Persons with hidradenitis suppurativa who reported feelings of stigma because of their condition had a worse quality of life and higher levels of depression and social anxiety than those who did not report feelings of stigma. it was high.
social impact of hidradenitis suppurativa (HS) may increase patient quality of life (QOL) burden and risk of adverse behavioral health outcomes, according to findings published in Archives of Dermatology Research.
HS is characterized as a debilitating skin disease that can adversely affect patients’ quality of life, even with mild symptoms. The painful nodules, abscesses, and sinus tracts that affect HS patients can cause significant psychosocial burden, researchers note.
In particular, feelings of stigmatization, defined as perceptions of devaluation, distrust, or social disapproval based on physical characteristics or attributes, can lead to feelings of shame and isolation in patients due to fear of negative reactions. This is a notable concern because
“Although quantitative studies using objective measures to assess stigma sentiment are limited, stigma sentiment has been associated with a proportional dependence on the clinical stage and location of disease,” said Dr. study authors said. “Furthermore, the association between stigma secondary to HS and the psychiatric comorbidities and burden of HS is limited.”
They compared between June and September 2018 of 153 patients (n = 30 clinics; n = 123 mail) who had a clinical diagnosis of HS from the Atrium Health Wake Forest Baptist Dermatology clinic within the past 5 years. Conduct observational studies and use stigmatization and objective tools to explore the relationship between patient QOL, depression, and social anxiety.From this cohort, 67 responses (response rate [RR]44%) received (clinic, n = 27 [RR, 90%]; email, n=40 [RR, 33%]).
Participants completed the Dermatology Quality of Life Index (DLQI) to assess skin-related quality of life. Patient Health Questionnaire-9 (PHQ-9) to assess depression. Negative Evaluation Brief Fear (BFNE) to assess social anxiety. Increased DLQI, PHQ-9, and BFNE scores correlate with worse QOL, increased levels of depression, and social anxiety, respectively.
Participants also completed an adapted version of the Stigmatization Feelings (FoS) survey to measure stigmatization scored on a scale of 0 (least stigmatization) to 155 (maximum stigmatization). Respondents were divided into two groups based on their median FoS (72): high stigma (above 72) and low stigma (below 72).
The mean age of the respondent study cohort was 39 years, 57% were African American patients, and 90% were female patients. The median stigma score was 74 and the median score was 72. FoS was shown to be weakly correlated (r = 0.51) with PHQ-9 (r = 0.42) and moderately (r = 0.51) with DLQI (r = 0.68) and BFNE (r = 0.51).
Findings showed that participants in the high stigma group were more likely to be in the low stigma group (6.7, P. < .001; 4.9, P. < .001; 23.2, P. < .001, respectively). FoS showed no difference in disease severity.
A limited response rate among the cohorts was cited as a potential limitation of the study results. Furthermore, the FoS is a valid objective measure of stigmatization, although it was originally targeted at patients with psoriasis.
“Participants who experienced more stigma had worse quality of life, higher levels of social anxiety, and were more likely to be depressed,” the study authors concluded. “A multidisciplinary, patient-centered focus on treating both the physical and psychosocial aspects of HS may help reduce the burden of HS.”
reference
Singh R, Kelly KA, Senthilnathan A, Feldman SR, Picardo RO. Stigmatization, a social perception that may have debilitating effects in patients with hidradenitis suppurativa: an observational study. Arch Dermatol Res2022;1-4.doi:10.1007/s00403-022-02412-5
