JAAD international · 2025
Stress in dermatology patients: A multicenter observational study of 8295 outpatients and controls from 22 European clinics.
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Balieva Flora, Schut Christina, Szabó Csanád, Sampogna Francesca, Dalgard Florence J, Altunay Ilknur K, Bewley Anthony, Ferreira Bárbara Roque, Finlay Andrew Y, Gieler Uwe, Gracia-Cazaña Tamara, Grivcheva-Panovska Vesna, Jemec Gregor B, Legat Franz J, Lien Lars, Lvov Andrey, Marron Servando E, Misery Laurent, Reich Adam, Romanov Dmitry, Koulil Saskia Spillekom-van, Ständer Sonja, Svensson Ake, Szepietowski Jacek C, Thompson Andrew R, Titeca Geraldine, Tomás-Aragonés Lucía, Vulink Nienke, Zeidler Claudia, Kupfer Jörg, ESDaP Study collaborators
Аннотация
BACKGROUND: Skin diseases are symptomatic, visible, and stigmatizing and it is acknowledged that they can be associated with stress. However, large studies comparing disease-specific stress are scarce.
OBJECTIVES: To investigate stress in a large, diverse sample of patients with different skin conditions and identify predictors of stress.
METHODS: A cross-sectional, multicenter study was conducted in 22 dermatology clinics across 17 European countries (response rate 82.4%). The study included 5487 patients diagnosed with various dermatological conditions and 2808 skin-healthy controls. The Perceived Stress Scale, 10 items was used to measure stress.
RESULTS: Patients reported significantly higher stress levels, more stressful life events during the last 6 months, and more economic difficulties than controls. Patients with psychodermatological conditions, hyperhidrosis, hidradenitis suppurativa, atopic dermatitis, acne, and urticaria experienced the highest stress levels. 44% of the variance of perceived stress in patients with skin conditions could be predicted by sociodemographic data and disease-related and psychological variables (depression, anxiety, stigmatization, and body dysmorphic concerns).
LIMITATIONS: As with all cross-sectional studies, causality and directionality cannot be inferred.
CONCLUSION: Stress poses a significant psychosocial burden to dermatological patients, especially to vulnerable subgroups. Health interventions targeting stress may be essential to improve clinical outcomes.
OBJECTIVES: To investigate stress in a large, diverse sample of patients with different skin conditions and identify predictors of stress.
METHODS: A cross-sectional, multicenter study was conducted in 22 dermatology clinics across 17 European countries (response rate 82.4%). The study included 5487 patients diagnosed with various dermatological conditions and 2808 skin-healthy controls. The Perceived Stress Scale, 10 items was used to measure stress.
RESULTS: Patients reported significantly higher stress levels, more stressful life events during the last 6 months, and more economic difficulties than controls. Patients with psychodermatological conditions, hyperhidrosis, hidradenitis suppurativa, atopic dermatitis, acne, and urticaria experienced the highest stress levels. 44% of the variance of perceived stress in patients with skin conditions could be predicted by sociodemographic data and disease-related and psychological variables (depression, anxiety, stigmatization, and body dysmorphic concerns).
LIMITATIONS: As with all cross-sectional studies, causality and directionality cannot be inferred.
CONCLUSION: Stress poses a significant psychosocial burden to dermatological patients, especially to vulnerable subgroups. Health interventions targeting stress may be essential to improve clinical outcomes.