Background: The literature on predictors of health-related quality of life in psoriasis is inconsistent. Objective: To assess potential predictors of quality of life in psoriasis. Methods: In a cross-sectional study involving 130 dermatological practices and outpatient clinics, data of 1,210 patients with psoriasis were collected. Quality of life was evaluated using the Dermatology Life Quality Index. Medical history, clinical and sociodemographic characteristics, therapy and health care features were used as independent variables in a backward multiple regression analysis. Results: Twelve predictors were included in the model explaining 38% of variance in quality of life. The strongest predictor was daily treatment time (β = 0.30), followed by patient-defined treatment benefit (β = –0.18), disease severity (β = 0.19) and treatment satisfaction (β = –0.16). Conclusion: Treatment burden requires special attention when quality of life in psoriasis is to be improved. Since the larger part of variance is left unexplained, further factors predicting quality of life have yet to be detected.

Keywords:
Psoriasis vulgaris, Health-related quality of life, predictors, Treatment burden, Dermatology Life Quality Index, Multiple regression
1.
Schaefer I, Rustenbach S, Zimmer L, Augustin M: Prevalence of skin diseases in a cohort of 48,665 employees in Germany. Dermatology 2008;217:169–172.
2.
Stern RS, Nijsten T, Feldman SR, Margolis DJ, Rolstad T: Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatol Symp Proc 2004;9:136–139.
3.
Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T: The impact of psoriasis on quality of life – results of a 1998 National Psoriasis Foundation Patient-Membership Survey. Arch Dermatol 2001;137:280–284.
4.
Zachariae R, Zachariae H, Blomqvist K, Davidsson S, Molin L, Mørk C, Sigurgeirsson B: Quality of life in 6,497 Nordic patients with psoriasis. Br J Dermatol 2002;146:1006–1016.
5.
Augustin M, Lange S, Wenninger K, Seidenglanz K, Amon U, Zschocke I: Validation of a comprehensive Freiburg Life Quality Assessment (FLQA) core questionnaire and development of a threshold system. Eur J Dermatol 2004;14:107–113.
6.
Dubertret L, Mrowietz U, Ranki A, van de Kerkhof PC, Chimenti S, Lotti T, Schäfer G, EUROPSO Patient Survey Group: European patient perspectives on the impact of psoriasis: the EUROPSO patient membership survey. Br J Dermatol 2006;155:729–736.
7.
Schöffski O, Augustin M, Prinz J, Rauner K, Schubert E, Sohn S, Reich K: Costs and quality of life in patients with moderate to severe plaque-type psoriasis in Germany: a multi-center study. J Dtsch Dermatol Ges 2007;5:209–219.
8.
Schmid-Ott G, Schallmayer S, Calliess IT: Quality of life in patients with psoriasis and psoriasis arthritis with a special focus on stigmatization experience. Clin Dermatol 2007;25:547–554.
9.
EUROPSO: The EUROPSO psoriasis patient study: treatment history and satisfaction reported by 17,990 members of European psoriasis patient associations. Helsinki, EUROPSO, 2002. http://www.psori.fi/document. php?DOC_ID=15&SEC=34647e69c785fc 6d395205ab7e9c25e5.
10.
Bullinger M: Assessing health related quality of life in medicine: an overview over concepts, methods and applications in international research. Restor Neurol Neurosci 2002;20:93–101.
11.
de Korte J, Sprangers MAG, Mombers FMC, Bos JD: Quality of life in patients with psoriasis: a systematic literature review. J Investig Dermatol Symp Proc 2004;9:140–147.
12.
Gelfand JM, Feldman SR, Stern RS, Thomas J, Rolstad T, Margolis DJ: Determinants of quality of life in patients with psoriasis: a study from the US population. J Am Acad Dermatol 2004;51:704–708.
13.
Schmitt JM, Ford DE: Role of depression in quality of life for patients with psoriasis. Dermatology 2007;215:17–27.
14.
Vardy D, Besser A, Amir M, Gesthalter B, Biton A, Buskila D: Experiences of stigmatization play a role in mediating the impact of disease severity on quality of life in psoriasis patients. Br J Dermatol 2002;147:736–742.
15.
