Quality of life and contact with healthcare systems among patients with psoriasis and psoriatic arthritis: results from the NORdic PAtient survey of Psoriasis and Psoriatic arthritis (NORPAPP)

Duvetorp, Albert; Østergaard, Mikkel; Skov, Lone; Seifert, Oliver; Tveit, Kåre Steinar; Danielsen, Kjersti; Iversen, Lars

doi:10.1007/s00403-019-01906-z

Cited by 33 publications

(29 citation statements)

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“…In our study, 33% of the PsA patients reported to be moderately anxious or depressed whereas only 5% reported to be extremely anxious or depressed. In a Nordic survey, 16.2% of the PsO and 34.9% of the PsA patients reported feelings of anxiety and depression [21]. In a recently published systematic review article of mental health in PsA including 24 studies, the authors concluded that anxiety and depression are highly prevalent among PsA patients [43].…”

Section: Discussionmentioning

confidence: 99%

“…Sleep impairment has been reported to be more severe in PsA patients than in PsO patients [ 19 , 20 ]. In a Nordic survey, sleep disturbances were reported by 16% of patients with PsO but by 45% of patients with PsA [ 21 ]. In our study, the prevalence of PsA patients reporting sleep disturbances was 38% (defined by ≥ 5 on a 0–10 NRS).…”

Section: Discussionmentioning

confidence: 99%

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Psoriatic arthritis: exploring the occurrence of sleep disturbances, fatigue, and depression and their correlates

2020

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Introduction: Sleep disturbances, fatigue, and anxiety/depression in psoriatic arthritis (PsA) may be influenced by skin and musculoskeletal manifestations. All of these in turn affect the psychosocial impact of disease. The objective was to explore the occurrence of sleep disturbances, fatigue, and anxiety/depression in psoriatic arthritis (PsA) patients, and their correlates. Methods: A broad data collection was performed in 137 Norwegian PsA outpatient clinic patients including demographics, disease activity measures for both skin and musculoskeletal involvement, and patient-reported outcome measures. Sleep disturbances and fatigue were defined present if the numeric rating scale (0-10) score was ≥ 5. Anxiety/depression was assessed using a questionnaire (1-3; 1 defined as no anxiety/depression). Descriptive statistics was applied, and associations were explored using univariate and adjusted linear regression analysis. Results: The mean age was 52.3 years, PsA disease duration 8.8 years; 49.6% were men and 54.8% were currently employed/working. The prevalence of sleep disturbances was 38.0%, fatigue 44.5%, and anxiety/depression 38.0%. In adjusted analysis, pain, fatigue, and higher mHAQ were associated with sleep disturbances. Sleep disturbances, pain, and anxiety/depression were associated with fatigue, whereas only fatigue was associated with anxiety/ depression. Conclusions: The prevalence of sleep disturbances, fatigue, and anxiety/depression was frequently reported by PsA patients. No measures reflecting skin involvement or objective measures of musculoskeletal involvement were independently associated with sleep disturbances, fatigue, or anxiety/depression. Our data suggest that patients' perceptions of musculoskeletal involvement (pain or mHAQ) play an important role causing sleep disturbances and fatigue, whereas fatigue in PsA patients is strongly associated with anxiety/depression.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psoriatic arthritis: exploring the occurrence of sleep disturbances, fatigue, and depression and their correlates

2020

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“…Sleep disturbances, which in our study was independently associated with impaired HRQoL, have also by others been reported to be frequent in PsA patients. 24 25 In a Nordic survey study, as many as 44.5% of the PsA patients reported sleep disturbances. 24 Anxiety was also, in the recent published study by Baviere et al , found to be independently associated with impaired HRQoL.…”

Section: Discussionmentioning

confidence: 99%

“…24 25 In a Nordic survey study, as many as 44.5% of the PsA patients reported sleep disturbances. 24 Anxiety was also, in the recent published study by Baviere et al , found to be independently associated with impaired HRQoL. 26 The impact of depression and anxiety on HRQoL of life is significant as also shown in our PsA patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of skin, musculoskeletal and psychosocial aspects on quality of life in psoriatic arthritis patients: A cross-sectional study of outpatient clinic patients in the biologic treatment era

