Explaining Psychiatric Comorbidities in Patients With Skin Conditions: The Importance of Clinical Characteristics and Patient-Reported Disease Impact
Author(s)
Allison FitzGerald, BA, BS1, Neuza da Silva Burger, PhD2, Rachael Pattinson, BSc, MSc, PhD3, Nirohshah Trialonis-Suthakharan, MSc4, Jennifer Austin, BA5, Chris Bundy, PhD6, Matthias Augustin, PhD2.
1Director of Operations, GlobalSkin, Ottawa, ON, Canada, 2Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, 3School of Dentistry, Cardiff University, Cardiff, United Kingdom, 4Padvocates, Munich, Germany, 5International Alliance of Dermatology Patient Organizations, Ottawa, ON, Canada, 6School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom.
1Director of Operations, GlobalSkin, Ottawa, ON, Canada, 2Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, 3School of Dentistry, Cardiff University, Cardiff, United Kingdom, 4Padvocates, Munich, Germany, 5International Alliance of Dermatology Patient Organizations, Ottawa, ON, Canada, 6School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom.
OBJECTIVES: The prevalences for depression and anxiety disorders are estimated at 3.8% and 4% of the global population; however, these can ascend to 30% in dermatology patients. This study aimed to contribute to explain these high rates of psychiatric comorbidity by examining the associations between clinical variables, disease impact, and mental health.
METHODS: An online survey, available in 17 different languages, was conducted between June 2023 and January 2024. Adults with a self-reported dermatological condition were recruited through patient organizations and social media. Participants completed the Patient-Reported Impact of Dermatological Diseases (PRIDD; 16 items assessing physical, life responsibilities, psychological and social impact domains), the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder Assessment (GAD-7), and provided sociodemographic and clinical information. Hierarchical regression analyses were conducted to identify sociodemographic characteristics, clinical variables and impact domains associated with depression and anxiety.
RESULTS: 3680 participants were included, 76.4% female, mean age of 48.7±15.7 years, from 87 different countries, and across 114 dermatological conditions (e.g., 12.8% Lichen Sclerosus, 12.3% Psoriasis, 8.2% Hidradenitis Suppurativa). 1349 (36.7%) respondents scored above the threshold for clinical depression (PHQ-9≥10) and 956 (26.0%) for clinical anxiety (GAD-7≥10). Sociodemograhic characteristics (younger age, female sex) explained 3.9% and 5.2% of the variance in depression and anxiety scores, respectively. Clinical variables explained 20.1% of depression and 15.0% of anxiety scores: rare diseases, higer disease severity, presence of comorbidities, and lower satisfaction with current healthcare were associated with higher scores for both depression and anxiety; besides, being member of a patient organization was associated with lower levels of anxiety. PRIDD dimensions (higher physical, psychological and social impact; lower life responsibilities impact) explained an additional variance of 22.6% for depression and 22.8% for anxiety.
CONCLUSIONS: These results emphasize the importance of capturing the multidimensional burden of skin conditions on patients’ lives, as a significant risk factor for psychiatric comorbidities.
METHODS: An online survey, available in 17 different languages, was conducted between June 2023 and January 2024. Adults with a self-reported dermatological condition were recruited through patient organizations and social media. Participants completed the Patient-Reported Impact of Dermatological Diseases (PRIDD; 16 items assessing physical, life responsibilities, psychological and social impact domains), the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder Assessment (GAD-7), and provided sociodemographic and clinical information. Hierarchical regression analyses were conducted to identify sociodemographic characteristics, clinical variables and impact domains associated with depression and anxiety.
RESULTS: 3680 participants were included, 76.4% female, mean age of 48.7±15.7 years, from 87 different countries, and across 114 dermatological conditions (e.g., 12.8% Lichen Sclerosus, 12.3% Psoriasis, 8.2% Hidradenitis Suppurativa). 1349 (36.7%) respondents scored above the threshold for clinical depression (PHQ-9≥10) and 956 (26.0%) for clinical anxiety (GAD-7≥10). Sociodemograhic characteristics (younger age, female sex) explained 3.9% and 5.2% of the variance in depression and anxiety scores, respectively. Clinical variables explained 20.1% of depression and 15.0% of anxiety scores: rare diseases, higer disease severity, presence of comorbidities, and lower satisfaction with current healthcare were associated with higher scores for both depression and anxiety; besides, being member of a patient organization was associated with lower levels of anxiety. PRIDD dimensions (higher physical, psychological and social impact; lower life responsibilities impact) explained an additional variance of 22.6% for depression and 22.8% for anxiety.
CONCLUSIONS: These results emphasize the importance of capturing the multidimensional burden of skin conditions on patients’ lives, as a significant risk factor for psychiatric comorbidities.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR88
Topic
Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Mental Health (including addition), Rare & Orphan Diseases