Abstract
Perceived stigmatization places a large psychosocial burden on patients with some skin conditions. Little is known about the experience of stigmatization across a wide range of skin diseases. This observational cross-sectional study aimed to quantify perceived stigmatization and identify its predictors among patients with a broad spectrum of skin diseases across 17 European countries. Self-report questionnaires assessing perceived stigmatization and its potential predictors were completed by 5,487 dermatology outpatients and 2,808 skin-healthy controls. Dermatological diagnosis, severity, and comorbidity were clinician-assessed. Patients experienced higher levels of perceived stigmatization than controls (p < 0.001, d = 0.26); patients with psoriasis, atopic dermatitis, alopecia, and bullous disorders were particularly affected. Multivariate regression analyses showed that perceived stigmatization was related to sociodemographic (lower age, male sex, being single), general health-related (higher body mass index, lower overall health), disease-related (higher clinician-assessed disease severity, presence of itch, longer disease duration), and psychological (greater distress, presence of suicidal ideation, greater body dysmorphic concerns, lower appearance satisfaction) variables. To conclude, perceived stigmatization is common in patients with skin diseases. Factors have been identified that will help clinicians and policymakers to target vulnerable patient groups, offer adequate patient management, and to ultimately develop evidence-based interventions.
Original language | English |
---|---|
Article number | adv6485 |
Pages (from-to) | adv6485 |
Journal | Acta Dermato-Venereologica |
Volume | 103 |
DOIs | |
Publication status | Published - 22 Jun 2023 |
Keywords
- medical psychology
- multicentre study
- skin diseases
- social stigma
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In: Acta Dermato-Venereologica, Vol. 103, adv6485, 22.06.2023, p. adv6485.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Perceived Stigmatization among Dermatological Outpatients Compared with Controls
T2 - An Observational Multicentre Study in 17 European Countries
AU - van Beugen, Sylvia
AU - Schut, Christina
AU - Kupfer, J. rg
AU - Bewley, Antony P.
AU - Finlay, Andrew Y.
AU - Gieler, Uwe
AU - Thompson, Andrew R.
AU - Grazia-Cazaña, Tamara
AU - Balieva, Flora
AU - Ferreira, B. R.
AU - Jemec, Gregor B.
AU - Lien, Lars
AU - Misery, Laurent
AU - Marron, Servando E.
AU - Ständer, Sonja
AU - Zeidler, Claudia
AU - Szabó, Csanád
AU - Szepietowski, Jacek C.
AU - Reich, Adam
AU - Elyas, Amna
AU - Altunay, Ilknur K.
AU - Legat, Franz J.
AU - Grivcheva-Panovska, Vesna
AU - Romanov, Dmitry V.
AU - Lvov, Andrey N.
AU - Titeca, G. raldine
AU - Sampogna, Francesca
AU - Vulink, Nienke C.
AU - Tomás-Aragones, Lucia
AU - European Society for Dermatology and Psychiatry (ESDaP) Study collaborators
AU - Evers, Andrea W. M.
AU - Dalgard, Florence J.
N1 - Funding Information: The authors acknowledge the Swedish Hudfonden and the Swedish Psoriasis Society (Psoriasforbundet) for additional funding for this study, as well as Dr Frank de Vos and Dr Elise Dusseldorp for their statistical advice. Funding Information: The study was approved by the Institutional Review Board of the Department of Medicine at the University of Giessen (protocol number 87/17), and at each recruitment centre. Conflicts of interest. SvB received lecture fees from Abbvie and Almirall, and research funding from NWO. APB received ad hoc consultancy/travel/lecturing fees from Abbvie, Almirall, Eli Lilly, Galderma, Leo Pharma, Janssen, Novartis, Sanofi, and UCB. AWME received funding from the following agencies: ERC, NWO, Dutch Health Associations (e.g. Diabetesfonds, ReumalandNL, Nierstichting), L’Oreal, and Province South Holland. UG received support and lecture honorarium in clinical and scientific meetings from AbbVie, Eli Lilly, Galderma, JanssenCilag, Leo Pharma, Pfizer, Sanofi-Aventis and UCB. He is principal investigator in acne studies about stigmatization and scars in acne patients, CoInvestor in Stigmatization in Rosaceapatients with Galderma, and Principal Investigator in HabitReversal Techniques in atopic dermatitis patients with Beiersdorf and CoInvestor in a communication and psychosocial comorbidities study in psoriasis patients with Novartis. FJL received support for participation in clinical and scientific meetings from AbbVie, Celgene, Eli Lilly, Galderma, Jansen-Cilag, Leo Pharma, Novartis, Pelpharma, and Pfizer. He has received Honoraria as Scientific Board Member/Consultant/Speaker from Almirall, Celgene, Eli