Psychological Well-Being and Associated Factors Among Adults with Chronic Skin Diseases: A Cross-Sectional Study

Abstract

Background: Emotional well-being, self-esteem, social interactions, and quality of life are all impacted by chronic skin conditions. This study aimed to determine the psychological health of affected individuals and identify factors associated with moderate-to-severe psychological distress. Methods: This study included 180 consecutively recruited adults with chronic dermatological conditions at a tertiary care teaching hospital. The disease characteristics, duration, frequency of flares, visibility of the lesions, dermatology activity, psychological health, social functioning, coping strategies, and dermatology-related quality of life were evaluated by interview, validated questionnaires, clinical examination, and medical-record review. The data were analysed using SPSS version 26.0. Descriptive statistics were used to summarize the characteristics of the participants, and Chi-square or Fisher's exact tests were used to assess the association. Moderate to severe psychological distress was predicted by independent variables using multivariable logistic regression, with a P-value <0.05 as significant. Results: The mean age was 36.8 ± 13.7 years, and 57.2% were female. The most common diagnoses were psoriasis 64 (35.6%) and eczema 54 (30.0%). 110 (61.1%) had moderate-to-severe psychological distress, 99 (55.0%) had lowered self-esteem, and 98 (54.4%) had social avoidance. Frequent flare-ups (AOR=2.96), reduced self-esteem (AOR=2.58), disease duration >5 years (AOR=2.39), female gender (AOR=1.94), and visible skin lesions (AOR= 3.44) were the strongest independent predictors of distress. Conclusion: Psychological and social impairments were significant with chronic skin diseases. Psychological assessment, counselling, and referral should be a part of dermatology care. Future multicenter longitudinal studies should assess integrated long-term dermatological and psychological management.