Stigmatization Level in Patients With Psoriasis Impacts Satisfaction with Life

A recent study found that patients with psoriasis with a stronger sense of stigmatization had lower satisfaction with life, while those with higher education had higher satisfaction with life.

Stigmatization of skin lesions can contribute to psychosocial problems as well as a deterioration of life quality, which can all lead to a lack of illness acceptance, lowered self-esteem, and other somatic comorbidities. As psychosocial problems develop, the course of a patient’s psoriasis can be exacerbated.

This study aimed to determine the effect of psoriasis on quality of life, sense of stigmatization and self-esteem, and the general satisfaction with life and self-esteem of patients with psoriasis.

Researchers enrolled 111 patients (46.8% women and 53.2% men) with a diagnosis of plaque psoriasis from two private clinics of dermatology and medical cosmetology in Bialystok, Poland. Participants responded to a short survey and five validated scales:

• Dermatology Life Quality Index (DLQI)
• 6-Item Stigmatization Scale
• 33-Item Feelings of Stigmatization Questionnaire
• Rosenberg Self-Esteem Scale (SES)
• Satisfaction With Life Scale (SWLS)

Most of the respondents presented with low DLQI scores (mean 10.8 pts), slightly higher than average levels of self-esteem (mean SES score of approximately 27 pts) and slightly lower than average levels of satisfaction with life (SWLS score of 18.5 pts).

According to DLQI scoring, the patients presented with lower quality of life and their self-esteem and satisfaction with life was significantly modulated by stigmatization level, as measured by the 6-Item Stigmatization Scale and 33-Item Feelings of Stigmatization Questionnaire. While the location of psoriatic lesions significantly affected two components of the 33 Stigmatization Scale (Shame and Guilt, and Positive Attitudes), it did not have an association with the overall quality of life or other generic psychometric measures. Overall, the study showed that the discomfort stemming from psoriasis had a detrimental effect on a patient’s overall well-being.

Researchers noted that while the relationship between patients’ self-esteem and satisfaction with life with stigmatization level “are relatively well understood, future research should verify whether and how they evolve in response to social changes, and if this evolution warrants the adjustment of psychotherapeutic approaches and/or modification of the forms and objectives of social campaigns supporting patients with psoriasis.”

Reference
Jankowiak B, Kowalewska B, Krajewska-Kułak E, et al. Skin-disease specific and generic psychometric measures in patients with psoriasis. Dermatol Ther. 2021;11(6):1999-2015. doi:10.1007/s13555-021-00609-6