Greater psychological distress and depression symptoms were associated with lower satisfaction with physicians among patients with psoriasis, according to the finding of a 14-year retrospective study.
Associations between psoriasis and mental health comorbidities have been well documented, highlighting a need for physicians to screen, as well as refer or treat, patients with various mental conditions in addition to their skin disease. On the flip side, how mental health is associated with patient satisfaction with physicians is rarely studied among adults with skin conditions, the researchers said.
Using data from the 2004 through 2017 Medical Expenditure Panel Survey, the researchers analyzed the association between mental health comorbidities among patients with psoriasis and their satisfaction with physicians in the US. Mental health comorbidities were measured using the Kessler 6-Item Psychological Distress Scale and the Patient Health Questionnaire 2. They used the patient-physician communication composite score to assess patients’ satisfaction with their physician.
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The researchers analyzed a total of 8,876,767 adults with psoriasis, with a mean age of 52.1 years, and 54% were women (unweight total 652 patients). Of these patients, 27% had moderate to severe symptoms of psychological distress, and 21% had moderate to severe symptoms of depression.
Compared with patients with no or mild symptoms of psychological distress, those with moderate to severe symptoms were less satisfied with their clinicians. Patients with moderate psychological distress symptoms were 2.8 times more likely to report low patient satisfaction compared with those with no or mild symptoms (95% CI, 1.5-4.9). Likewise, those with severe psychological distress symptoms were 2.3 times more likely to report low patient satisfaction compared to patients with no or mild symptoms (95% CI, 1.1-4.7).
In addition, the researchers observed similar trends in patients with depression symptoms, where those with moderate to severe symptoms were less satisfied with their clinicians compared with those with no or mild symptoms. Compared to patients with no or mild depression symptoms, patients with moderate symptoms were 4.6 times more likely to report low patient satisfaction (95% CI 2.1-10).
“This study suggests that patients with greater psychological distress and depression report lower satisfaction with their clinicians than those without such mental health symptoms,” the researchers concluded, adding “Clinicians need to be adaptable and supportive when communicating with patients with mental health comorbidities. Evaluating clinician performance solely based on patient satisfaction can be problematic and incomplete.”
Read C, Armstrong AW. Association between the mental health of patients with psoriasis and their satisfaction with physicians [Published online May 06, 2020]. JAMA Dermatol. doi:10.1001/jamadermatol.2020.1054