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Patients with mental illness less satisfied with their doctors.

PSORIASIS PATIENTS with symptoms of psychological distress and depression reported lower satisfaction with their clinicians than did those without mental health comorbidities, according to a retrospective analysis of survey data.

The findings highlight the importance of clinicians being supportive and adaptable in their communication style when interacting with psoriasis patients with mental illness.

The investigators, Charlotte Read, MBBS, of Imperial College London, and April W Armstrong, MD, MPH, of the University of Southern California, Los Angeles, retrospectively analyzed longitudinal data from over 8.8 million U.S. adults with psoriasis who participated in the Medical Expenditure Panel Survey from 2004 to 2017. The primary outcome, patient satisfaction with their physician, was assessed using a patient-physician communication composite score.

Mental health comorbidities were evaluated using standard questionnaires. The mean age of participants was 52 years; 54% were female; 73% had no or mild psychological distress symptoms; and 27% had moderate or severe symptoms.

Patients with moderate psychological distress symptoms were 2.8 times more likely to report lower satisfaction with their physician than were those with no or mild symptoms (adjusted odds ratio, 2.8; P = .001). Patients with severe symptoms were more likely to report lower satisfaction (aOR, 2.3; P = .03).

Based on the results, the authors emphasized the importance of bettering the patient experience for those with mental illness given the potential association with improved health outcomes. "Because depressed patients can be more sensitive to negative communication, the clinician needs to be more conscious about using a positive and supportive communication style," they said.

They acknowledged the inadequacy of evaluating clinician performance using patient satisfaction alone, so their findings may not be generalizable to all clinical settings.

The study was funded by the National Psoriasis Foundation. Dr. Armstrong reported financial affiliations with several pharmaceutical companies.



SOURCE: Read C, Armstrong AW. JAMA Dermatol. 2020 May 6. doi: 10.1001/jamadermatol.2020.1054.

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Title Annotation:PSORIASIS
Author:Rans, Caleb
Publication:Dermatology News
Date:Jul 1, 2020
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