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Development of the pruritus-associated stress scale: a cross-sectional pilot study
Svenja Royeck1, Johanna Papathanassiou1, Angelika Weigel2
1Pruritus Medicine Section, Department of Dermatology and Center for Chronic Pruritus (KCP), University Hospital Münster, Münster, Germany.
Frontiers in Medicine
|January 2, 2026
Summary
A new scale, the Pruritus-Associated Stress Scale (PASS), was developed to measure stress related to chronic itching. This tool helps assess the significant impact of pruritus-associated stress on patients with skin conditions.
Area of Science:
- Dermatology
- Psychosomatic Medicine
- Patient-Reported Outcome Measures
Background:
- Chronic pruritic dermatoses are significantly exacerbated by perceived stress.
- A lack of validated tools to measure pruritus-associated stress is evident.
- Understanding the psychological impact of chronic itching is crucial for effective management.
Purpose of the Study:
- To develop and pilot the Pruritus-Associated Stress Scale (PASS).
- To create a patient-reported outcome measure (PROM) for assessing stress linked to pruritus.
- To provide a validated instrument for quantifying the psychological burden of chronic itching.
Main Methods:
- Development of the preliminary PASS following PROM guidelines.
- Interviews with patients experiencing chronic prurigo (CPG), atopic dermatitis (AD), and chronic pruritus on non-lesional skin (CPNL).
- Utilized PSS-10 and PSQ-30 for perceived stress assessment and item refinement through impact analysis and reliability testing.
Main Results:
- 94.5% of 55 patients reported pruritus-associated stress in the prior two weeks.
- The preliminary PASS showed excellent internal consistency (Cronbach's alpha = 0.91).
- Key items identified related to nervousness, coping strategies, fatigue, and scratching urges.
Conclusions:
- A preliminary PASS was successfully developed and piloted.
- The study identified key factors contributing to pruritus-associated stress.
- Further refinement via exploratory factor analysis in a larger sample is planned.