Lilly, Galderma, Menlo Therapeutics, Novartis, Pelpharma, Pfizer, Trevi Therapeutics, and Vifor Pharma. He is Principal investigator in clinical studies for the following sponsors: Almirall, DS Biopharma, Eli Lilly, Galderma, Kiniksa, Menlo Therapeutics, Leo Pharma, Pfizer, and Trevi Therapeutics. BRF received fees from a lecture organized by Novartis and for participation in advisory board from La RochePosay. AYF is joint copyright owner of various quality of life measures. Cardiff University receives royalties: AYF receives a share under standard university policy. Lecture honoraria from Eli Lilly and WebinarMD. MG has participated in advisory boards and/or received fees from lectures from Abbvie, Leo, Lilly, Novartis, Pfizer, Sanofi, and Takeda. LM has received research grants from: Beiersdorf, Clarins, Expanscience, Galderma, Gilbert, Lilly, and Naos. He has received honoraria as an investigator from: Abbvie, Amgen, Biogen, Galderma, GSK, Janssen, Kiniksa, Lilly, Menlo, Novartis, Pfizer, Sanofi, and Trevi. He has done consultancy and/or has been in advisory boards for: Abbvie, Almirall, Amgen, Beiersdorf, Celgene, Clexio, Janssen, Lilly, Galderma, Kiniksa, Leo Pharma, Maruho, Menlo, Novartis, Pfizer, Sanofi, Sienna, Trevi, and Vifor. He has received speaker fees from: Abbvie, Almirall, Amgen, Biogen, BMS, Janssen, Lilly, Sanofi, Galderma, L’Oréal, Menlo, Beiersdorf, Leo Pharma, Novartis, Pfizer, and Vifor. AR has been a consultant or speaker for AbbVie, Bioderma, Celgene, Chema Elektromet, Eli Lilly, Galderma, Janssen, Leo Pharma, Medac, Menlo Therapeutics, Novartis, PierreFabre, Sandoz and Trevi; and principal investigator or subinvestigator in clinical trials sponsored by AbbVie, Drug Delivery Solutions Ltd, Galderma, Genentech, Janssen, Kymab Ltd, Leo Pharma, Menlo Therapeutics, MetrioPharm, MSD, Novartis, Pfizer and Trevi. SS has received research grants from: Almirall, Beiersdorf, German Research Foundation (DFG), European Academy of Dermatology and Venereology (EADV), German Federal Ministry of Education and Research (BMBF), Interdisciplinary Center for Clinical Research Münster (IZKF), Leo Pharma, Menlo, Novartis, Sanofi, and Trevi Therapeutics. She has received honoraria as an investigator from: Clexio, Dermasence, Galderma, GSK, Kiniksa, Menlo, Novartis, Sanofi, Trevi, and Vanda. She has done consultancy and/or has been in advisory boards for:Abbvie, Almirall, Beiersdorf, Bellus Health, Benevolent, Bionorica, Cara, Celgene, CelloHealth, Clexio, DS Biopharma, Eli Lilly, Escient, Galderma, Grünenthal, Kiniksa, Klinge Pharma, Leo Pharma, Maruho, Menlo, Merz, P.G. Unna Academy, Perrigo, Pfizer, Sanofi, Sienna, Symbio Research, Trevi, Vanda, Vifor, WebMD. She has received speaker fees from: Almirall, BMS, Eli Lilly, Sanofi, Galderma, L’Oréal, Menlo, Omnicuris, Beiersdorf, Leo Pharma, Novartis, P. G. Unna Academy, Pfizer, Pierre Fabre, Universitätsklinikum Würzburg, and Vifor. CS has received lecture fees from Novartis, is a consultant for Mahana Therapeutics, US, and has received research funding from the University Clinic Marburg and Gießen (UKGM). JCS has been in Advisory Boards for, and/or has received honoraria for consultations from: AbbVie, Leo Pharma, Novartis, Sandoz, Sanofi-Genzyme, Trevi, UCB, and Vifor. He has received speaker fees from: Abbvie, Janssen-Cilag, Eli-Lilly, Novartis, Sanofi-Genzyme. and UCB. He has received honoraria as an investigator from: AbbVie, Amgen, BMS, Galderma, Galapagos, Incyte, InfraRX, JanssenCilag, Menlo Therapeutics, Merck, Novartis, Pfizer, Regeneron, UCB, and Trevi. ART is a scientific advisor to a number of dermatology charities including the vitiligo society in US. He is a trustee for the charity Changing Faces and a psychological advisor to the All Party Parliamentary Group on Skin and The Scar Free Foundation in US. He has received honorarium and research related funding from UCB, Funding Information: Pfizer, Novartis, and Sanofi. He has received research grant funding from The British Skin Foundation, and The National Institute for Health Research. GT has received payment or honoraria for lectures, presentations, speakers’bureaus, manuscript writing or educational events from Abbvie, Janssen, Leo Pharma, Novartis, and Almirall. She has received support for attending meetings and/or travel from Abbvie, Leo Pharma, Eli Lilly, Sanofi, Almirall, and Amgen. AE has received lecture fees from Perrigo and Beiersdorf, and lecture and travel fees from LEO Pharma. IKA, FB, FD, JK, LL, ANL, SEM, DVR, LT-A, NV, CZ have no conflicts of interest to declare. Publisher Copyright: © 2023, Medical Journals/Acta D-V. All rights reserved.
