The Sense of Stigmatization in Patients with Plaque Psoriasis

Abstract

Background: Psoriasis is a systemic inflammatory disease capable of creating stigmatization in the form of social exclusion and decrement of psychological conditions. Aim: The aim of the study was to determine the level of stigmatization in patients with plaque psoriasis. Methods: The study included 166 patients with plaque psoriasis (55.6% women and 44.3% men) with Psoriasis Area and Severity Index scores ≤10. The age of the study patients ranged between 18 and 72 years (arithmetic mean = 37.4; median = 38; standard deviation [SD] = 11.0). The mean age at the diagnosis of psoriasis was 21.5 years (median = 20; SD = 9.1) and disease duration varied from 2 to 59 years (arithmetic mean = 15.8; median = 15; SD = 11.3). The study patients completed the Polish version of the 6-item Stigmatization Scale and the 33-item Feelings of Stigmatization Questionnaire and a survey developed by the authors of this study, containing questions about the participants’ sociodemographic characteristics (sex, age, place of residence, marital status, education, employment status) and information about their disease (location of psoriatic lesions, time elapsed since the diagnosis of psoriasis). Results: The mean score for the 6-item Stigmatization Scale for the whole study group was 7.6 out of 18 points (median = 7; SD = 3.8; minimum = 0; maximum = 17). The average score for the 33-item Stigma Feelings Questionnaire in our series was 84.5 out of 165 points (median = 88; SD = 20.9; minimum = 30; maximum = 136). A statistically significant sex-related difference was observed in the 6-item Stigmatization Scale scores, with higher stigmatization levels found in men than in women (p = 0.0082). Moreover, significantly higher levels of stigmatization were observed in countryside dwellers (p = 0.0311) and unmarried persons (p = 0.0321). Patients with a longer history of the disease (≥15 years) scored significantly higher on the 6-item Stigmatization Scale (p = 0.0217) than those in whom psoriasis lasted less long, and presented with higher, at the threshold of statistical significance, scores for the 33-item Feelings of Stigmatization Questionnaire. Conclusions: Stigmatization awareness should be promoted among physicians and psoriatic patients to improve psoriasis management.

Stigmatization in Patients With Psoriasis: A Mini Review

“…It was proved that several factors could predict the stigmatization level of patients with psoriasis, including sociodemographic variables, disease-related variables, and personality variables. Among the sociodemographic variables, gender correlated with stigmatization level in some studies (27,49), while in others not (26,34). Lower education (50), lack of professional knowledge (51), and countryside residence (52) were associated with higher levels of stigmatization, which might be secondary to inadequate understanding of psoriasis.…”

“…Several body regions were identified as ‘sensitive’, where psoriasis was associated with negative mental health. Another study included 166 patients with plaque psoriasis to determine their level of stigmatization and the association between the level of stigmatization and other factors ( 36 ). Men, countryside dwellers, unmarried persons, patients with a longer history of the disease had significantly higher stigmatization levels than women.…”

The Implication of Misinformation and Stigma in Age-Related Quality of Life, Depression, and Coping Mechanisms of Adult Patients with Psoriasis

“…A recent study showed that 51.1% of patients with psoriasis feel that society does not show tolerance for their condition, 57% of patients have received uncomfortable questions regarding their condition and 59.1% report that they have experienced discrimination because of psoriasis [ 8 ]. In another paper, approximatively 66% of patients report that they are perceived as contagious and unattractive by society at large.…”

“…Stigmatization can exacerbate negative emotions and unfavorable self-perceptions such as low self-esteem and a negative body image [ 4 , 5 ]. Stigmatization not only leads to the social exclusion of patients with psoriasis but also affects their mental status, possibly causing anxiety, anger, depression or its most serious complication, suicide [ 6 , 7 , 8 , 9 ].…”

Quality of life in skin diseases as perceived by patients and nurses

“…Skin is an essential medium to both express and perceive emotions, and as such, plays a pivotal role during interpersonal contacts. The appearance of the skin and its appendages not only reflects the general body condition, but also exerts an effect on one’s self-esteem and self-image, and the way he/she is perceived by the others [ 2 – 4 ]. Hence, individuals suffering from various dermatological conditions have usually distorted self-image and tend to estimate their QOL as low [ 5 – 8 ].…”