Sampogna F, Chren M M, Melchi C F, Pasquini P, Tabolli S, Abeni D
Health Services Research Unit, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Via dei Monti di Creta 104, 00167 Rome, Italy.
Br J Dermatol. 2006 Feb;154(2):325-31. doi: 10.1111/j.1365-2133.2005.06909.x.
Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue.
To investigate whether older patients with psoriasis have a different impairment in quality of life compared with younger patients, considering level of severity, duration of disease, gender and psychological distress.
The study was performed between February 2000 and February 2002 at the inpatient wards of the Dermatological Institute IDI-IRCCS, Rome, Italy, in the framework of a large project on clinical, epidemiological, emotional and quality of life aspects of psoriasis (IMPROVE study). This is a hospital-based cross-sectional study, with measures of quality of life (Skindex-29, Dermatology Life Quality Index and Psoriasis Disability Index) and of psychological distress, generic (12-item General Health Questionnaire) and psoriasis-related (Psoriasis Life Stress Inventory), all self-assessed by patients. We compared the mean scores of each quality of life instrument in patients aged < 65 years and >/= 65 years, in subsets of patients based on clinical and sociodemographic characteristics.
We analysed 936 patients hospitalized at IDI-IRCCS with a diagnosis of psoriasis. Quality of life was significantly more impaired in the older group for all the Skindex-29 scales, and psychological distress was higher in older patients. In particular, older women suffering from anxiety or depression had the greatest impairment in quality of life. The results were somewhat different using the other quality of life instruments.
These results should alert dermatologists that similar levels of clinical severity in psoriasis may be associated with different levels of quality of life and psychological distress of patients. Particular attention should be devoted to older patients, and especially to older women.
银屑病对患者的生活质量有很大影响,而人口老龄化是一个重要的公共卫生问题。
考虑疾病严重程度、病程、性别和心理困扰,调查老年银屑病患者与年轻患者在生活质量方面是否存在不同程度的损害。
该研究于2000年2月至2002年2月在意大利罗马皮肤病研究所IDI-IRCCS的住院病房进行,是关于银屑病临床、流行病学、情绪和生活质量方面的大型项目(IMPROVE研究)的一部分。这是一项基于医院的横断面研究,采用生活质量测量方法(Skindex-29、皮肤病生活质量指数和银屑病残疾指数)以及心理困扰测量方法,包括通用测量方法(12项一般健康问卷)和与银屑病相关的测量方法(银屑病生活压力量表),均由患者自行评估。我们比较了年龄<65岁和≥65岁患者中每种生活质量工具的平均得分,并根据临床和社会人口学特征对患者亚组进行了比较。
我们分析了936名在IDI-IRCCS住院且诊断为银屑病的患者。在Skindex-29所有量表中,老年组的生活质量受损程度明显更高,老年患者的心理困扰也更严重。特别是,患有焦虑或抑郁的老年女性生活质量受损最为严重。使用其他生活质量工具时,结果略有不同。
这些结果应提醒皮肤科医生,银屑病临床严重程度相似时,患者的生活质量和心理困扰水平可能不同。应特别关注老年患者,尤其是老年女性。