Determinants of Quality of Life and Mental Health in Kenyan Psoriasis Patients: A Cross-Sectional Analysis from the Kenyan Psoriasis Registry.

Abstract

Purpose: Psoriasis is a chronic immune-mediated disease with global prevalence of 2-3% that is associated with significantly reduced quality of life (QoL) and worsened mental health. Despite this, there is a lack of research in African psoriasis populations, with no modern epidemiological studies conducted in Kenya to examine these factors. This study aims to identify demographic and clinical features associated with dermatology-related QoL and mental health among psoriasis patients enrolled in the newly established Kenyan Psoriasis Registry (KPR), based at Moi Teaching and Referral Hospital in Eldoret, Kenya.

Patients and methods: In a cross-sectional analysis of 97 adult psoriasis patients enrolled in the KPR, we evaluated associations of demographic and disease characteristics with independent outcomes of dermatology-associated QoL (Dermatology Life Quality Index, DLQI), anxiety (Generalized Anxiety Disorder 7-item, GAD-7), and depression (Patient Health Questionnaire 9-item, PHQ-9). Univariate and multivariate linear regression models were used to identify associations, with P < 0.05 considered statistically significant.

Results: In univariate analyses, age, female gender, marital status, certain subethnicities, high-impact body sites, itch and pain, sleep disturbance, and disease severity were factors associated with worse QoL, anxiety, and depression scores. In multivariate analyses, younger age, Itch Numeric Rating Scale, and Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance T-score remained significantly associated with worse DLQI. Both PROMIS Sleep Disturbance and separated marital status were associated with worse GAD-7 and PHQ-9.

Conclusion: Kenyan psoriasis patients experience significant QoL and mental health burden, with younger age, itch, sleep disturbance, and separated marital status associated with worse outcomes.