Lada G, Chinoy H, Talbot PS, Warren RB, Kleyn CE. The effect of the Covid‐19 pandemic on illness perceptions of psoriasis and the role of depression: Findings from a cross‐sectional study.
SKIN HEALTH AND DISEASE 2022;
2:e145. [PMID:
36092261 PMCID:
PMC9435449 DOI:
10.1002/ski2.145]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022]
Abstract
Background
Illness perceptions in psoriasis have an impact on adherence and disability. Changes in dermatological healthcare provision during the Covid‐19 pandemic and distress may have affected illness perceptions in psoriasis patients.
Objectives
To test whether illness perceptions about psoriasis changed during the first year of the Covid‐19 pandemic compared to pre‐pandemic in a tertiary population with psoriasis and whether pandemic effects differed depending on depressive burden, given this population's high depression prevalence.
Methods
In a cross‐sectional survey of n = 188 tertiary patients with dermatologist‐confirmed psoriasis recruited before and during the pandemic, eight illness perceptions domains were assessed using the Brief‐Illness Perceptions Questionnaire (BIPQ). Presence of depression was assessed with the Hospital Anxiety and Depression Scale (HADS).
Results
Beliefs about treatment control and patients' understanding of psoriasis were significantly worse in patients responding during the pandemic compared to before Covid‐19. These differences were greater when depression was absent (treatment control: adjusted p < 0.001; coherence: adjusted p = 0.01). However, participants during the pandemic felt less emotionally affected (adjusted p = 0.02) and concerned (adjusted p = 0.007) about psoriasis, independently of depression.
Conclusions
We found diverse pandemic effects on illness perception domains in psoriasis. Uncertainty and reduced healthcare access may drive poorer treatment and coherence beliefs during Covid‐19. These beliefs can hinder patients' health‐promoting behaviours and may explain the high pandemic non‐adherence reported previously in psoriasis. Appropriate interventions are needed to establish positive long‐term cognitions and improve psoriasis management, for example, using the PsoWell patient materials. Dermatology services should invest in engaging and educating patients regardless of concurrent psychological distress.
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