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Stigmatisation and body image impairment in dermatological patients: protocol for an observational multicentre study in 16 European countries
  1. Florence J Dalgard1,2,
  2. Anthony Bewley3,
  3. Andrea W Evers4,
  4. Uwe Gieler5,
  5. Lars Lien2,
  6. Francesca Sampogna6,
  7. Sonja Ständer7,
  8. Lucia Tomas-Aragones8,
  9. Ninke Vulink9,
  10. Jörg Kupfer10
  1. 1 Department of Dermatology and Venereology, Skåne University Hospital, Malmo, Sweden
  2. 2 National Centre for Dual Diagnosis, Innlandet Hospital Trust, Brumunddal, Norway
  3. 3 Department of Dermatology, Barts Health NHS Trust, London, UK
  4. 4 Department of Health, Medical and Neuropsychology, Faculty of Social and Behavioral Science, Leiden, The Netherlands
  5. 5 Department of Dermatology, Justus Liebig University, Giessen, Germany
  6. 6 Clinical Epidemiology Unit, Istituto Dermopatico dell’Immacolata, Rome, Italy
  7. 7 Center for Chronic Pruritus and Department of Dermatology, University Hospital Münster, Münster, Germany
  8. 8 Department of Psychology, University of Zaragoza, Zaragoza, Spain
  9. 9 Department of Psychiatry, Academic Medical Hospital, Amsterdam, The Netherlands
  10. 10 Institute of Medical Psychology, Justus Liebig University, Giessen, Germany
  1. Correspondence to Dr Florence J Dalgard; florikje{at}


Introduction Patients with common skin diseases may have substantial psychosocial comorbidity and reduced quality of life. This study aims at exploring further the psychosocial burden of skin diseases by assessing stigmatisation and body image problems in a large sample of patients with skin disease across Europe.

Methods and analysis The study is an observational cross-sectional multicentre study across 16 European countries comparing stigmatisation and body image in patients with skin disease compared with controls. Consecutive patients will be recruited in outpatient clinics and will complete validated questionnaires prior to clinical examination by a dermatologist at each recruitment site. In addition to sociodemographic background information, the outcomes will be: mood disorders assessed by short versions of the Patient Health Questionnaire and the General Anxiety Disorder Assessment; general health assessed by the EuroQol-Visual Analogue Scale; stigmatisation experience assessed by the Perceived Stigmatisation Questionnaire; stress assessed by the Perceived Stress Scale and body image assessed by the Dysmorphic Concern Questionnaire. The main criteria for eligibility are to be 18 years old or more. The analysis will include comparison between patients and controls for the main outcomes using t-tests, analyses of covariance and multivariate logistic regression models adjusting for potential confounding factors.

Ethics and dissemination The study protocol is approved by the University of Giessen and by the local Ethical Committee in each recruitment centre. Informed consent will be given by each participant. The results of the study will be disseminated by publications in international peer-reviewed journals and presented at international conferences and general public conferences. Results will influence support intervention and management of patients with skin disease across Europe.

Trial registration number DRKS00012745; Pre-results.

  • dermatological epidemiology
  • stigmatisation
  • body image
  • burden of disease

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  • Contributors JK and FJD contributed substantially to the idea and design of the study protocol, reviewed critically the protocol and the study procedures. AB, AWE, UG, LL, FS, SS, LT-A and NV have contributed fully to the conception and design of the work, the drafting of the manuscript and revised critically important intellectual content. All coauthors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy and integrity of any part of the work are appropriately investigated and resolved. All authors have given final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests The authors are all members of the EADV Taskforce for psychodermatology.

  • Patient consent Not required.

  • Ethics approval Study procedures for the whole study have been approved by the Ethical Committee at Giessen University (Protocol number 87/17) and at each centre of recruitment.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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