Korean journal of dermatology (대한피부과학회지)

Korean Dermatological Association (대한피부과학회)
권호 표지

Quality of Life in Patients with Psoriasis

건선 환자의 삶의 질

Ryu, Jeong-Ho;Kim, Kwang-Ho;Kim, Kwang-Joong;Kim, Se-Joo
류정호;김광호;김광중;김세주

  • Published : 20040300
⟨ Previous Next ⟩

Abstract

Background: Quality of life is a broad concept that incorporates all aspects of an individual's existence. Psoriasis is a chronic relapsing disease of the skin and may produce a range of quality of life impacts, as complex as those from a more debilitating and life-threatening disease. However, the association between quality of life in psoriasis patients and their clinical characteristics has not yet been investigated in Korea. Objective: The purpose of this study is to compare the quality of life in patients with psoriasis and healthy controls by using the WHO Quality of Life (QOL) Scale. This evaluates the domains of physical health, psychological health, social relationship and the environment, to assess the quality of life in patients with psoriasis by using the generic (WHOQOL) and dermatology-specific questionnaires (Skindex-29). The relationship between their quality of life and their clinical characteristics, comprising; onset, sex, age, education, duration of symptoms, severity, stress, anxiety and depression will be investigated. Methods: Seventy one patients with psoriasis and twenty nine healthy controls were recruited in this study all of whom completed the WHOQOL Scale. The total scores and the scores of the domains of the WHOQOL Scale in both groups were compared. Correlation analysis and multiple regression analysis were performed to examine the relationship between quality of life and the clinical characteristics in patients with psoriasis. Results: The total WHOQOL scores and all domain scores, except those of the environmental domain, of the WHOQOL scale in patients with psoriasis were lower than those of the healthy controls. scores for the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Psoriasis Life Stress Inventory (PLSI) were all high. The high self reported severity, long duration, high PASI score and low education levels all showed significant correlation with low QOL. Of these characteristics, the BDI, BAI, PASI, and the self reported severity showed strong association with QOL. Stepwise multiple regression analysis revealed the BDI score, PLSI score, and education level were influencing factors on QOL scores. Conclusion: The quality of life in patients with psoriasis was poorer than that of the healthy controls. The association between QOL and the self reported severity was stronger than the QOL and the PASI score. The severity of depression and stress were the most important predictors on QOL

Keywords

References

  1. Min SK, Lee CI, Kim KI, Suh SY, Kim DK. Development of korean version of WHO quality of life scale abbreviated version (WHOQOL-BREF). J Korean Neuropsychiatr Assoc 2000;39:571-579
  2. De Arruda LH, De Moraes AP. The impact of psoriasis on quality of life. Br J Dermatol 2001;144:33-36
  3. Gupta MA, Gupta AK. Quality of life of psoriasis patients. J Eur Acad Dermatol Venereol 2000;14:241-242 https://doi.org/10.1046/j.1468-3083.2000.00134.x
  4. De Korte J, Mombers FM, Sprangers MA, Bos JD. The suitability of quality-of-life questionnaires for psoriasis research: a systematic literature review. Arch Dermatol 2002;138:1221-1227 https://doi.org/10.1001/archderm.138.9.1221
  5. 한홍무, 염태호, 신영우, 김교헌, 윤도준, 정근재. Beck's Depression Inventory의 한국 표준화 연구정상집단을 중심으로. 신경정신의학 1985;24:487-502
  6. 육성필, 김중술. 한국판 Beck Anxiety Inventory의 임상적 연구 : 환자군과 비환자군의 비교. 한국심리학회지 1997;16;185-197
  7. Gupta MA, Gupta AK. The Psoriasis Life Stress Inventory: a preliminary index of psoriasis-related stress. Acta Derm Venereol 1995;75:240-243
  8. Chren MM, Lasek RJ, Flocke SA, Zyzanski SJ. Improved discriminative and evaluative capability of a refined version of Skindex, a quality-of-life instrument for patients with skin diseases. Arch Dermatol 1997;133:1433-1440 https://doi.org/10.1001/archderm.133.11.1433
  9. Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol 1999;41:401-407 https://doi.org/10.1016/S0190-9622(99)70112-X
  10. O'Neill P, Kelly P. Postal questionnaire study of disability in the community associated with psoriasis. BMJ 1996;313:919-921 https://doi.org/10.1136/bmj.313.7062.919
  11. Gupta MA, Gupta AK. Age and gender differences in the impact of psoriasis on quality of life. Int J Dermatol 1995;34:700-703 https://doi.org/10.1111/j.1365-4362.1995.tb04656.x
  12. Fortune DG, Richards HL, Main CJ, Griffiths CE. What patients with psoriasis believe about their condition. J Am Acad Dermatol 1998;39:196-201 https://doi.org/10.1016/S0190-9622(98)70074-X
  13. Kirby B, Fortune DG, Bhushan M, Chalmers RJ, Griffiths CE. The Salford Psoriasis Index: an holistic measure of psoriasis severity. Br J Dermatol 2000;142:728-732 https://doi.org/10.1046/j.1365-2133.2000.03418.x
  14. Gupta MA, Gupta AK, Kirkby S, Weiner HK, Mace TM, Schork NJ, Johnson EH, Ellis CN, Voorhees JJ. Pruritus in psoriasis. A prospective study of some psychiatric and dermatologic correlates. Arch Dermatol 1988;124:1052-1057 https://doi.org/10.1001/archderm.124.7.1052
  15. Choi J, Koo JY. Quality of life issues in psoriasis. J Am Acad Dermatol 2003:49:S57-61 https://doi.org/10.1016/S0190-9622(03)01136-8
  16. Gupta MA, Schork NJ, Gupta AK, Kirkby S, Ellis CN. Suicidal ideation in psoriasis. Int J Dermatol 1993;32:188-190 https://doi.org/10.1111/j.1365-4362.1993.tb02790.x
  17. Devrimci-Ozguven H, Kundakci TN, Kumbasar H, Boyvat A. The depression, anxiety, life satisfaction and affective expression levels in psoriasis patients. J Eur Acad Dermatol Venereol 2000;14:267-271 https://doi.org/10.1046/j.1468-3083.2000.00085.x
  18. Gupta MA, Gupta AK, Watteel GN. Perceived deprivation of social touch in psoriasis is associated with greater psychologic morbidity: an index of the stigma experience in dermatologic disorders. Cutis 1998;61:339-342
  19. Fortune DG, Main CJ, O'Sullivan TM, Griffiths CE. Quality of life in patients with psoriasis: the contribution of clinical variables and psoriasis-specific stress. Br J Dermatol 1997;137:755-760 https://doi.org/10.1111/j.1365-2133.1997.tb01113.x
  20. AI'Abadie MS, Kent GG, Gawkrodger DJ. The relationship between stress and the onset and exacerbation of psoriasis and other skin conditions. Br J Dermatol 1994;130:199-203 https://doi.org/10.1111/j.1365-2133.1994.tb02900.x
  21. Gupta MA, Gupta AK, Watteel GN. Early onset (< 40years age) psoriasis is comorbid with greater psychopathology than late onset psoriasis: a study of 137 patients. Acta Derm Venereol 1996;76:464-466
  22. Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T. The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patient-membership survey. Arch Dermatol 2001;137:280-284