Intended for healthcare professionals

General Practice

Postal questionnaire study of disability in the community associated with psoriasis

BMJ 1996; 313 doi: (Published 12 October 1996) Cite this as: BMJ 1996;313:919
  1. Patrick O'Neill, general practitionera,
  2. Peter Kelly, directorb
  1. a Norton Medical Centre, Norton, Stockton on Tees TS20 1AN,
  2. b Centre for Health and Medical Research, University of Teeside, Middlesborough TS1 3BA
  1. Correspondence to: Dr O'Neill.
  • Accepted 7 August 1996


Objective: To study the disability caused by psoriasis in patients recorded as having psoriasis by their general practitioner.

Design: Postal questionnaire survey using the psoriasis disability index and SF-36.

Setting: Five general practices in Cleveland.

Subjects: Of 767 patients identified, 546 completed the questionnaire and 435 were eligible and gave informed consent.

Main outcome measures: Scores on SF-36 and psoriasis disability index.

Results: The psoriasis disability index score was highly negatively correlated with all eight of the SF-36 health measures (P<0.0001 for each), and the manual social classes scored higher than the non-manual social classes (P<0.0001). The manual social class group scored significantly lower scores than the controls on all the SF-36 scales, and the non-manual group scored significantly lower for physical and mental role limitation (P<0.0004 and P = 0.026), mental health (P<0.0001), energy and vitality (P<0.0004), and health perception (P<0.0001). Also, the manual group had poorer health perception on five of the SF-36 variables when compared with the non-manual group.

Conclusions: Patients with psoriasis have an overall lower perception of their quality of life than healthy controls, and those in the lower social classes suffer a greater degree of disability from their disease than the higher social classes.

Key messages

  • In this study people with psoriasis had a greater disability than healthy controls

  • These patients did not consult about their skin condition frequently, yet most used some treatment

  • The manual social classes suffer greater disability than non-manual classes

  • The psoriasis disability index may help measure disability in general practice


  • Funding Psoriasis Association and Cleveland Primary Care Research Panel.

  • Conflict of interest None.

  • Accepted 7 August 1996
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