PY - 2023/6/22
Y1 - 2023/6/22
N2 - Perceived stigmatization places a large psychosocial burden on patients with some skin conditions. Little is known about the experience of stigmatization across a wide range of skin diseases. This observational cross-sectional study aimed to quantify perceived stigmatization and identify its predictors among patients with a broad spectrum of skin diseases across 17 European countries. Self-report questionnaires assessing perceived stigmatization and its potential predictors were completed by 5,487 dermatology outpatients and 2,808 skin-healthy controls. Dermatological diagnosis, severity, and comorbidity were clinician-assessed. Patients experienced higher levels of perceived stigmatization than controls (p < 0.001, d = 0.26); patients with psoriasis, atopic dermatitis, alopecia, and bullous disorders were particularly affected. Multivariate regression analyses showed that perceived stigmatization was related to sociodemographic (lower age, male sex, being single), general health-related (higher body mass index, lower overall health), disease-related (higher clinician-assessed disease severity, presence of itch, longer disease duration), and psychological (greater distress, presence of suicidal ideation, greater body dysmorphic concerns, lower appearance satisfaction) variables. To conclude, perceived stigmatization is common in patients with skin diseases. Factors have been identified that will help clinicians and policymakers to target vulnerable patient groups, offer adequate patient management, and to ultimately develop evidence-based interventions.
AB - Perceived stigmatization places a large psychosocial burden on patients with some skin conditions. Little is known about the experience of stigmatization across a wide range of skin diseases. This observational cross-sectional study aimed to quantify perceived stigmatization and identify its predictors among patients with a broad spectrum of skin diseases across 17 European countries. Self-report questionnaires assessing perceived stigmatization and its potential predictors were completed by 5,487 dermatology outpatients and 2,808 skin-healthy controls. Dermatological diagnosis, severity, and comorbidity were clinician-assessed. Patients experienced higher levels of perceived stigmatization than controls (p < 0.001, d = 0.26); patients with psoriasis, atopic dermatitis, alopecia, and bullous disorders were particularly affected. Multivariate regression analyses showed that perceived stigmatization was related to sociodemographic (lower age, male sex, being single), general health-related (higher body mass index, lower overall health), disease-related (higher clinician-assessed disease severity, presence of itch, longer disease duration), and psychological (greater distress, presence of suicidal ideation, greater body dysmorphic concerns, lower appearance satisfaction) variables. To conclude, perceived stigmatization is common in patients with skin diseases. Factors have been identified that will help clinicians and policymakers to target vulnerable patient groups, offer adequate patient management, and to ultimately develop evidence-based interventions.
KW - medical psychology
KW - multicentre study
KW - skin diseases
KW - social stigma
UR - http://www.scopus.com/inward/record.url?scp=85164042008&partnerID=8YFLogxK
U2 - https://doi.org/10.2340/actadv.v103.6485
DO - https://doi.org/10.2340/actadv.v103.6485
M3 - Article
C2 - 37345973
SN - 0001-5555
VL - 103
SP - adv6485
JO - Acta Dermato-Venereologica
JF - Acta Dermato-Venereologica
M1 - adv6485
ER -