Determinants of Quality of Life in Patients with Atopic Dermatitis and Psoriasis: A Multivariate Approach

Abstract

Health-related quality of life (HRQoL) is reduced in atopic dermatitis and psoriasis. Several factors impact HRQoL including sociodemographic and skin disease-related characteristics, health behaviours, cardiometabolic comorbidities, and psychological conditions. However, their differential and unique effects on HRQoL are not well studied. In this cross-sectional online survey, adult patients with atopic dermatitis (n = 155) or psoriasis (n = 246) provided data on features of their respective skin diseases, health behaviours, and cardiometabolic comorbidities. Validated self-report measures assessed HRQoL, psychopathology (Patient Health Questionnaire-4), and stress (Perceived Stress Scale). Linear regression analyses were used to determine key predictors of HRQoL. In atopic dermatitis, linear regression analyses revealed that self-rated disease severity (Patient-Oriented Eczema Measure), anxiety, and stress were significant predictors of the Dermatology Life Quality Index (DLQI), explaining 59% of the variance. In psoriasis, disease severity (Psoriasis Symptoms and Signs Diary) and depression significantly predicted DLQI, with an explained variance of 57%. Health behaviours and cardiometabolic comorbidities did not impact DLQI scores. While skin disease severity is the most important determinant of HRQoL, stress and anxiety are important in atopic dermatitis, whereas depression is relevant in psoriasis. These findings hold implications for both clinical practice and research.

Keywords

• atopic dermatitis
• cardiometabolic comorbidities
• health behaviors
• health-related quality of life
• psoriasis
• psychological factors