Significance of chronic pruritus for intrapersonal burden and interpersonal experiences of stigmatization and sexuality in patients with psoriasis

被引:25
作者
Sommer, R. [1 ]
Augustin, M. [1 ]
Hilbring, C. [1 ]
Staender, S. [2 ]
Hubo, M. [3 ]
Hutt, H. J. [3 ]
von Stuelpnagel, C. C. [1 ]
da Silva, N. [1 ]
机构
[1] Univ Med Ctr Hamburg Eppendorf UKE, German Ctr Hlth Serv Res Dermatol CVderm, Inst Hlth Serv Res Dermatol & Nursing IVDP, Hamburg, Germany
[2] Univ Klinikum Munster UKM, Kompetenzzentrum Chron Pruritus, Munster, Germany
[3] LEO Pharma GmbH, Neu Isenburg, Germany
关键词
QUALITY-OF-LIFE; PERCEIVED STIGMATIZATION; COMFORT QUESTIONNAIRE; GENDER-DIFFERENCES; TREATMENT GOALS; GERMAN VERSION; PREVALENCE; ITCH; DEPRESSION; VALIDATION;
D O I
10.1111/jdv.17188
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background 60-90% of patients with psoriasis suffer from pruritus and 65% report itching as one of the most burdensome symptoms, raising significant quality of life (QoL) impairments. However, pruritus is not only an intrapersonal symptom but also a psychosocial interactive phenomenon and little is known about the effects of itching on interpersonal experiences. Objectives This study aimed to compare the disease burden and patient needs between patients with none/mild vs. moderate/severe pruritus, and to examine the impact of disease parameters and intrapersonal burden on perceived stigmatization and sexual relationships. Methods This cross-sectional study included German patients aged >= 18 years with psoriasis vulgaris. Disease severity was assessed with Psoriasis Area and Severity Index; patients reported on intensity of pruritus, skin-generic and pruritus-specific QoL, patient needs and benefits, anxiety and depression symptoms, dysmorphic concerns, perceived stigmatization and sexual dysfunction. Results A total of 107 patients with psoriasis participated (mean age = 46.3 +/- 14.6 years; 52.3% male): 64 with none/mild pruritus (NRS <= 3) and 43 with moderate/severe pruritus (NRS >= 4). Patients with moderate/severe pruritus reported more QoL impairments, depression and anxiety symptoms and dysmorphic concerns, but less treatment benefits, than those with none/mild pruritus. The patient needs most frequently rated as 'very/quite important' were 'be healed of all skin defects' (88.8%), and 'be free of itching' (87.0%), with no differences between the groups. Younger age, disease severity, frequency of scratching behaviours, dysmorphic concerns and treatment benefits were positively associated with stigmatization experiences; disease severity, sleeping problems and skin-generic QoL impairments were positively associated with sexual dysfunction. Conclusions Pruritus induces significant burden in patients with psoriasis. Along with disease severity, intrapersonal burden has a great impact on social and dyadic relationships. Treatment choices that are effective in reducing pruritus should be prioritized in patient-centred healthcare.
引用
收藏
页码:1553 / 1561
页数:9
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