Internalized stigma in psoriasis: A multicenter study
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Date
2017
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Abstract
Internalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P < 0.001 in all). Lower percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease. © 2017 Japanese Dermatological Association
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Adult , Body Image , Cost of Illness , Cross-Sectional Studies , Depression , Female , Health Status , Humans , Male , Middle Aged , Poverty , Prospective Studies , Psoriasis , Quality of Life , Self Concept , Severity of Illness Index , Social Stigma , Surveys and Questionnaires , Time Factors , adult , alcohol consumption , Article , body surface , cross-sectional study , disease severity , educational status , family history , female , General Health Questionnaire , health status , human , internalized stigma , major clinical study , male , marriage , perception , psoriasis , Psoriasis Area and Severity Index , Psoriasis Internalized Stigma Scale , quality of life , rating scale , risk assessment , risk factor , scoring system , social status , stereotypy , stigma , body image , clinical trial , cost of illness , depression , middle aged , multicenter study , poverty , prospective study , psoriasis , psychology , quality of life , questionnaire , self concept , severity of illness index , social stigma , time factor