This article examines how perceiving concealment in close relationships influences marital well-b... more This article examines how perceiving concealment in close relationships influences marital well-being. It suggests that the perception of concealment from a partner signals separateness from one’s partner and contributes to feelings of perceived partner exclusion. These feelings of exclusion, in turn, should negatively affect relational quality. These predictions are tested in a prospective study among 199 newlywed couples. Results suggest that perceiving concealment reduced marital adjustment and trust and increased conflict over time. Importantly, change in perceived partner exclusion mediated these effects. This article demonstrates that the perception of concealment (a) has deleterious effects on relational well-being in the long run and (b) is harmful in part because it elicits feelings of exclusion.
Journal of the American Academy of Dermatology, 2014
Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (P... more Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (PsA), but are limited by methodology or enrollment requirements. To further the understanding of the unmet needs of psoriasis and PsA patients. This was a large, multinational, population-based survey of psoriasis and/or PsA patients in North America and Europe. Patients were selected by list-assisted random digit dialing and did not have to currently be under the care of a health care provider, a patient organization member, or receiving treatment; 139,948 households were screened and 3426 patients completed the survey. The prevalence of psoriasis/PsA ranged from 1.4% to 3.3%; 79% had psoriasis alone and 21% had PsA. When rating disease severity at its worst, 27% (psoriasis) and 53% (PsA ± psoriasis) of patients rated it as severe. Psoriasis patients indicated that their most bothersome signs or symptoms were itching (43%), scales (23%), and flaking (20%). Of psoriasis patients, 45% had not seen a physician in a year; >80% of psoriasis patients with ≥ 4 palms body surface area and 59% of PsA patients were receiving no treatment or topical treatment only. Of patients who had received oral or biologic therapy, 57% and 45%, respectively, discontinued therapy, most often for safety/tolerability reasons and a lack/loss of efficacy. The survey lacked a control group, did not account for ethnic and health care system differences across countries, and was limited by factors associated with any patient survey, including accurate recall and interpretation of questions. Several identified unmet needs warrant additional attention and action, including improved severity assessment, PsA screening, patient awareness, and treatment options.
Coal tar is an effective treatment for psoriasis and eczema, but it contains several carcinogenic... more Coal tar is an effective treatment for psoriasis and eczema, but it contains several carcinogenic compounds. Occupational and animal studies have shown an increased risk of cancer after exposure to coal tar. Many dermatologists have abandoned this treatment for ...
Journal of the European Academy of Dermatology and Venereology : JEADV, 2015
Concerns exist about a risk of non-melanoma skin cancer (NMSC) in psoriasis patients and rheumato... more Concerns exist about a risk of non-melanoma skin cancer (NMSC) in psoriasis patients and rheumatoid arthritis (RA) patients treated with TNF-inhibitors. However, current data also show that in some psoriasis patients, NMSC is diagnosed relatively short after the start of TNF-inhibitors, which suggests that these NMSC can be explained by previous therapies instead of by TNF-inhibitor therapy. To investigate whether there was a difference in time until first NMSC and the rate of NMSC between psoriasis and RA patients on TNF-inhibitors. Time until first NMSC and the rate of NMSC were compared between psoriasis and RA patients from the same region treated with TNF-inhibitors and followed up for at least one year in prospective cohort studies, by using Cox regression and Poisson regression. Both analyses were corrected for confounders (age, gender, disease duration, prior NMSC, duration of anti-TNF and other systemic therapies). The NMSC risk was significantly higher in the psoriasis gro...
Web shopping has some clear advantages over shopping in regular shops: web shops are open 24 hour... more Web shopping has some clear advantages over shopping in regular shops: web shops are open 24 hours a day; the prices of products can be easily compared and are often lower than regular prices; the choice of products is often larger; and consumers don't have to leave their homes to buy something. Still, web shopping has developed at a much slower rate than expected and the amount of money spent online is only a very small percentage of the money spent in regular shops, even in countries where web shopping is popular (for ...
Treatment goals have been developed to optimize daily clinical practice psoriasis care, but have ... more Treatment goals have been developed to optimize daily clinical practice psoriasis care, but have not yet been studied in real life. To investigate to what extent treatment decisions made by dermatologists in daily clinical practice for patients with psoriasis on biologics are already in accordance with treatment goals without the active application of the treatment goals algorithm. Data were extracted from a prospective daily practice cohort of patients with psoriasis on biologics. Analysis was done on effectiveness (Psoriasis Area and Severity Index score) and quality of life (Dermatology Life Quality Index questionnaire). Treatment decisions such as dosage adjustments, combination treatments, or switching therapy were compared with the treatment goals algorithm. In 64% (253 of 395) of visits, physicians followed the treatment goals algorithm. There were 162 (41%) visits in which there should have been a treatment modification according to treatment goals (group Modify) and a modification was indeed made in 59 of these 162 visits (36%). In 233 (59%) visits no treatment modification was necessary (group Continue) and therapy was indeed not modified in 194 of 233 visits (83%). Physicians acted in accordance with treatment goals in the majority of patient visits. In the patient group not achieving these goals, physicians should have modified therapy according to treatment goals but continued the same therapeutic regimen in the majority of visits. Optimizing therapy and defining barriers in the latter group might increase treatment results in daily practice psoriasis care.
