The psychological burden and life quality in patients with skin disease: A European study in dermatological patients

Knowledge of the psychological burden of skin disease in the general dermatological population is scarce. We collected data on the distribution of skin diseases in Norwegian and European dermatological outpatients by asking consecutive patients and healthy controls to complete standardized questionnaires. We explored the prevalence of psychiatric comorbidity (depression and anxiety) and reduction in life quality. The results can be used to increase health professionals’ awareness of the specific needs of these patients for providing optimal health care. The thesis shows in its first part the high association between skin disease and psychiatric comorbidity, especially in Norwegian patients, where depression and anxiety are higher than in the other participating European countries. In its second part, the thesis confirms the large impact skin conditions have on patients’ wellbeing, differentiating between different aspects and domains of HRQoL. Patients with skin diseases reported reduced HRQoL comparable to patients with chronic obstructive lung disease, diabetes mellitus, cardio-vascular disease and cancers. These findings are important in the prioritization of resource allocation between medical fields and within dermatological sub-specialities. Finally, we show that treatments for skin diseases also contribute considerably to reducing HRQoL, even for diseases that do not impact HRQL significantly (such as skin cancer): the burden of dermatological treatment should be considered when planning therapy, designing instruments for evaluating HRQoL and when evaluating new dermatological therapeutic options