BACKGROUND
Patient-generated health data (PGHD) from different sources including social media were recently promoted to generate new insights into personal experience of chronic disease such as psoriasis. Psoriasis is a relatively frequent and chronic immune-mediated inflammatory disease that is typically characterised by the appearance of red or silver scaly plaques, typically distributing the elbows, knees, and scalp. The disease induces an important psychosocial burden with mood disorders including depression and anxiety higher than in the general population.
OBJECTIVE
The objective of this qualitative study is therefore to understand the experience of French-speaking patients with psoriasis by analysing the content of posts on several social media.
METHODS
To investigate more finely and accurately the lived experience of patients with psoriasis, spontaneous conversations on psoriasis published between 2017 and 2020 have been extracted from the following social networks: forums and blogs, Facebook, Twitter and Instagram. Data analysis has allowed the classification of verbatim reports into five topics reflecting the burden induced by the psoriasis.
RESULTS
Patients with psoriasis described major consequences of the symptoms on their mood with negative thoughts such as shame and helplessness, and emotions such as sadness. A significant part of publications revealed suicidal thoughts. Patients demonstrated sometimes paroxysmic anxiety, due to the risk of symptoms exacerbation and side effects of treatments. The burden of the disease was highly impacted by pain induced by inflammatory plaques on the skin and psoriatic arthritis. Itch was described as one the most severe symptoms providing skin lesions and sleep disorders (related to depressive and anxious states). Patients’ body image was related to low self-esteem, depreciation and shame, notably in case of visible lesions. Stigmatisation and self-stigma were reported with consequences on work, social relationships and projection into the future. Stress has been considered as a cause as well as a consequence of the disease but remained controversial. Heritability has been viewed as a matter of culpability in case of transmission and of fear for future generations. Patients described some difficulties to find the accurate medical resources and to obtain an exact diagnosis. Globally the health pathway seemed complicated for patients with psoriasis. They have reported disappointing results of medications with sometimes severe side effects. Numerous patients have described their use of alternative and complementary medicines.
CONCLUSIONS
To our knowledge, this is the first study of spontaneous conversations on social media in French population with psoriasis. The analysis of these patient-generated health data highlights the major psychosocial burden of psoriasis.