ABSTRACT The development of a multidimensional health status inventory for chronic skin diseases ... more ABSTRACT The development of a multidimensional health status inventory for chronic skin diseases is described that includes both generic and skin-specific scales. The skin-specific part assesses dimensions of physical functioning, more specifically skin status, physical symptoms of itch, pain and fatigue and scratching responses as well as disease-specific stressors of stigmatization. The generic part gauges dimensions of psychological functioning, disease-related impact scales, illness cognitions and social support by means of existing scales validated for other chronic diseases. Reliability and validity of the questionnaire were studied in patients with psoriasis and atopic dermatitis. The scales of the questionnaires showed high internal reliability and test-retest reliability and satisfying convergent validity in both patient groups. Sensitivity to change was demonstrated for both dermatological and cognitive-behavioural itching treatment. The overall highly satisfying results for reliability and validity support the usefulness and applicability of the questionnaire for different chronic skin diseases.
Journal of the European Academy of Dermatology and Venereology, 2007
Skin diseases are a substantial part of the problems dealt with by general practitioners. Althoug... more Skin diseases are a substantial part of the problems dealt with by general practitioners. Although the psychosocial consequences of skin diseases in secondary care has been extensively studied, little is known about the psychosocial well-being of patients with skin diseases in primary care. To investigate the psychosocial well-being of patients with skin diseases in primary care. Questionnaires about the psychosocial consequences of skin diseases were sent to patients with a skin disease who were registered within a research network (continuous morbidity registration) of general practices that continuously have recorded morbidity data since 1971. Questionnaires completed by 532 patients were eventually suitable for analyses. Compared with the general population, patients with skin diseases reported significantly lower scores for psychosocial well-being. Furthermore, a lower psychosocial wellbeing was significantly related with higher levels of disease-severity, lower disease-related quality of life, longer disease duration, more comorbidity and more physical symptoms of itch, pain and fatigue. After demographic variables and comorbidity were controlled for, sequential regression analyses showed that disease duration, disease severity and physical symptoms (itch, pain and fatigue) were significant predictors of psychosocial well-being. The psychosocial well-being of patients with skin diseases in primary care is lower than that of the general population. Special attention has to be directed to those patients with lowered psychosocial well-being who might be at risk of developing severe psychosocial impairments such as clinical depression.
This article examines how perceiving concealment in close relationships influences marital well-b... more This article examines how perceiving concealment in close relationships influences marital well-being. It suggests that the perception of concealment from a partner signals separateness from one’s partner and contributes to feelings of perceived partner exclusion. These feelings of exclusion, in turn, should negatively affect relational quality. These predictions are tested in a prospective study among 199 newlywed couples. Results suggest that perceiving concealment reduced marital adjustment and trust and increased conflict over time. Importantly, change in perceived partner exclusion mediated these effects. This article demonstrates that the perception of concealment (a) has deleterious effects on relational well-being in the long run and (b) is harmful in part because it elicits feelings of exclusion.
Journal of the American Academy of Dermatology, 2014
Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (P... more Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (PsA), but are limited by methodology or enrollment requirements. To further the understanding of the unmet needs of psoriasis and PsA patients. This was a large, multinational, population-based survey of psoriasis and/or PsA patients in North America and Europe. Patients were selected by list-assisted random digit dialing and did not have to currently be under the care of a health care provider, a patient organization member, or receiving treatment; 139,948 households were screened and 3426 patients completed the survey. The prevalence of psoriasis/PsA ranged from 1.4% to 3.3%; 79% had psoriasis alone and 21% had PsA. When rating disease severity at its worst, 27% (psoriasis) and 53% (PsA ± psoriasis) of patients rated it as severe. Psoriasis patients indicated that their most bothersome signs or symptoms were itching (43%), scales (23%), and flaking (20%). Of psoriasis patients, 45% had not seen a physician in a year; >80% of psoriasis patients with ≥ 4 palms body surface area and 59% of PsA patients were receiving no treatment or topical treatment only. Of patients who had received oral or biologic therapy, 57% and 45%, respectively, discontinued therapy, most often for safety/tolerability reasons and a lack/loss of efficacy. The survey lacked a control group, did not account for ethnic and health care system differences across countries, and was limited by factors associated with any patient survey, including accurate recall and interpretation of questions. Several identified unmet needs warrant additional attention and action, including improved severity assessment, PsA screening, patient awareness, and treatment options.
Coal tar is an effective treatment for psoriasis and eczema, but it contains several carcinogenic... more Coal tar is an effective treatment for psoriasis and eczema, but it contains several carcinogenic compounds. Occupational and animal studies have shown an increased risk of cancer after exposure to coal tar. Many dermatologists have abandoned this treatment for ...
