Abstract: 【Abstract】 Objective To investigate direct and indirect economic burden, psychological impact, and quality of life in patients with psoriasis. Methods Patients with psoriasis were recruited nationwide from “the psoriasis patient mutual assistance network”, a WeChat official account of “psoriasis patient mutual assistance platform”, and WeChat groups of psoriasis patients in different regions between July and September in 2018. An internet?based online questionnaire survey was carried out on these patients by using a self?designed questionnaire and Dermatology Life Quality Index （DLQI） scale. Comparison of enumeration data was carried out by using chi?square test, and comparison of measurement data by using Mann?Whitney U test. Results A total of 497 valid questionnaires were collected, and 497 patients with psoriasis were enrolled into this survey, including 190 patients with mild to moderate psoriasis and 307 patients with severe psoriasis. These patients were from 8 geographic regions of China, and mainly in east China and north China. The total annual expenditure for psoriasis per patient accounted for 20% （8%, 50%） （M［P25, P75］）of the total annual income, the annual hospitalization rate was 21.3%, the annual sick leave or absence duration was 15.0 （1.0, 40.0） days, and the unemployment rate due to psoriasis was 37.0%. Of the 497 patients, 443 （89.1%） suffered from mental stress due to psoriasis, 169 （34.0%） had suicide intention, and 23 （4.6%） had ever attempted suicide. The DLQI score for all the patients was 14 （8, 19）, 307 （61.8%） patients reported a severe or extremely severe impact on the quality of life （DLQI > 10, severe psoriasis group）, and 190 （38.2%） patients reported a mild or moderate impact on the quality of life （0 ≤ DLQI ≤ 10, mild to moderate psoriasis group）. Compared with the mild to moderate psoriasis group, the severe psoriasis group showed a significantly higher ratio of total annual expenditure to total annual income （30% vs. 10.0%, P < 0.01）, hospitalization rate （26.4% vs. 13.2%, P < 0.01）, annual sick leave or absence duration （20.0 days vs. 5.5 days, P < 0.01）, unemployment rate （47.9% vs. 19.5%, P < 0.01）, proportion of patients with mental stress （99.0% vs. 73.2%, P < 0.01）, proportion of patients with suicide intention （46.3% vs. 14.2%, P < 0.01） and proportion of patients who had suicide behavior （6.8% vs. 1.1%, P < 0.01）. Conclusions Psoriasis imposes heavy economic and psychological burden on patients, and decreases their quality of life. Meanwhile, patients with severely or extremely severely affected quality of life have higher disease burden compared with those with mildly to moderately affected quality of life.

Key words: Psoriasis, Sickness impact profile, Quality of life, Economic burden, Psychological burden