Relationship Between Quality of Life and Disease Severity in Patients with Psoriasis
Background & Aim: Besides the disease severity of Psoriasis, the quality of life is highly important; however, the relationship between the two is not clear. This study was carried out with the aim of determining the relationship between the quality of life and disease severity in patients with psoriasis.
Methods & Materials: This cross-sectional study was conducted on 99 patients with psoriasis who referred to Razi hospital, Tehran University of Medical Sciences, Tehran, Iran in 2015. The patients who met the inclusion criteria of the study were recruited by convenience sampling. The data was collected, using Dermatology Quality of Life Index and Psoriasis Area Severity Index. Data was analyzed using Pearson correlation coefficient, independent t-tests, one-way ANOVA, and linear regression analysis via SPSS v.21 at a significance level less than 0.05.
Results: The mean scores (standard deviation) of psoriasis severity and total quality of life were 14.26 (9.41) and 14.13 (6.47), respectively. There was a positive, strong, and significant relationship between psoriasis severity and total quality of life (r= 0.622, P < 0.0001). Psoriasis severity was found to be mostly associated with the dimensions of psoriasis effects on daily life activities, symptoms, and emotions, respectively.
Conclusion: As the results revealed, the higher the psoriasis severity indicated the lower the quality of life. This study showed the significance of addressing quality of life along with psoriasis severity in the process of assessing and treating patients. The results can serve as a foundation for interventional studies aiming at improving the quality of life in patients with psoriasis.
Milčić D, Janković S, Vesić S, Milinković M, Janković J. Assessment of quality of life in patients with psoriasis: a study from Serbia. International journal of dermatology. 2015;54(5):523-8
Berth-Jones J. Psoriasis. Medicine. 2013; 41(6): 334-340.
Helmick CG, Lee-Han H, Hirsch SC, Baird TL, Bartlett CL. Prevalence of psoriasis among adults in the US: 2003–2006 and 2009–2010 National Health and Nutrition Examination Surveys. American journal of preventive medicine. 2014;47(1):37-45.
Noorbala M, Kafaie P. Pattern of skin diseases in the Central Iran, Yazd Province. Journal of Pakistan Association of Dermatology. 2016;20(3):137-41.
Chen K-C, Hung S-T, Yang C-WW, Tsai T-F, Tang C-H. The economic burden of psoriatic diseases in Taiwan. Journal of dermatological science. 2014;75(3):183-9.
Manjula VD, Sreekiran S, Saril PS, Sreekanth MP. A study of psoriasis and quality of life in a tertiary care teaching hospital of Kottayam, Kerala. Indian Journal of Dermatology. 2011;56(4):403-406
Ljosaa TM, Rustoen T, Mörk C, Stubhaug A, Miaskowski C, Paul SM, Wahl AK. Skin pain and discomfort in psoriasis: an exploratory study of symptom prevalence and characteristics. Acta Derm Venereol. 2010;90(1):39-45.
Böhm D, Stock Gissendanner S, Bangemann K, Snitjer I, Werfel T, Weyergraf A, et al. Perceived relationships between severity of psoriasis symptoms, gender, stigmatization and quality of life. Journal of the European Academy of Dermatology and Venereology. 2013; 27(2):220-6.
Horn EJ, Fox KM, Patel V, Chiou C-F, Dann F, Lebwohl M. Association of patient-reported psoriasis severity with income and employment. Journal of the American Academy of Dermatology. 2007 2007/12/01/;57(6):963-71.
Vladut CI, Kállay É. Psychosocial implications of psoriasis: theoretical review. Cognitie, Creier, Comportament. 2010;14(1):23.
Kimball A, Gieler U, Linder D, Sampogna F, Warren R, Augustin M. Psoriasis: is the impairment to a patient’s life cumulative? Journal of the European Academy of Dermatology and Venereology. 2010;24(9):989-1004.
Meyer N, Paul C, Feneron D, Bardoulat I, Thiriet C, Camara C, et al. Psoriasis: an epidemiological evaluation of disease burden in 590 patients. Journal of the European Academy of Dermatology and Venereology. 2010;24(9):1075-82.
Boehncke W, Boehncke S, Schön M. Managing comorbid disease in patients with psoriasis. BMJ (Clinical research ed). 2009;340:b5666-b.
Butler D, Gupta R, Levin E, Huynh M, Leon A, Koo J. Psoriasis and quality of life. Hong Kong Journal of Dermatol Venereol. 2013;21:64-8.
Bes JD, Legierse CM, Prinsen CA, Korte JD. Patient education in chronic skin diseases: a systematic review. Acta dermato-venereologica. 2011;91(1):12-7.
Cestari TF, Hexsel D, Viegas M, Azulay L, Hassun K, Almeida A, et al. Validation of a melasma quality of life questionnaire for Brazilian Portuguese language: the MelasQoL‐BP study and improvement of QoL of melasma patients after triple combination therapy. British Journal of Dermatology. 2006;156(s1):13-20.
