Publications

Poster presented at the 52. Jahrestagung der Deutschen Dermatologischen Gesellschaft (DDG-Tagung), Berlin, Germany.

Oral presentation presented at the 25th World Congress of Dermatology, Singapore

Oral presentation presented at the 22^nd DKVF Conference, Berlin, Germany

Poster preseted at the Society of Behavioral Medicine, Baltimore, MD.

ePoster presented at 31st European Academy of Dermatology and Venereology (EADV) Congress

Objectives While stress plays a paramount role on the onset/exacerbation of psoriasis, via overactivation of the hypothalamic–pituitary–adrenal axis and increased release of pro-inflammatory cytokines, cutaneous inflammatory response induces, in turn, anxiety/depression symptoms, via body disfigurement and stigmatisation. The intensity of pruritus and anogenital involvement are additional risk factors for psychological comorbidity.Aims were to (1) examine the effects of intensity of pruritus and anogenital psoriasis on disease burden and psychological comorbidity and (2) identify the variables associated with the presence of clinically significant depression, anxiety, and dysmorphic concerns.

Design Cross-sectional study.

Setting Conducted at the University Medical Center Hamburg-Eppendorf (UKE).

Participants 107 patients with psoriasis (mean age = 46.3, SD = 14.6 years; 53.3% male): 64 with none/mild pruritus; 43 with moderate/severe pruritus; 31 with anogenital psoriasis; 76 not affected in the anogenital area.

Primary/secondary outcomes measures Disease severity was assessed with Psoriasis Area and Severity Index and intensity of pruritus was rated by patients. Patient-reported outcomes included the Dermatology Life Quality Index, ItchyQoL, Patient Benefit Index, Perceived Stigmatisation Questionnaire, and Relationship and Sexuality Scale. Psychological morbidity was assessed with the Patient Health Questionnaire, Generalised Anxiety Disorder, and Dysmorphic Concern Questionnaire.

Results Patients with moderate/severe pruritus reported more quality of life impairments, depression, anxiety and dysmorphic concerns, and less treatment benefits than those with none/mild pruritus. Moderate/severe pruritus had a deleterious effect on depression and stigmatisation for patients without anogenital involvement. Less patient benefits were associated with a higher likelihood of clinically significant depression/anxiety.

Conclusion Pruritus induces significant burden and psychological morbidity, particularly for patients without anogenital involvement. However, coping strategies used by patients with anogenital psoriasis might be dysfunctional for overall psychosocial adaptation. Patient-centred healthcare might be the best way to prevent psychological comorbidity.

Patient-relevant benefits from treatment of inflammatory skin diseases can be measured with the validated 25-item questionnaire Patient Benefit Index Standard version (PBI-S; www.patient-benefit-index.com). It consists of two parts: the Patient Needs Questionnaire, in which patients rate the importance of 25 different treatment goals, and the Patient Benefit Questionnaire, in which patients evaluate the achievement of these goals by therapy. From all items, an importance-weighted total benefit score is determined. However, shorter instruments are often preferable both in practice and in clinical trials. We therefore developed and tested a 10-item short form of the PBI-S named the ‘PBI-S-10’, which should maintain both content validity and good psychometric properties. The short form should allow for the calculation of a total score that indicates overall patient-relevant benefit and demonstrate high agreement with the long form.

Br J Dermatol. 2022 Jan 22. doi: 10.1111/bjd.21029

The quality of dermatology consultations is partly determined by how clinicians approach patient care. The term ‘Personal Models’ describes the explanatory frameworks of thoughts, feelings and experiences that drive behaviour. One study found that clinicians’ personal models, specifically their beliefs about autonomy and patient self-management, influenced the degree to which clinicians engage patients in shared decision-making during consultations. Further research is needed to further explore how clinicians’ personal models inform and affect the quality of patient care.

Poster presented at the DKVF Conference, Potsdam, Germany 

This study aimed to examine the health-related quality of life (HrQoL), coping, height-related beliefs, and social support of children/adolescents with short stature, the sociodemographic, clinical, and psychosocial variables associated with HrQoL, and the moderating role of sociodemographic and clinical variables on the associations between psychosocial variables and HrQoL.