Fortune D G, Main C J, O'Sullivan T M, Griffiths C E
Department of Medicine, University of Manchester, Hope Hospital, Salford, U.K.
Br J Dermatol. 1997 Nov;137(5):755-60.
The purpose of this study was: (i) to examine the impact of the clinical severity, anatomical location and treatment of psoriasis on patients' quality of life, and (ii) to investigate the effects of perceptions of psoriasis-related stress on patients' physical and mental health and on areas of disability in everyday life. All patients (n = 204) attending a psoriasis specialty clinic were invited to complete a multidimensional quality of life assessment comprising the Psoriasis Disability Index (PDI), the SF-36 Health Survey and the Psoriasis Life Stress Inventory (PLSI). Results (n = 150) indicated that overall clinical severity of psoriasis as assessed by the Psoriasis Area and Severity Index, and duration of psoriasis, were unrelated to impairment in any areas of quality of life. Anatomical location (social visibility) of psoriasis was associated with self-report of poor physical health (P = 0.01), and there was a modest association with patients' mental health (P = 0.04); however, anatomical location of psoriasis was not significantly associated with self-reported disability in everyday life, or stress scores. Patients who were classified as more reactive to the stress associated with psoriasis (78% of the sample) were functioning less well in terms of their mental health (P = 0.001) and also experienced significantly more disability in all areas of everyday life (P = 0.001). Differences in method of treatment for psoriasis did not significantly affect scores on the psoriasis-specific (PDI; PLSI) or generic (SF-36) quality of life measures. A multiple regression analysis demonstrated that stress resulting from anticipating other people's reactions to their psoriasis contributed more to the variance in patients' disability in everyday life than any other medical or health status variable. The results support the importance of assessing the effects of stress in patients' adjustment to their condition and may indicate a role for adjunctive psychological stress management training for a significant number of patients with psoriasis.
（i）研究银屑病的临床严重程度、解剖部位和治疗对患者生活质量的影响，以及（ii）调查对银屑病相关压力的认知对患者身心健康和日常生活残疾领域的影响。邀请了一家银屑病专科诊所的所有患者（n = 204）完成一项多维生活质量评估，包括银屑病残疾指数（PDI）、SF - 36健康调查和银屑病生活压力量表（PLSI）。结果（n = 150）表明，根据银屑病面积和严重程度指数评估的银屑病总体临床严重程度以及银屑病病程，与生活质量的任何领域的损害均无关。银屑病的解剖部位（社会可见性）与身体健康状况差的自我报告相关（P = 0.01），与患者心理健康有适度关联（P = 0.04）；然而，银屑病的解剖部位与日常生活中自我报告的残疾或压力得分无显著关联。被归类为对银屑病相关压力反应更强的患者（样本的78%）在心理健康方面功能较差（P = 0.001），并且在日常生活的所有领域也经历了明显更多的残疾（P = 0.001）。银屑病治疗方法的差异对银屑病特异性（PDI；PLSI）或通用（SF - 36）生活质量测量的得分没有显著影响。多元回归分析表明，预期他人对其银屑病的反应所产生的压力比任何其他医疗或健康状况变量对患者日常生活残疾的方差贡献更大。这些结果支持了评估压力对患者适应病情影响的重要性，并可能表明对大量银屑病患者进行辅助心理压力管理培训的作用。
