The contribution of perceptions of stigmatisation to disability in patients with psoriasis

Objective: The aim of the present study was to assess the significance of g eneral and psoriasis specific psychological variables in patients with psor iasis and to examine the relative importance of disease status and these ps ychological variables in predicting psoriasis-related disability. Method: A total of 115 patients with psoriasis underwent clinical assessment and com pleted a number of psychological and psoriasis specific questionnaires. Res ults: High levels of self-reported distress were identified with 43% and 10 % of patients scoring as probable cases on the Hospital Anxiety and Depress ion Scale (HADS) subscales of anxiety (mean 9.3 +/- 4.9) and depression (me an 4.8 +/- 3.7), respectively. Multiple regression analysis indicated that clinical severity of psoriasis and anatomical area of involvement had no im pact on psychological distress and disability. Perceptions of stigmatisatio n were significantly related to both psychological distress and degree of d isability (P's<.001) and accounted for a significant amount of the variance in disability over and above general psychological distress (F change = 11 .03; P<.001). Conclusion: Psychological factors were much stronger determin ants of disability in patients with psoriasis than disease severity, locati on or duration. This has important implications in relation to the clinical management of psoriasis. (C) 2001 Elsevier Science Inc. All rights reserve d.