Skin Distress Screening: Validation of an Efficient One-question Tool

Area of Science:

• Dermatology
• Psychological distress screening
• Health-related quality of life

Background:

• Skin diseases significantly impact patients' physical, emotional, and social well-being, leading to skin-related distress.
• Early identification of skin-related distress is crucial during outpatient dermatology visits.
• Validated screening tools are needed to efficiently assess distress in clinical settings.

Purpose of the Study:

• To validate the Distress Thermometer, a one-question screening tool adapted for skin conditions, for identifying skin-related distress.
• To assess the reliability and validity of the Distress Thermometer compared to the Skindex29.
• To determine an optimal cut-off score for the Distress Thermometer in a general practice setting.

Main Methods:

• A cross-sectional questionnaire study involving 214 patients with chronic skin diseases across two Amsterdam medical centers.
• Validation using the Skindex29 as the gold standard for assessing health-related quality of life.
• Test-retest reliability assessed by administering questionnaires at two different time points.

Main Results:

• Severely impaired health-related quality of life was identified in 30% of patients based on Skindex29 scores (cut-off ≥44).
• Receiver operating characteristic curve analysis showed an area under the curve of 0.813, indicating good diagnostic accuracy.
• A Distress Thermometer cut-off score of ≥4 demonstrated optimal sensitivity (90.7%) and specificity (56.1%).

Conclusions:

• The Distress Thermometer is a rapid, valid, and reliable tool for screening skin-related distress in chronic skin disease patients.
• A cut-off score of ≥4 on the Distress Thermometer is recommended for general practice screening.
• Implementing this tool can improve the timely identification and management of psychological distress in dermatological care.