Feelings of stigmatization in patients with psoriasis.

The concept of stigma, defined as a discrediting mark that sets a person off from others, is used in a systematic, in-depth examination of how 100 adults with psoriasis experience their illness. Information on demographic and illness variables that might predict feelings of being stigmatized were obtained. Through factor analysis of a specially designed questionnaire, six dimensions of the stigma experience were identified: anticipation of rejection, feeling of being flawed, sensitivity to others' attitudes, guilt and shame, secretiveness, and positive attitudes. There was marked variability in the presence and magnitude of these feelings. Different predictors emerged for different dimensions of the stigma experience, the most frequent being age at onset, extent of bleeding, employment status, duration, and rejection experience. Of all the aspects of the illness, bleeding proved the strongest predictor of stigma feelings and of despair, which correlates highly with stigma. Despair and feeling stigmatized may lead to noncompliance with treatment, possibly worsening the status of the psoriasis.