of HRQL supporting the need for multidimensional treatment models.

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Most cited references 20

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The Medical Outcomes Study

Alvin R Tarlov (1989)

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Suicidal ideation in psoriasis.

Ravindra K. Gupta, Erle C. Ellis, Nicholas S. Kirkby … (1993)

Psoriasis has been associated with depressive disease and case reports of completed suicide. 217 consenting psoriasis patients completed the Carroll Rating Scale for Depression (CRSD), a 52-item self-rated scale, with four of the items directly addressing wishes to be dead and suicidal ideation. The patients also self-rated the severity of their psoriasis. 9.7% of patients reported a wish to be dead, and 5.5% reported active suicidal ideation at the time of the study. The death wish and suicidal ideation were associated with higher depression scores (P < 0.0001) and higher patient self-ratings of psoriasis severity (P < 0.05). Patient self-reports of psoriasis severity correlated directly with the overall depression scores (r = 0.39), P < 0.0001). The comorbidity between depressive symptoms, suicidal ideation, and psoriasis severity is in contrast with reports that severe depression and suicidal ideation are mainly a feature of life-threatening medical disorders such as malignancies. Our finding may have important implications in the management of psoriasis.

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Validation of Sickness Impact Profile and Psoriasis Disability Index in Psoriasis.

A Y Finlay, G K Khan, D K Luscombe … (1990)

A prospective cross-sectional questionnaire study of 32 patients with psoriasis was carried out in order to validate the use of the Sickness Impact Profile (SIP) in psoriasis and compare its sensitivity with the Psoriasis Disability Index (PDI). Overall PDI scores, but not overall SIP scores, correlated well with PASI scores (P less than 0.05). There was good correlation between the PDI and overall SIP scores (P less than 0.01). Psychosocial factors are more severely impaired than physical activities in patients with psoriasis. It is now possible to directly compare the disability experienced by psoriatic patients with that experienced by patients suffering from other systemic diseases, using the SIP. The PDI is an appropriate method to give a rapid overall measure of psoriasis disability.