Psoriasis causes as much disability as other major medical diseases.

BACKGROUND Little is known about how the health-related quality of life (HRQL) associated with psoriasis compares with that of other patient populations. OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSION 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.

[1]  S Greenfield,et al.  Detection of depressive disorder for patients receiving prepaid or fee-for-service care. Results from the Medical Outcomes Study. , 1989, JAMA.

[2]  S. Feldman,et al.  Interpersonal concerns and psychological difficulties of psoriasis patients: effects of disease severity and fear of negative evaluation. , 1998, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[3]  D. Luscombe,et al.  Validation of Sickness Impact Profile and Psoriasis Disability Index in psoriasis , 1990, The British journal of dermatology.

[4]  L. Nall.  EPIDEMIOLOGIC STRATEGIES IN PSORIASIS RESEARCH , 1994, International journal of dermatology.

[5]  Sally A. Shumaker,et al.  The international assessment of health-related quality of life : theory, translation, measurement and analysis , 1995 .

[6]  A. Shalita,et al.  Obsessive-compulsive disorder in patients with chronic pruritic conditions: case studies and discussion. , 1992, Journal of the American Academy of Dermatology.

[7]  S. Feldman,et al.  Clearance is not a realistic expectation of psoriasis treatment. , 2000, Journal of the American Academy of Dermatology.

[8]  P. Santonastaso,et al.  Life events and psychological distress in dermatologic disorders: psoriasis, chronic urticaria and fungal infections. , 1980, The British journal of medical psychology.

[9]  D. Turk,et al.  Pain and Behavioral Medicine: A Cognitive-Behavioral Perspective , 1983 .

[10]  S. Feldman,et al.  The self-administered psoriasis area and severity index is valid and reliable. , 1996, The Journal of investigative dermatology.

[11]  S. Feldman,et al.  The Physical, Psychological and Social Impact of Psoriasis , 1997, Journal of health psychology.

[12]  A. Stewart,et al.  Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. , 1989, JAMA.

[13]  A. Fleischer,et al.  Disease severity measures in a population of psoriasis patients: the symptoms of psoriasis correlate with self-administered psoriasis area severity index scores. , 1996, The Journal of investigative dermatology.

[14]  S J Zyzanski,et al.  Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. , 1996, The Journal of investigative dermatology.

[15]  William H. Rogers,et al.  Functional Status and Well-Being of Patients with Chronic Conditions , 1989 .

[16]  P. Cimbolic,et al.  Suicide and stress-related dermatoses. , 1972, Diseases of the nervous system.

[17]  R. Seville.  Psoriasis and stress * , 1977, The British journal of dermatology.

[18]  Edward B. Perrin,et al.  The Medical Outcomes Study. An application of methods for monitoring the results of medical care , 1989 .

[19]  S Jowett,et al.  Skin disease and handicap: an analysis of the impact of skin conditions. , 1985, Social science & medicine.

[20]  N. Schork,et al.  A psychocutaneous profile of psoriasis patients who are stress reactors. A study of 127 patients. , 1989, General hospital psychiatry.

[21]  N. Schork,et al.  SUICIDAL IDEATION IN PSORIASIS , 1993, International journal of dermatology.

[22]  A. Finlay,et al.  Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use , 1994, Clinical and experimental dermatology.

[23]  M. Weinstein.  Psychosocial Perspectives on Psoriasis , 1984 .

[24]  A. Menter,et al.  The annual cost of psoriasis. , 1993, Journal of the American Academy of Dermatology.

[25]  C. Lyketsos,et al.  Hostile personality characteristics, dysthymic states and neurotic symptoms in urticaria, psoriasis and alopecia. , 1985, Psychotherapy and psychosomatics.

[26]  M. Nichol,et al.  The application of multiple quality-of-life instruments in individuals with mild-to-moderate psoriasis. , 1996, PharmacoEconomics.

[27]  J. Cotterill,et al.  A Study of Depression and Obsessionality in Dysmorphophobic and Psoriatic Patients , 1982, British Journal of Psychiatry.

[28]  A. Fleischer,et al.  Patient measurement of psoriasis disease severity with a structured instrument. , 1994, The Journal of investigative dermatology.

[29]  P. Matussek,et al.  Aggression in depressives and psoriatics. , 1985, Psychotherapy and psychosomatics.

[30]  Psychiatric Symptoms in Dermatology Patients , 1983, British Journal of Psychiatry.