Uttjek M, Dufaker M, Nygren L, Stenberg B: Determinants of quality of life in a psoriasis population in northern Sweden. Acta Derm Venereol 2004;84:37–43.
16.
Ciocon DH, Horn EJ, Kimball AB: Quality of life and treatment satisfaction among patients with psoriasis and psoriatic arthritis and patients with psoriasis only – results of the 2005 Spring US National Psoriasis Foundation Survey. Am J Clin Dermatol 2008;9:111–117.
17.
Reich K, Kruger K, Mossner R, Augustin M: Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1,511 patients with plaque-type psoriasis. Br J Dermatol 2009;160:1040–1047.
18.
Myon E, Finlay P, Lefrançois P, Taïeb C: Duration of psoriasis and quality of life. J Eur Acad Dermatol Venereol 2003;17(suppl 3): 165.
19.
Augustin M, Reich K, Reich C, Purwins S, Jeff Rustenbach S, Schäfer I, Radtke M: Quality of psoriasis care in Germany – results of the national study PsoHealth 2007. J Dtsch Dermatol Ges 2008;6:640–646.
20.
Radtke MA, Reich K, Blome C, Rustenbach S, Augustin M: Prevalence and clinical features of psoriatic arthritis and joint complaints in 2,009 patients with psoriasis: results of a German national survey. J Eur Acad Dermatol Venereol 2009;23:683–691.
21.
Finlay A, Khan G: Dermatology Life Quality Index (DLQI) – a simple practical measure for routine clinical use. Clin Exp Dermatol 1994;19:210–216.
22.
Augustin M, Zschocke I, Lange S, Seidenglanz K, Amon U: Lebensqualität bei Hauterkrankungen: Vergleich verschiedener Lebensqualitäts-Fragebögen bei Psoriasis und atopischer Dermatitis [Quality of life in skin diseases: methodological and practical comparison of different quality of life questionnaires in psoriasis and atopic dermatitis]. Hautarzt 1999;50:715–722.
23.
Garduno J, Bhosle MJ, Balkrishnan R, Feldman SR: Measures used in specifying psoriasis lesion(s), global disease and quality of life: a systematic review. J Dermatol Treat 2007;18:223–242.
24.
Augustin M, Radtke MA, Zschocke I, Blome C, Behechtnejad J, Schäfer I, Reusch M, Mielke V, Rustenbach SJ: Patient benefit index (PBI) – a novel approach in patient-defined outcomes measurement for skin diseases. Arch Dermatol Res 2009;301:561–571.
25.
Hongbo Y, Thomas CL, Harrison MA, Salek MS, Finlay AY: Translating the science of quality of life into practice: what do Dermatology Life Quality Index scores mean? J Invest Dermatol 2005;125:659–664.
26.
Chen T, Bertenthal D, Sahay A, Sen S, Chren MM: Predictors of skin-related quality of life after treatment of cutaneous basal cell carcinoma and squamous cell carcinoma. Arch Dermatol 2007;143:1386–1392.
27.
Wittkowski A, Richards HL, Griffiths CEM, Main CJ: The impact of psychological and clinical factors on quality of life in individuals with atopic dermatitis. J Psychosom Res 2004;57:195–200.
28.
Lange S, Zschocke I, Seidenglanz K, Schiffler A, Zöllinger A, Amon U, Augustin M: Predictors of the Quality of Life in Patients with Atopic Dermatitis. Dermatol Psychosom 2000;1:66–70.
29.
Ziaian T, Sawyer MG, Reynolds KE, Carbone JA, Clark JJ, Baghurst PA, Couper JJ, Kennedy D, Martin AJ, Staugas RE, French DJ: Treatment burden and health-related quality of life of children with diabetes, cystic fibrosis and asthma. J Paediatr Child Health 2006;42:596–600.
30.
Augustin M, Krüger K, Radtke MA, Schwippl I, Reich K: Disease severity, quality of life and health care in plaque-type psoriasis: a multicenter prospective cross-sectional study in Germany. Dermatology 2008;216:366–372.
31.
Rhee JS, Matthews BA, Neuburg M, Logan BR, Burzynski M, Nattinger AB: The Skin Cancer Index: clinical responsiveness and predictors of quality of life. Laryngoscope 2007;117:399–405.
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2010
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