Perceived Stigmatization among Dermatological Outpatients Compared with Controls: An Observational Multicentre Study in 17 European Countries
Acta Dermato Venereologica, vol. 103, pp. adv6485
Abstract
Perceived stigmatization places a large psychosocial burden on patients with some skin conditions. Little is known about the experience of stigmatization across a wide range of skin diseases. This observational cross-sectional study aimed to quantify perceived stigmatization and identify its predictors among patients with a broad spectrum of skin diseases across 17 European countries. Self-report questionnaires assessing perceived stigmatization and its potential predictors were completed by 5,487 dermatology outpatients and 2,808 skin-healthy controls. Dermatological diagnosis, severity, and comorbidity were clinician-assessed. Patients experienced higher levels of perceived stigmatization than controls (p < 0.001, d = 0.26); patients with psoriasis, atopic dermatitis, alopecia, and bullous disorders were particularly affected. Multivariate regression analyses showed that perceived stigmatization was related to sociodemographic (lower age, male sex, being single), general health-related (higher body mass index, lower overall health), disease-related (higher clinician-assessed disease severity, presence of itch, longer disease duration), and psychological (greater distress, presence of suicidal ideation, greater body dysmorphic concerns, lower appearance satisfaction) variables. To conclude, perceived stigmatization is common in patients with skin diseases. Factors have been identified that will help clinicians and policymakers to target vulnerable patient groups, offer adequate patient management, and to ultimately develop evidence-based interventions.
Authors 31
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Affiliation as printed
Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands. s.van.beugen@fsw.leidenuniv.nl
Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
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Justus-Liebig-Universität Gießen
Affiliation as printed
Institute of Medical Psychology, Justus-Liebig-University Gießen, Gießen, Germany
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Justus-Liebig-Universität Gießen
Affiliation as printed
Institute of Medical Psychology, Justus-Liebig-University Gießen, Gießen, Germany
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Queen Mary University of London · Barts Health NHS Trust
Affiliation as printed
Barts Health NHS Trust & Queen Mary University, London, UK
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Affiliation as printed
Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Justus-Liebig-Universität Gießen · Vitos
Affiliation as printed
Department of Dermatology, Justus-Liebig- University Giessen and Vitos Klinik, Giessen, Germany
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Cardiff and Vale University Health Board · Cardiff University
Affiliation as printed
South Wales Clinical Psychology Programme, Cardiff & Vale University Health Board, & School of Psychology, Cardiff University, UK
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Universidad de Zaragoza · Hospital Universitario Miguel Servet · Instituto de Investigación Sanitaria Aragón
Affiliation as printed
Miguel Servet University Hospital, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
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Affiliation as printed
Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
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Unidade Local de Saúde de Coimbra
Affiliation as printed
Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal
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Affiliation as printed
Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
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Affiliation as printed
Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
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Centre Hospitalier Régional Universitaire de Brest
Affiliation as printed
Department of Dermatology, University Hospital of Brest, Brest, France
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Hospital Universitario Miguel Servet
Affiliation as printed
Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
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University of Münster · University Hospital Münster
Affiliation as printed
Department of Dermatology, University Clinic Münster, Münster, Germany
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University of Münster · University Hospital Münster
Affiliation as printed
Department of Dermatology, University Clinic Münster, Münster, Germany
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Affiliation as printed
Institute of Psychology, University of Szeged, Szeged, Hungary
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University of Wrocław · Wroclaw Medical University
Affiliation as printed
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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Affiliation as printed
Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
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Affiliation as printed
Department of Dermatology and Venereology, Skåne University Hospital, Malmo, Sweden
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Affiliation as printed
University of Health Sciences. Hamidiye Etfal Research and Training Hospital, Department of Dermatology and Venereology, Istanbul, Turkey
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Affiliation as printed
Department of Dermatology, Medical University of Graz, Graz, Austria
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Ss. Cyril and Methodius University in Skopje
Affiliation as printed
University St Cyril and Methodius, School of Medicine, PHI University Clinic of Dermatology Skopje, N. Macedonia
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Affiliation as printed
Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Affiliation as printed
Department of Dermatovenereology and Cosmetology, Central State Medical Academy of department of presidential affairs, Moscow, Russia
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Affiliation as printed
Department of Dermatology/ Clinique Notre Dame de Grâce, Gosselies, Belgium
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Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
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Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers
Affiliation as printed
Department of Psychiatry, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
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Affiliation as printed
Department of Psychology, University of Zaragoza, Zaragoza Spain
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Affiliation as printed
Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
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Affiliation as printed
Department of Dermatology and Venereology, Skåne University Hospital, Malmo, Sweden
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