Abstract

BackgroundWhile it is well established that skin disease places significant psychosocial burden on a patient’s wellbeing, its effects have rarely been examined in Asian populations.ObjectiveEvaluate the psychosocial burden of skin disease among community-dwelling adults in Singapore.MethodsThis cross-sectional study included 1510 participants interviewed on their history of thirteen skin diseases. The Patient Health Questionnaire (PHQ-9), Lubben Social Network Scale-6 (LSNS-6), University of California Los Angeles (UCLA) Loneliness Scale, and European Quality of Life-5 Dimensions- 5 Level (EQ-5D-5L) were used as measures for depressive symptoms, social isolation, loneliness and quality of life respectively. Multiple linear regression analysis was used to examine the association of skin diseases with each of the four measured outcomes.ResultsParticipants with skin diseases reported significantly higher PHQ-9 and UCLA Loneliness scale scores, and lower LSNS-6 and EQ-5D-5L scores when compared to their healthy counterparts. The presence of skin disease was positively associated with depressive symptoms (B = 0.40, SE = 0.11), and negatively associated with quality of life (B = -0.03, SE = 0.01). As disease severity was not evaluated in this study, we were unable to ascertain the associations between disease severity and measured outcomes.ConclusionParticipants with skin diseases were more likely to have depressive symptoms, social isolation, loneliness and lower quality of life. Unemployed, single and elderly patients were at higher risk of developing depressive symptoms. More emphasis should be placed on the psychosocial aspect of care to reduce the burden of skin disease. Some considerations include monitoring patients for mood-related changes and implementing early psychosocial interventions.

Highlights

  • Skin disease contributes 1.79% to the global burden of disease and is the fourth leading cause of non-fatal disease burden [1]

  • Participants with skin diseases reported significantly higher PHQ-9 and University of California Los Angeles (UCLA) Loneliness scale scores, and lower Lubben Social Network Scale-6 (LSNS-6) and EQ-5D-5L scores when compared to their healthy counterparts

  • The presence of skin disease was positively associated with depressive symptoms (B = 0.40, SE = 0.11), and negatively associated with quality of life (B = -0.03, SE = 0.01)

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Summary

Background

While it is well established that skin disease places significant psychosocial burden on a patient’s wellbeing, its effects have rarely been examined in Asian populations. Data Availability Statement: According to the Data Protection Act Commission Singapore - Advisory Guidelines for the Healthcare Sector, the personal health data collected for the Population Health Index study are not publicly available due to legal and ethical restrictions related to data privacy protection. The anonymous minimal dataset underlying the findings in the manuscript are available upon request to interested researchers after authorization of the ethical committee of the National Health Group Domain Specific Review Board. Interested researchers may contact Mr Kiok Liang Teow

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