Irish people living with psoriasis have indicated that the condition has a ‘very large effect’ on their lives, according to a new international survey. Erica Mills reports on the study’s findings and the latest medical advice
Psoriasis can have a detrimental effect on the relationships, careers and emotional well-being of those with the condition, according to a worldwide survey conducted by Abbott Laboratories and the Psoriasis Association of Ireland. The study, which included 325 Irish people, was conducted in Ireland through the website www.psoriasisuncovered.ie.
The survey also collected responses from 16 other countries attracting over 10,800 responses. Abbott, which employs 3,800 people in Ireland, conducted the research to uncover some of the emotional and mental effects psoriasis can have on individuals and to assess how the condition can impact on the social aspects of their lives, in particular the impact it can have on their career.
The survey is being released in Ireland to mark World Psoriasis Day 2009 on 29 October.
According to http://www.psoriasisuncovered.ie: “For the most part, people with psoriasis function normally. Sometimes people experience low self-esteem because of their psoriasis. Psoriasis is often misunderstood by the public, which can make social interactions difficult. This may lead to emotional reactions such as anxiety, anger, embarrassment and depression.”
Caroline Irwin, Chairperson of the Psoriasis Association of Ireland, hopes that the survey results will help draw attention to the problems faced by people with psoriasis in Ireland. “These results highlight the huge impact that psoriasis, perceived by many to be a simple skin complaint, can have on a person’s quality of life,” she said.“For the 100,000 people in Ireland, there is often a stigma attached to the condition, which impacts on many facets of daily life. We hope that this research will go some way towards uncovering the, often hidden, impact of psoriasis and that by understanding the social and psychological effects of psoriasis in Ireland and around the world, we can begin to address them.”
People with psoriasis were asked to rate how having psoriasis had affected various aspects of their life, including their social life, their ability to work and to study and how it affected their mood and behaviour.
These responses were also measured using Dermatology Life Quality Index (DLQI) scores. The DLQI is commonly used by dermatologists to understand the impact a dermatological condition has on a patient’s life. The responses are scored between 0-30 points, with 0-1 indicating no impact on a person’s life and 21-30 indicating an extremely large effect.
Of the total survey respondents worldwide, the average DLQI score was 9, indicating a ‘moderate effect’ on the respondent’s life. However, the score was found to be higher in Ireland with an average score of 11, indicating a ‘very large effect’ on the respondent’s life.
Irish respondents also scored more negatively when asked to assess the impact of the condition on various aspects of their life. The results show that many feel that psoriasis has hampered their ability to work normally as 31.8 per cent felt that psoriasis has prevented them from pursuing their desired career path or field, compared to 25.3 per cent worldwide; while 39.8 per cent felt that their behaviour in work was affected by psoriasis compared to 32.2 per cent worldwide. Almost 17 per cent of respondents reported having to quit a job because of their psoriasis with 3.4 per cent reporting that they are currently unemployed because of their psoriasis.
However, the condition was perceived by Irish respondents to be better accepted by their colleagues as only 15.8 per cent of respondents reported that they were treated differently than their colleagues who did not have psoriasis, compared with 18.4 per cent worldwide.
They also felt less discriminated against in the workplace with 13.1 per cent reporting that they have been discriminated against as opposed to the worldwide average of 23.8 per cent.
Of the respondents, 83.2 per cent said it had impacted on their mood or mental health and 85.8 per cent reported that it affected their ability to enjoy life.
“I often see the serious impact psoriasis can have on the quality of life of my patients, particularly those living with moderate to severe psoriasis. Newer treatment options are now available which can make significant improvements on the condition long-term with positive benefits on overall quality of life. Early diagnosis and treatment is critical in ensuring optimum results,” she said.
Treatment will vary from person to person based on factors such as the type of psoriasis, the location on the body and the severity of the condition.
Effective treatment of psoriasis is important, not only because of the reported social and psychological impact on those with the condition but also because of the potential physical complications associated with it. The ‘psoriasis uncoverered’ website advises of the risk of psoriatic arthritis, which can occur in up to 30 per cent of those with psoriasis, manifesting similar abnormalities as found in rheumatoid arthritis.
Psoriasis may be more problematic than previously thought, according to the ‘psoriasis uncovered’ research, as it may be indicative of other health problems. While psoriasis was once considered to be a simple skin condition, evidence suggests that cardiovascular disease markers are in increased in psoriatic patients; people with psoriasis were found to have greater incidences of diabetes, obesity, high blood pressure and high cholesterol.
A total of 60.9 per cent of Irish respondents and 40.5 per cent of worldwide respondents reported that their social or leisure activities had been affected by their psoriasis in the week before they took the study. The survey found that 36.9 per cent of Irish participants and 36.1 per cent of those worldwide also reported that their sexual activity had been affected — such factors may lead to increased BMI, low self esteem and depression, a fact which is recognised by the American Academy of Dermatology.
In combination with dermatological treatments, the Psoriasis Association of Ireland recommends secondary measures that patients with psoriasis should be advised to follow. Patients with psoriasis who smoke should be advised to stop immediately because of the damage it causes to the immune system; smokers are at increased risk of developing chronic plaque psoriasis and developing pustular psoriasis on their soles and feet.
Doctors should also be advised that there is a link between increased alcohol intake and psoriasis in men, according to the Association. They also note that this link is not seen with other skin conditions.
The website http://www.psoriasisuncovered.ie also offers practical advice to people with psoriasis. It advises patients to:
- Acknowledge their feelings as it is normal to feel sad, angry and frustrated when they are dealing with psoriasis.
- Manage stress as stress is often the trigger for developing psoriasis for the first time or can irritate existing psoriasis.
- Stay informed about the condition through reading, talking to others, through the internet and in discussions with their doctor.
- Change the way they live — this is stressed as one of the most important steps a person with psoriasis can take. Along with remembering to take any prescribed medication, a good skin care routine with daily moisturising or emollients can make a substantial difference to the condition.
- Not to give up even when psoriasis feels uncontrollable — they stress that it can be managed.
- Seek the support of family and friends.
The Psoriasis Association of Ireland is a patient group for those living with the condition. Set up in 2003, the Association provides a range of services including public information seminars, self-help groups, an advice line, a website, e-newsletters and information leaflets. People with psoriasis can visit http://www.psoriasisuncovered.ie to find more information.
ERICA MILLS 