Happiness and depression in psoriasis: a cross-sectional study in Germany

Abstract

Purpose Prior research on the psychological consequences of skin diseases has focused on assessing mental comorbidities. The aim of this study was to investigate subjective well-being in a large sample of individuals affected by psoriasis, a chronic inflammatory skin disease, and to explore the associations with depression and disease-related parameters such as disease severity. Methods A cross-sectional online survey was conducted from March to June 2019. The link to the questionnaire was shared on websites and Facebook pages of psoriasis patient organizations and campaigns. Participants filled in validated scales measuring subjective well-being—operationalized as positive affect (PA), negative affect (NA) and satisfaction with life (SWL); and depression. Results The data of 722 participants were analyzed. Exploratory factor analysis supported the differentiation of PA, NA, SWL, and depression as four different constructs. The respondents reported lower levels of PA than healthy individuals and judged themselves to be less happy and were less satisfied with their lives than the general population (except age group 65 + years). 40.3% of respondents were screened positive for depression. More severe psoriasis was associated with lower affective well-being and a higher risk for depression. Conclusion The results of this study empirically supported the differentiation of subjective well-being and depression as different constructs in individuals with psoriasis, and underline the large mental burden of the disease which goes beyond a higher risk for depression. Measures of well-being should thus be incorporated in both research and clinical practice in patients with psoriasis in order to achieve a more comprehensive picture of the mental burden of this disease.

The Impact of Psoriasis and Atopic Dermatitis on Quality of Life: A Literature Research on Biomarkers

“…Controversial results are available regarding the association between age, disease duration, age of onset and QoL as well as SWL in psoriatic patients [89][90][91][92]97,98,[106][107][108]. For example, some studies reported greater QoL impairment in younger individuals [90,106], while one study [89] reported higher SWL and better QoL in the youngest patients (18-30 years) and still others found no age differences [91,92,98].…”

“…Based on DLQI but also various patient reported outcomes of interest, including SWLS and happiness, a significant association has been demonstrated between increasing AD severity, disease extent, eczema sites and impaired QoL, particularly social functioning and mental health [99,100,[102][103][104][105]107,[111][112][113]. Studies for PSO provide inconclusive results regarding the association between disease severity and QoL [90,96,98,106,108,[114][115][116][117][118].…”

Sociodemographic, clinical and therapeutic factors as predictors of life quality impairment in psoriasis: A cross‐sectional study in Italy

“…Psoriasis is a chronic inflammatory skin disease showing a high burden due to its aesthetic, social, psychological, and quality of life (QoL) implications which also affect patient‐physician relationship and, consequently, the adherence to treatments 1,2 . Indeed, it has been previously reported that psoriasis is associated with a higher risk of anxiety, depression, and a negative impact on patients' well‐being limiting the ability to engage in daily life or recreational activities 3–6 . Moreover, the disease has been shown to exert a significant influence on various aspects of patients' lives including their careers, incomes, relationships, and physical intimacy 7 .…”

“…1,2 Indeed, it has been previously reported that psoriasis is associated with a higher risk of anxiety, depression, and a negative impact on patients' well-being limiting the ability to engage in daily life or recreational activities. [3][4][5][6] Moreover, the disease has been shown to exert a significant influence on various aspects of patients' lives including their careers, incomes, relationships, and physical intimacy. 7 Currently we have only limited data on the natural history of psoriasis and factors predicting its prognosis.…”

How important is subjective well-being for patients? A qualitative interview study of people with psoriasis

“…Measuring affective SWB in addition to HRQoL may provide valuable insights of the subjective full life impact of a disease. Schuster and colleagues showed that both affective and cognitive SWB are reduced in psoriatic patients, while lower levels of affective well-being indicate a higher risk for depression [ 30 , 31 ]. Reimus and colleagues revealed that SWB and dermatologists assessment of illness severity are not related [ 10 ].…”