Shafiei Z, Babaee S, Nazari A. Relationship between self-efficacy and quality of life in coronary artery bypass graft surgery in Isfahan Chamran hospital, 2010-2011. Iranian Journal of Surgery. 2014; 22(1):64-72. [Persian]
Abdi M, Kamrani F, Saheb-al-Zamani M, Zohour A. Comparing quality of life patients suffering from psoriasis with vitiligo refrrring to skin clinics of medical centers related to Tabriz medical science university and remedial and sanitation services. Urmia Medical Journal, 2012; 23 (5): 499-505. [Persian]
Ansar A, Jahangard L, Pahlevani P, Rasouli B, Torabian S, Rasouli S. Quality of life in patients with psoriasis vulgaris: A case-control study. Journal of Dermatology and Cosmetic. 2013;4(3):113-9. [Persian]
Zandi S, Shamsi Meymandi S, Hasheminasab Gorji S, Sabouri Shahrebabak F. Evaluation of quality of life in patients with psoriasis. Journal of Dermatology and Cosmetic. 2011;2(3):166-73. [Persian]
Ghatnekar O, Ljungberg A, Wirestrand L-E, Svensson Å. Costs and quality of life for psoriatic patients at different degrees of severity in southern Sweden–a cross-sectional study. European Journal of Dermatology. 2012;22(2):238-45.
Korman N, Zhao Y, Pike J, Roberts J. Relationship between psoriasis severity, clinical symptoms, quality of life and work productivity among patients in the USA. Clinical and experimental dermatology. 2016;41(5):514-21.
Silva MFPd, Fortes MRP, Miot LDB, Marques SA. Psoriasis: correlation between severity index (PASI) and systemic treatment. Anais brasileiros de dermatologia. 2013;88(5):760-3.
Reich K, Griffiths CE. The relationship between quality of life and skin clearance in moderate-to-severe psoriasis: lessons learnt from clinical trials with infliximab. Archives of dermatological research. 2008;300 (10):537-44.
Nijsten T, Meads DM, De Korte J, Sampogna F, Gelfand JM, Ongenae K, et al. Cross-cultural inequivalence of dermatology-specific health-related quality of life instruments in psoriasis patients. Journal of Investigative Dermatology. 2007;127(10):2315-22.
Korte J, Femke MC, Mombers Jan D, Bos Mirjam AG. Quality of Life in Patients with Psoriasis: A Systematic Literature Review. Journal of Investigative Dermatology Symposium Proceedings. March 2004; 9 (2): 140–147
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994 May;19(3):210-6.
ghaei S, Sodaifi M, Jafari P, Mazharinia N, Finlay AY. DLQI scores in vitiligo: reliability and validity of the Persian version. BMC dermatology. 2004;4(1):8.
Fredriksson T, Pettersson U. Severe psoriasis--oral therapy with a new retinoid. Dermatologica. 1978;157(4):238-44.
Puzenat E, Bronsard V, Prey S, Gourraud PA, Aractingi S, Bagot M, et al. What are the best outcome measures for assessing plaque psoriasis severity? A systematic review of the literature. Journal of the European Academy of Dermatology and Venereology. 2010;24(s2):10-6.
Schmitt J, Wozel G. The psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis. Dermatology. 2005;210(3):194-9.
Farías M, Serrano V, De La Cruz C. Psoriasis and obesity: a review and practical recommendations. Actas Dermo-Sifiliográficas (English Edition). 2011;102(7):505-9.
Al Raddadi A, Jfri A, Samarghandi S, Matury N, Habibullah T, Alfarshoti M, et al. Psoriasis: Correlation between severity index (PASI) and quality of life index (DLQI) based on the type of treatment. Journal of Dermatology & Dermatologic Surgery. 2016;20(1):15-8.
Ghajarzadeh M, Ghiasi M, Kheirkhah S. Associations between skin diseases and quality of life: a comparison of psoriasis, vitiligo, and alopecia areata. Acta Medica Iranica. 2012;50(7):511-15.
Lundberg L, Johannesson M, Silverdahl M, Hermansson C, Lindberg M. Health-related quality of life in patients with psoriasis and atopic dermatitis measured with SF-36, DLQI and a subjective measure of disease activity. Acta Dermato Venereologica. 2000;80(6):430-4.
Mabuchi T, Yamaoka H, Kojima T, Ikoma N, Akasaka E, Ozawa A. Psoriasis affects patient’s quality of life more seriously in female than in male in Japan. Tokai J Exp Clin Med. 2012;37(3):84-8.
Vettuparambil A, Asokan N, Narayanan B. Psoriasis can markedly impair the quality of life of patients irrespective of severity: Results of a hospital-based cross-sectional study. Muller J Med Sci Res 2016;7:111-4
Zeljko-Penavić J, Šitum M, Šimić D, Vurnek-Živković M. Quality of life in psoriatic patients and the relationship between type I and type II psoriasis. Collegium antropologicum. 2010;34(1):195-8.
Çakmur H, Derviş E. The relationship between quality of life and the severity of psoriasis in Turkey. European Journal of Dermatology. 2015;25(2):169-76.
Sampogna F, Sera F, Abeni D. Measures of clinical severity, quality of life, and psychological distress in patients with psoriasis: a cluster analysis. Journal of Investigative Dermatology. 2004;122(3): 602-7.
Unaeze J, Nijsten T, Murphy A, Ravichandran C, Stern RS. Impact of psoriasis on health-related quality of life decreases over time: an 11-year prospective study. Journal of Investigative Dermatology. 2006;126(7):1480-9.
Tang MM, Chang CC, Chan LC, Heng A. Quality of life and cost of illness in patients with psoriasis in Malaysia: a multicenter study. International journal of dermatology. 2013;52(3):314-22 .