Stress in dermatological patients: a multicenter observational study of 8295 outpatients and controls from 22 European clinics

Balieva, Flora, Schut, Christina, Szabó, Csanád, Sampogna, Francesca, Dalgard, Florence J., Altunay, Ilknur K., Bewley, Anthony, Ferreira, Bárbara Roque, Finlay, Andrew Y. ORCID: https://orcid.org/0000-0003-2143-1646, Gieler, Uwe, Gracia‐Cazaña, Tamara, Grivcheva‐Panovska, Vesna, Jemec, Gregor B., Legat, Franz J., Lien, Lars, Lvov, Andrey, Marron, Servando E., Misery, Laurent, Reich, Adam, Romanov, Dmitry, Koulil, Saskia Spillekom‐van, Ständer, Sonja, Svensson, Ake, Szepietowski, Jacek C., Thompson, Andrew R. ORCID: https://orcid.org/0000-0001-6788-7222, Titeca, Geraldine, Tomás‐Aragonés, Lucía, Vulink, Nienke, Zeidler, Claudia and Kupfer, Jörg 2025. Stress in dermatological patients: a multicenter observational study of 8295 outpatients and controls from 22 European clinics. JAAD International 10.1016/j.jdin.2025.12.005 Item availability restricted.

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Abstract

Background 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. Objectives To investigate stress in a large, diverse sample of patients with different skin conditions and identify predictors of stress. Methods 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 (PSS-10) was used to measure stress. Results Patients reported significantly higher stress levels, more stressful life events during the last six months as well as 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, disease-related and psychological variables (depression, anxiety, stigmatization, body dysmorphic concerns). Limitations As with all cross-sectional studies, causality and directionality cannot be inferred. Conclusion Stress poses a significant psychosocial burden to dermatological patients, especially to vulnerable subgroups. Health interventions targeting stress may be essential to improve clinical outcomes.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine Schools > Psychology
ISSN:	2666-3287
Date of First Compliant Deposit:	7 January 2026
Date of Acceptance:	12 December 2025
Last Modified:	07 Jan 2026 16:17
URI:	https://orca.cardiff.ac.uk/id/eprint/183687

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