A measure of chronic quality of life predicts socioeconomic and medical outcomes in psoriasis patients

Abstract

Psoriasis is a chronic skin disorder that detracts from quality of life, including elements of physical, psychological and social functioning. This study investigated whether retrospective questions about chronic quality of life (CQoL) were better predictors of poor socioeconomic and medical outcomes than the current Dermatology Life Quality Index (DLQI). One hundred fourteen participants answered the 10 questions used in the standard DLQI for 'over the last week', 'over the last year' and 'over your lifetime with psoriasis'. Subjects were examined and completed a self-administered questionnaire regarding disabilities, relationships, education and medical and economic outcomes (a smaller subset of 58 subjects also answered questions regarding religion and discrimination). Greater lifetime DLQI (LT DLQI) correlated with lower satisfaction with treatment (P=0.007), greater concern that psoriasis will worsen (P=0.012), worse perceived general health (P=0.003), younger age at which weight became problematic (P=0.002), greater likelihood of believing psoriasis had caused weight gain (P<0.001), shorter retention of current job (P=0.001), more experiences of discrimination at work (P=0.002) and in social settings (P<0.001) over one's lifetime and more severe discrimination in social settings over one's lifetime (P=0.002). Greater LT DLQI predicted more packs smoked per day (P=0.005), greater likelihood of believing psoriasis caused smoking (P=0.012), greater likelihood of recreational drug use (P=0.004), greater likelihood of a depression diagnosis (P<0.001), greater likelihood of having felt depressed (P=0.011) and greater likelihood of believing psoriasis caused depression (P<0.001). Compared to the standard LW DLQI, LT DLQI was a better predictor of patient outcomes related to weight, discrimination and depression.