Assessing Psychosocial Burden in Psoriasis Patients Using the PRISM-RII Tool: A Comprehensive Evaluation

Abstract

Introduction: Psoriasis is a chronic, immune-mediated inflammatory disease that significantly impacts patients' quality of life due to its visible lesions and associated stigma. Psychological comorbidities are prevalent among psoriasis patients. Objectives: This study aimed to evaluate the utility of the Pictorial Representation of Illness and Self Measure Revised II (PRISM-RII) tool in assessing the psychosocial burden, including internalized stigma, in psoriasis patients. Methods: A cross-sectional study was conducted with 190 psoriasis patients recruited from a university hospital dermatology treatment center. Participants completed the PRISM-RII Psoriasis Internalized Stigma Scale (PISS), Hospital Anxiety and Depression Scale (HADS), and Dermatology Life Quality Index (DLQI). Clinical severity was measured using the Psoriasis Area and Severity Index (PASI). Results: Significant correlations were observed between PRISM-RII parameters and measures of quality of life, internalized stigma, anxiety, and depression. Our study revealed significant differences in PASI scores among different Illness Perception Measures (IPM). A negative correlation was found between PASI and Self-Illness Separation (SIS), suggesting that increased disease severity is associated with a higher perceived burden of illness. Additionally, significant negative correlations were observed between SIS and DLQI, HADS, and PISS. Patients with larger IPM reported higher levels of anxiety, depression, and internalized stigma, as well as lower treatment satisfaction. Conclusions: The PRISM-RII tool effectively captures the psychosocial burden of psoriasis including internalized stigmatization, highlighting the need to address both physical and psychological aspects in clinical practice. Incorporating PRISM-RII into routine assessments can enhance patient-centered care by identifying and addressing the psychosocial dimensions of psoriasis.