Quality of life affected more by psycho-cognitive factors than disease severity

Key takeaways:

• Emotional representation of disease, anxiety and negative social comparison highly correlated with impaired quality of life, whereas disease severity did not.
• Multivariable regression confirmed these findings.

NEW ORLEANS — In an analysis of psoriasis and eczema patients, psycho-cognitive factors proved to impact quality of life more than objective disease severity.

“Treatment options and recommendations for many inflammatory dermatoses are based primarily upon objective assessments of disease severity,” Ellie Choi, MBBS, MRCP, of the division of dermatology in the department of medicine at the National University Hospital in Singapore, and colleagues wrote in a poster presentation at the American Academy of Dermatology Annual Meeting. “This cross sectional study aims to determine the relative importance of psycho-cognitive and objective factors in influencing quality of life (QoL) impairment.”

In this interim secondary analysis, 578 outpatient adults with psoriasis (n = 153) and eczema (n = 415) were included from two tertiary dermatological centers in Singapore. Patients completed assessments with dermatologists as well as self-administered questionnaires.

Mean body surface area involvement was 7.3% (standard deviation [SD], 12.4%) for eczema and 7.1% (SD, 9.4%) for psoriasis patients. The mean Skindex-16 score, which measures QoL, was 55.5% (SD, 26.7%) across groups.

Results showed that the highest correlations to poorer QoL were emotional representation of disease (correlation coefficient [r] = 0.6), anxiety (r = 0.5) and negative social comparison (r = 0.41). Objective disease severity, as determined by body surface area involvement, IGA scores and PGA scores, had a weaker correlation (r = 0.24).

According to the researchers, multivariable regression confirmed that anxiety and negative social comparison were the top indicators for QoL impairment followed by cyclical disease course, lack of treatment control, lack of illness coherence, having eczema vs. psoriasis, and increased objective disease severity.

“Psychosocial factors explain why patients with the same observed disease state can have widely varying symptom burden,” the authors said. “This highlights the potential role of psychological interventions in moderating the QoL impairment of skin disease.”