Study Highlights Happiness Differences in European Countries Among Dermatology Patients

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Patient happiness levels were notably different among various European countries, recent findings suggest, with unique impairment observed among those with atopic dermatitis compared to psoriasis.¹

This new research—led by S. Ziehfreund from the department of dermatology and allergy at the Technical University of Munich in Germany—was carried out to assess the disease- and country-specific distinctions present in disease-related happiness and quality of life. Additionally, the investigators sought to explore influences on heuristic happiness among Europeans with psoriasis and atopic dermatitis.

The research team noted that most dermatology research has been shown not to be as comprehensive as possible in highlighting the differences among patients with different skin diseases.²

“This study aimed to comprehensively evaluate patient happiness in psoriasis and (atopic dermatitis), considering country-specific happiness variations and its impact on quality of life and disease-related factors across Europe,” Ziehfreund and colleagues wrote.¹

Background and Study Design

The research team used a cross-sectional multicenter trial design, conducting their research within dermatology departments in 8 European countries’ university-affiliated hospitals. In Italy, Germany, Malta, Romania, Poland, Austria, Portugal, and Ukraine, the team recruited individuals with diagnoses of psoriasis or atopic dermatitis out of between October 2021 - February 2023.

Participants were involved if they were within the age range of 18 and older, had confirmed diagnoses of atopic dermatitis or psoriasis, and resided in the countries identified previously. A standardized questionnaire was filled out in subjects’ native languages either on paper or online.

Their questionnaire was made up of sections for both healthcare professionals and patients. The investigators used it to record sociodemographic information such as place of residence, age, employment status, gender, and marital status.

The research team asked participants to report their perception of disease severity on an 11-point scale from 0 ("not severely impacted") to 10 ("severely impacted"). They were also asked to score the effect of their condition on quality of life using the Dermatology Life Quality Index (DLQI), as well as their subjective well-being (SWB) using the Scale of Positive and Negative Experience (SPANE).

Life satisfaction was reported by the survey respondents using the Satisfaction with Life Scale (SWLS), a 5-item measure scored on a 7-point Likert scale. One item featured on the 11-point Likert scale was adapted from the European Social Survey (ESS) for the purposes of heuristic happiness measurement.

At each study site, the healthcare professionals involved in the study noted participants’ diagnoses, as well as their current and prior treatments, dates at the time of of initial diagnosis, and their clinical severity scores, using either the Psoriasis Area and Severity Index (PASI) or the SCORing Atopic Dermatitis (SCORAD) scale. Their following data analysis involved a descriptive analysis and quantile regression.

Differences Identified

The investigators identified almost no differences between the 723 individuals with psoriasis and the 316 with atopic dermatitis in terms of happiness, life satisfaction, and negative effects. They did, however, report that there were differences in DLQI and smaller distinctions in subjects’ positive effects.

Specifically, those with atopic dermatitis were shown to report a greater impact versus those with psoriasis. Variations among European countries were apparent in heuristic happiness, DLQI, positive and negative effects, and life satisfaction. Patients in Austria reported the highest satisfaction and positivity, happiness levels, and best treatment care as well as lowest disease severity.

The research team’s quantile regression demonstrated that there were varying coefficients for predictors across the different quantiles. This was suggested to show that there were positive impacts on subjects’ levels of heuristic happiness linked with current or prior systemic therapy receipt at different quantiles.

“(This study) highlights the importance of ensuring adequate treatment access and advocates for positive psychological interventions to enhance patient happiness,” they wrote. “Recognizing these disease-and country-specific differences is crucial for shaping future treatment strategies and health policies aimed at improving the lives of those affected by psoriasis and (atopic dermatitis).”

References

1. ^{Ziehfreund S, Wecker H, Mittag S, Weis J, Tizek L, Verkhoturova V, et al. Happiness across the borders—A cross-sectional study among patients with psoriasis and atopic dermatitis in Europe. J Eur Acad Dermatol Venereol. 2024; 00: 1–14. https://doi.org/10.1111/jdv.20288.}
2. ^{Schuster B, Ziehfreund S, Albrecht H, Spinner CD, Biedermann T, Peifer C, et al. Happiness in dermatology: a holistic evaluation of the mental burden of skin diseases. J Eur Acad Dermatol Venereol. 2020; 34(6): 1331–1339. https://doi.org/10.1111/jdv.16146.}