Personality traits and styles may affect the reporting of chronic pruritus: a cross-sectional study

Abstract

Introduction: Chronic pruritus (CP) is a common symptom, but can be a diagnostic and therapeutic challenge. Our objective was to determine how personality traits, and more specifically personality styles, influence quality of life (QoL) impact of CP. Methods: Cross-sectional study of patients with CP from 2 main groups: (1) National Eczema Association and (2) US Veterans Health Administration (VHA) National Patient Care Database. Participants (N=483) answered questions regarding demographics, characteristics of CP, personality traits (NEO Five-Factor Model) and pruritus impact (ItchyQoL). A multivariate linear regression was performed to determine which of 15 covariates (age, race, marital status, itch duration, itch frequency, and each of the 10 personality styles) were significantly associated with greater total mean ItchyQoL score (ie, greater burden of CP). Secondary outcome measures included the 3 ItchyQoL subscale scores (symptom, emotion, function). Results: The Lethargic personality style (low extraversion, low conscientiousness) was significantly associated with greater total mean ItchyQoL score (β=11.65, P=0.04) while the Overcontrolled (high neuroticism, high conscientiousness) and Undercontrolled (high neuroticism, low conscientiousness) styles were significantly associated with greater symptomatic impact from CP (β=2.76, P=0.01 and β=2.34, P=0.03), respectively. African American race was significantly associated with greater mean ItchyQoL score (β=8.14, P=0.002), ItchyQoL emotional score (β=2.98, P=0.02) and trended to significance for ItchyQoL symptom score (β=1.23, P=0.06). Curiously, white race was associated with higher ItchyQoL scores for the function construct (β=1.2, P=0.04). “Single” marital status trended to significance for higher mean ItchyQoL score (β=3.79, P=0.06). Discussion: Our results highlight certain personality styles (Lethargic, Overcontrolled, Undercontrolled) and important demographics (ie, African American race, single marital status) that may influence itch-related QoL impact. In the clinical setting these findings may suggest a role for support structures and other integrative measures (eg, support groups, cognitive and mindfulness based therapies) to augment traditional therapeutics for CP.