title: Socioeconomic and sociocultural determinants of psychological distress and quality of life among patients with psoriasis in a selected multi-ethnic Malaysian population.
abstract: Patients with psoriasis may have increased risk of psychological comorbidities. This cross-sectional study aimed at determining associations between sociocultural and socioeconomic factors with the Depression Anxiety Stress Scale (DASS) scores and the Dermatology Life Quality Index (DLQI) scores. Adult patients with psoriasis were recruited from a Dermatology outpatient clinic via convenience sampling. Interviews were conducted regarding socio-demographic factors and willing subjects were requested to complete the DASS and DLQI questionnaires. The Pearson χ2test, Fisher's exact test and multivariate logistic regression were used for statistical analysis to determine independent predictors of depression, anxiety, stress and severe impairment of quality of life. Unadjusted analysis revealed that depression was associated with Indian ethnicity (p = .041) and severe impairment of quality of life was associated with Indian ethnicity (p = .032), higher education (p = .013), higher income (p = .042), and employment status (p = .014). Multivariate analysis revealed that Indian ethnicity was a predictor of depression (p = .024). For stress, tertiary level of education (p = .020) was an independent risk factor while a higher monthly income was a protective factor (p = .042). The ethnic Indians and Malays were significantly more likely than the ethnic Chinese to suffer reduced quality of life (p = .001 and p = .006 respectively) and subjects with tertiary education were more likely to have severe impairment of quality of life (p = .002). Our study was unique in determining sociocultural influences on psychological complications of psoriasis in a South East Asian population. This has provided invaluable insight into factors predictive of adverse effects of psoriasis on psychological distress and quality of life in our patient population. Future studies should devise interventions to specifically target at risk groups in the development of strategies to reduce morbidity associated with psoriasis.
authors.affiliation: a Division of Dermatology, Department of Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia.|b Faculty of Medicine , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia.
authors.forename: Zhenli
authors.initials: Z
authors.lastname: Kwan
authors.affiliation: c Institute of Research Management and Monitoring , University of Malaya , Kuala Lumpur , Malaysia.
authors.forename: Yii Bonn
authors.initials: YB
authors.lastname: Bong
authors.affiliation: a Division of Dermatology, Department of Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia.
authors.forename: Leng Leng
authors.initials: LL
authors.lastname: Tan
authors.affiliation: a Division of Dermatology, Department of Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia.
authors.forename: Shu Xian
authors.initials: SX
authors.lastname: Lim
authors.affiliation: a Division of Dermatology, Department of Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia.
authors.forename: Adrian Sze Wai
authors.initials: AS
authors.lastname: Yong
authors.affiliation: a Division of Dermatology, Department of Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia.
authors.forename: Chin Chwen
authors.initials: CC
authors.lastname: Ch'ng
authors.affiliation: d Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia.
authors.forename: Maw Pin
authors.initials: MP
authors.lastname: Tan
authors.affiliation: e Department of Dermatology , Hospital Kuala Lumpur , Kuala Lumpur , Malaysia.
authors.forename: Suganthi
authors.initials: S
authors.lastname: Thevarajah
authors.affiliation: f Faculty of Medicine, MARA University of Technology , Shah Alam , Malaysia.
authors.forename: Rokiah
authors.initials: R
authors.lastname: Ismail
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003710:Demography; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000208:ethnology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012923:Social Class; D064890:Social Determinants of Health; D013315:Stress, Psychological / Q000209:etiology; D055815:Young Adult
keywords: Psoriasis; culture; psychology; quality of life; socioeconomic factors