Stress in dermatology patients: A multicenter observational study of 8295 outpatients and controls from 22 European clinics

Balieva, Flora ; Schut, Christina ; Szabó, Csanád ; Sampogna, Francesca ; Dalgard, Florence J. ; Altunay, Ilknur K. ; Bewley, Anthony ; Ferreira, Bárbara Roque ; Finlay, Andrew Y. ; Gieler, Uwe ; Gracia-Cazaña, Tamara (Universidad de Zaragoza) ; Grivcheva-Panovska, Vesna ; Jemec, Gregor B. ; Legat, Franz J. ; Lien, Lars ; Lvov, Andrey ; Marron, Servando E. (Universidad de Zaragoza) ; Misery, Laurent ; Reich, Adam ; Romanov, Dmitry ; Koulil, Saskia Spillekom-van ; Ständer, Sonja ; Svensson, Ake ; Szepietowski, Jacek C. ; Thompson, Andrew R. ; Titeca, Geraldine ; Tomás-Aragonés, Lucía ; Vulink, Nienke ; Zeidler, Claudia ; Kupfer, Jörg

Resumen: Background
Skin diseases are symptomatic, visible, and stigmatizing and it is acknowledged that they can be associated with stress. However, large studies comparing disease-specific stress are scarce.
Objectives
To investigate stress in a large, diverse sample of patients with different skin conditions and identify predictors of stress.
Methods
A cross-sectional, multicenter study was conducted in 22 dermatology clinics across 17 European countries (response rate 82.4%). The study included 5487 patients diagnosed with various dermatological conditions and 2808 skin-healthy controls. The Perceived Stress Scale, 10 items was used to measure stress.
Results
Patients reported significantly higher stress levels, more stressful life events during the last 6 months, and more economic difficulties than controls. Patients with psychodermatological conditions, hyperhidrosis, hidradenitis suppurativa, atopic dermatitis, acne, and urticaria experienced the highest stress levels. 44% of the variance of perceived stress in patients with skin conditions could be predicted by sociodemographic data and disease-related and psychological variables (depression, anxiety, stigmatization, and body dysmorphic concerns).
Limitations
As with all cross-sectional studies, causality and directionality cannot be inferred.
Conclusion
Stress poses a significant psychosocial burden to dermatological patients, especially to vulnerable subgroups. Health interventions targeting stress may be essential to improve clinical outcomes.

Idioma: Inglés

DOI: 10.1016/j.jdin.2025.12.005

Año: 2025

Publicado en: JAAD International 25, 69-77 (2025), [9 pp.]
ISSN: 2666-3287

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Dermatología (Dpto. Medicina, Psiqu. y Derm.)