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

## TL;DR

This study found that dermatology patients experience higher stress than healthy individuals, with certain skin conditions linked to the highest stress levels.

## Contribution

The study provides large-scale evidence on disease-specific stress in dermatology patients across Europe.

## Key findings

- Patients with skin conditions reported significantly higher stress levels and more stressful life events than controls.
- Psychodermatological conditions and specific skin diseases were associated with the highest stress levels.
- 44% of stress variance in patients was explained by sociodemographic, disease-related, and psychological factors.

## Abstract

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.

To investigate stress in a large, diverse sample of patients with different skin conditions and identify predictors of stress.

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.

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).

As with all cross-sectional studies, causality and directionality cannot be inferred.

Stress poses a significant psychosocial burden to dermatological patients, especially to vulnerable subgroups. Health interventions targeting stress may be essential to improve clinical outcomes.