Haugeberg¹,

Michelsen²,

Kavanaugh³

2020

RMD Open

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BackgroundIn psoriatic arthritis (PsA), both psoriasis and musculoskeletal manifestations may impair Health-Related Quality of Life (HRQoL). Our objective was to explore the impact of the various disease manifestations and disease consequences, including psychosocial factors, on HRQoL in PsA patients treated in the biologic treatment era.MethodsData collection in the 131 outpatient clinic PsA patients assessed included demographics, disease activity measures for both skin and musculoskeletal involvement and patient-reported outcome (PRO) measures, treatment and psychosocial burden. The skin dimension of quality of life was assessed by the Dermatology Life Quality Index (DLQI) and the overall HRQoL by the 15-Dimensional (15D) Questionnaire.ResultsThe mean age was 51.9 years, PsA disease duration 8.6 years, 50.4% were men, 56.9% were employed/working and 47.7% had ≥1 comorbidities. Prevalence of monotherapy with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) was 36.6% and with biologic DMARDs 12.2% and combination of both 22.9%. Mean DLQI was 3.3 and 15D 0.84. In adjusted analysis, not employed/working, higher scores for fatigue, sleep disturbances, anxiety and depression, Modified Health Assessment Questionnaire and presence of comorbidities were independently associated with impaired HRQoL (lower 15D scores), whereas Psoriasis Area Severity Index (PASI) and DLQI were not. Younger age and higher Psoriatic Arthritis Disease Activity Score and PASI scores were independently associated with impaired skin quality of life (higher DLQI score).ConclusionOur study highlights the negative impact the psychosocial burden, impaired physical function and comorbidities has on reduced HRQoL in PsA outpatients. Thus, to further improve HRQoL in PsA patients, not only physical concerns but also psychological concerns need to be addressed.

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“…Anxiety in PsA patients has an independent association with quality of life, thus accentuating the need for its proper screening and management [17]. Depression was found to have a profound effect on the health-related quality of life in patients with PsA in the Nordic Patient Survey of Psoriasis and Psoriatic Arthritis (NORPAPP) [18]. A large study from the UK described an increase in deaths attributable to suicide in patients with PsA, as compared to the general population [19].…”

Section: The Consequence Of Depression/anxiety In Patients With Psorimentioning

confidence: 99%

Depression in Psoriatic Arthritis: Dimensional Aspects and Link with Systemic Inflammation

Mathew

Chandran

2020

Rheumatol Ther

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Studying comorbidities in patients with psoriatic arthritis (PsA) provides a better understanding of the extended burden of the disease. Depression and anxiety are well recognized but understudied comorbidities in patients with PsA. The prevalence of depression is significantly higher in this patient population than in the general population, with far reaching consequences in terms of long-term quality of life. Over the past few years there has been an increasing interest in the link between inflammation and depression, with several novel studies being conducted. Recent evidence suggests a significant improvement of depression in PsA patients treated with biologic disease-modifying anti-rheumatic drugs (bDMARDs) as compared to conventional DMARDs. Depression in PsA is multidimensional, with recognized phenotypes, including cognitive disorder, alexithymia and anhedonia. The paucity of standardized, validated tools to screen these dimensional phenotypes remains an unmet need. Prevalence studies on depression in patients with PsA, mostly based on patient-reported outcomes, are only able to highlight the tip of the iceberg. A comprehensive, multidisciplinary approach addressing the subdomains of depression is imperative for a better understanding of depression in PsA patients, as well as to find a way forward for improving their quality of life. In this scoping review, we explore existing evidence on the burden of depression in PsA patients, the link between inflammation and depression in these patients and the screening tools used to evaluate the subdomains of depression.

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Quality of life and contact with healthcare systems among patients with psoriasis and psoriatic arthritis: results from the NORdic PAtient survey of Psoriasis and Psoriatic arthritis (NORPAPP)

Cited by 33 publications

References 18 publications

Psoriatic arthritis: exploring the occurrence of sleep disturbances, fatigue, and depression and their correlates

Psoriatic arthritis: exploring the occurrence of sleep disturbances, fatigue, and depression and their correlates

Impact of skin, musculoskeletal and psychosocial aspects on quality of life in psoriatic arthritis patients: A cross-sectional study of outpatient clinic patients in the biologic treatment era

Depression in Psoriatic Arthritis: Dimensional Aspects and Link with Systemic Inflammation

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