Assessment of Depression, Anxiety, and Quality of Life in Patients With Psoriasis Using the Dermatology Life Quality Index (DLQI) and Depression Anxiety Stress Scale-21 (DASS-21): A Cross-Sectional Study From Southern India.

Introduction Psoriasis is a chronic inflammatory skin disorder associated with significant psychosocial morbidity. Despite its visible nature and impact on daily functioning, data from India on the prevalence of depression and anxiety in psoriasis patients remains limited. This study aimed to evaluate psychological morbidity and its relationship with disease severity and quality of life (QoL) in patients with psoriasis. Methods A cross-sectional study was conducted among 63 adult patients with psoriasis attending a tertiary care teaching hospital in Southern India between February 2021 and August 2022. Patients aged 18-65 years with disease duration ≥12 months and without major comorbidities were included. Disease severity was assessed using the Psoriasis Area Severity Index (PASI), QoL was assessed using the Dermatology Life Quality Index (DLQI), and psychological status was assessed using the Depression Anxiety Stress Scale (DASS-21). Statistical analyses included independent t-test, Mann-Whitney U test, chi-square test, and Spearman correlation, with p<0.05 considered significant. Results The study population included 42 males (66.7%) and 21 females (33.3%). Female patients were significantly younger than males (34.8±11.9 vs. 44.5±13.1 years, respectively; p=0.006) and had higher DLQI scores (p=0.011). Depression and anxiety were observed in 22.2% and 9.5% of patients, respectively. PASI scores showed a weak positive correlation with DLQI (ρ=0.352; p=0.005). In contrast, DLQI demonstrated a moderate positive correlation with depression, anxiety, and stress scores (ρ=0.540-0.571; p<0.005). Family completion and prior systemic therapy were associated with significantly lower DLQI scores. Conclusion QoL correlates more strongly with psychological morbidity than with clinical severity in patients with psoriasis. Psychological burden appears to be only weakly associated with disease severity. Incorporating DLQI into routine dermatology practice may serve as a practical first-step screening tool, with higher scores prompting further evaluation using structured instruments such as DASS-21 and, where indicated, referral for psychiatric assessment.