Emotional Burden Outweighs Physical Symptoms: Determinants of Dermatological Quality of Life and Psychological Distress in Dermatological Patients

Abstract A Hungarian cross-sectional study of 3,514 dermatology patients investigated the drivers of psychological distress. Conducted via a teledermatology platform using validated tools (Distress Thermometer, Skindex-Mini), the research found that the emotional burden of skin disease—such as shame, anxiety, and frustration—was the primary factor associated with patient distress. This emotional impact was a stronger contributor than the physical symptoms of the condition itself. When emotional factors were accounted for, functional limitations were not a significant predictor. While the overall model explains a modest portion of the variance in distress (Adj. R²=0.09), the findings consistently underscore that emotional burden is the most critical factor. Furthermore, this emotional impact was more pronounced in men and older individuals, even though increasing age, in general, was linked to lower distress levels. The study highlights a significant gap in dermatological care and suggests that integrating routine psychological screening and management could improve patient outcomes by addressing this profound emotional dimension. Keywords: psychodermatology; emotional burden; distress thermometer; Skindex-Mini; dermatology; quality of life.