Rosacea is associated with mental distress and depression, yet no studies have looked at the mediating effect of stigmatization and other factors on psychological sequelae. Using a survey of affected individuals, the objective of this study was to explore relationships between self-reported symptom severity, discomfort, stress reactivity, quality of life, and symptoms of depression and anxiety. Participants were recruited from the mailing list of a German rosacea organization. The survey instrument included the Dermatology Life Quality Index (DLQI), the rejection scale of the Questionnaire on Experience with Skin Complaints (QES), and the German version of the Hospital Anxiety and Depression Scale (HADS-D). A total of 168 persons with rosacea were participated. The sample returned a HADS anxiety score of 7.2 ± 4.60, a HADS depression score of 5.1 ± 4.09, a DLQI of 4.05 ± 4.67, and a QES rejection score of 2.,61 ± 3.,37. Path analysis suggested that symptoms of anxiety and depression are linked with somatic symptoms indirectly, mediated through quality of life and stigmatization. Men are more negatively affected. Physicians treating rosacea patients should consider recommending psychological co-treatment for patients who have experienced stigmatization or who report low life quality.
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