Psychological Impact and Quality of Life in Chronic Psoriasis Patients: A Mixed-Methods Study Combining a Validated...

Psoriasis is a chronic inflammatory skin disease associated with a significant physical and psychosocial burden. It adversely affects not only the skin but also psychological well-being, social functioning, and overall quality of life. Although quantitative assessment tools provide valuable estimates of disease burden, they do not fully capture patients' lived experiences. This concurrent mixed-methods study aimed to explore the impact of chronic psoriasis on psychological well-being, quality of life, and coping strategies among affected individuals.

A concurrent cross-sectional mixed-methods study was conducted among 60 adults with chronic psoriasis attending a tertiary care dermatology clinic. Disease severity was assessed using the Psoriasis Area and Severity Index (PASI) and categorized as mild, moderate, or severe. Quantitative data were collected using a researcher-developed questionnaire assessing quality of life, psychological impact, social functioning, coping strategies, and patient-reported support needs. The questionnaire was developed following a review of the published literature, underwent expert content validation by a three-member multidisciplinary panel (Content Validity Index = 0.90), and demonstrated good internal consistency (Cronbach's α = 0.80). A purposive subsample of 20 participants subsequently underwent in-depth semistructured interviews, and qualitative data were analyzed using inductive thematic analysis.

Among the 60 participants, PASI-based disease severity assessment classified 28 (46.67%) participants as having moderate psoriasis and 18 (30.0%) as having severe psoriasis. Moderate-to-severe impairment in quality of life was observed in 48 (80.0%) participants, while psychological distress was present in 44 (73.3%), including moderate distress in 17 (28.3%) and severe distress in nine (15.0%) participants. Social interaction was adversely affected in 39 (65.0%) participants, and work performance was impaired in 34 (56.7%). Feelings of embarrassment were reported by 41 (68.3%) participants, anxiety by 36 (60.0%), and low self-esteem by 33 (55.0%). Qualitative analysis identified four major themes: perceived stigma, emotional burden, social withdrawal, and coping strategies.

Chronic psoriasis was associated with substantial impairment in quality of life and significant psychological distress. Integrating quantitative findings with qualitative patient narratives provided a more comprehensive understanding of the psychosocial burden experienced by affected individuals. The findings highlight the importance of incorporating psychosocial assessment, patient education, and appropriate psychological support into comprehensive dermatological care.