Psoriasis has a major secondary impact on the lives of family members and partners

Authors


  • Conflicts of interest A.Y.F. is joint copyright owner of the Dermatology Life Quality Index, Psoriasis Disability Index and Family Dermatology Life Quality Index.

A.M. Eghlileb.
E-mail: ahmed_eghlileb@yahoo.com

Summary

Background  Psoriasis affects the quality of life (QoL) of relatives and partners of patients with psoriasis, but little is known about this secondary impact.

Objectives  To identify the different ways in which the lives of relatives and partners of people with psoriasis are affected by the disease.

Methods  Relatives and partners of patients with psoriasis participated. Subjects were excluded if they had any skin disease. The severity of the psoriasis of the patients was measured using the Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and Psoriasis Disability Index (PDI). Subjects either had intensive qualitative interviews with one researcher or responded to a postal questionnaire. Both methods identified ways in which their relative's or partner's psoriasis had affected their lives.

Results  Thirty-three subjects were interviewed and 30 replied by postal questionnaire. Twenty-eight of the 63 subjects were relatives (seven men and 21 women) and 35 were partners (16 men and 19 women). The median age was 51 years (range 20–80). The patients (n = 63) had a mean DLQI of 10, mean PDI of 13·8 and mean PASI of 5·2. Forty different aspects of QoL impairment of relatives and partners were identified. The percentage of subjects in whom any of these aspects were mentioned is illustrated in six different categories. Seventy per cent stated that the treatment of their relative or partner resulted in them having to spend extra time on housework; 57% described psychological pressures including anxiety, being upset and being worried about the patient's future; 55% described social disruption due to lack of social confidence either because of embarrassment or because of the time required for care duties; 44% described limitations to holiday plans, sport and leisure activities and evenings out; 37% described limitations on their daily activities such as shopping, work and time spent with other family members; 37% felt that their close relationships had deteriorated. Only 8% described no effect at all on their QoL. The QoL of the relatives and partners (number of categories affected) was more closely related to the patients’ QoL (DLQI: r = 0·77, P < 0·001; PDI: r = 0·67, P < 0·001) than to the objective disease severity scores (PASI: r = 0·34, P < 0·05).

Conclusions  The QoL of partners and relatives of people with psoriasis can be significantly affected. Many different aspects of everyday life that are affected and the psychological impacts of having a partner or relative with psoriasis have been identified. It is of great importance to identify these issues to allow clinicians to develop appropriate care strategies not only for patients with psoriasis, but also for their partner and family.

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