Journal of the European Academy of Dermatology and Venereology : JEADV, 2015
Concerns exist about a risk of non-melanoma skin cancer (NMSC) in psoriasis patients and rheumato... more Concerns exist about a risk of non-melanoma skin cancer (NMSC) in psoriasis patients and rheumatoid arthritis (RA) patients treated with TNF-inhibitors. However, current data also show that in some psoriasis patients, NMSC is diagnosed relatively short after the start of TNF-inhibitors, which suggests that these NMSC can be explained by previous therapies instead of by TNF-inhibitor therapy. To investigate whether there was a difference in time until first NMSC and the rate of NMSC between psoriasis and RA patients on TNF-inhibitors. Time until first NMSC and the rate of NMSC were compared between psoriasis and RA patients from the same region treated with TNF-inhibitors and followed up for at least one year in prospective cohort studies, by using Cox regression and Poisson regression. Both analyses were corrected for confounders (age, gender, disease duration, prior NMSC, duration of anti-TNF and other systemic therapies). The NMSC risk was significantly higher in the psoriasis gro...
Web shopping has some clear advantages over shopping in regular shops: web shops are open 24 hour... more Web shopping has some clear advantages over shopping in regular shops: web shops are open 24 hours a day; the prices of products can be easily compared and are often lower than regular prices; the choice of products is often larger; and consumers don't have to leave their homes to buy something. Still, web shopping has developed at a much slower rate than expected and the amount of money spent online is only a very small percentage of the money spent in regular shops, even in countries where web shopping is popular (for ...
Treatment goals have been developed to optimize daily clinical practice psoriasis care, but have ... more Treatment goals have been developed to optimize daily clinical practice psoriasis care, but have not yet been studied in real life. To investigate to what extent treatment decisions made by dermatologists in daily clinical practice for patients with psoriasis on biologics are already in accordance with treatment goals without the active application of the treatment goals algorithm. Data were extracted from a prospective daily practice cohort of patients with psoriasis on biologics. Analysis was done on effectiveness (Psoriasis Area and Severity Index score) and quality of life (Dermatology Life Quality Index questionnaire). Treatment decisions such as dosage adjustments, combination treatments, or switching therapy were compared with the treatment goals algorithm. In 64% (253 of 395) of visits, physicians followed the treatment goals algorithm. There were 162 (41%) visits in which there should have been a treatment modification according to treatment goals (group Modify) and a modification was indeed made in 59 of these 162 visits (36%). In 233 (59%) visits no treatment modification was necessary (group Continue) and therapy was indeed not modified in 194 of 233 visits (83%). Physicians acted in accordance with treatment goals in the majority of patient visits. In the patient group not achieving these goals, physicians should have modified therapy according to treatment goals but continued the same therapeutic regimen in the majority of visits. Optimizing therapy and defining barriers in the latter group might increase treatment results in daily practice psoriasis care.
ABSTRACT The development of a multidimensional health status inventory for chronic skin diseases ... more ABSTRACT The development of a multidimensional health status inventory for chronic skin diseases is described that includes both generic and skin-specific scales. The skin-specific part assesses dimensions of physical functioning, more specifically skin status, physical symptoms of itch, pain and fatigue and scratching responses as well as disease-specific stressors of stigmatization. The generic part gauges dimensions of psychological functioning, disease-related impact scales, illness cognitions and social support by means of existing scales validated for other chronic diseases. Reliability and validity of the questionnaire were studied in patients with psoriasis and atopic dermatitis. The scales of the questionnaires showed high internal reliability and test-retest reliability and satisfying convergent validity in both patient groups. Sensitivity to change was demonstrated for both dermatological and cognitive-behavioural itching treatment. The overall highly satisfying results for reliability and validity support the usefulness and applicability of the questionnaire for different chronic skin diseases.
Journal of the European Academy of Dermatology and Venereology, 2007
Skin diseases are a substantial part of the problems dealt with by general practitioners. Althoug... more Skin diseases are a substantial part of the problems dealt with by general practitioners. Although the psychosocial consequences of skin diseases in secondary care has been extensively studied, little is known about the psychosocial well-being of patients with skin diseases in primary care. To investigate the psychosocial well-being of patients with skin diseases in primary care. Questionnaires about the psychosocial consequences of skin diseases were sent to patients with a skin disease who were registered within a research network (continuous morbidity registration) of general practices that continuously have recorded morbidity data since 1971. Questionnaires completed by 532 patients were eventually suitable for analyses. Compared with the general population, patients with skin diseases reported significantly lower scores for psychosocial well-being. Furthermore, a lower psychosocial wellbeing was significantly related with higher levels of disease-severity, lower disease-related quality of life, longer disease duration, more comorbidity and more physical symptoms of itch, pain and fatigue. After demographic variables and comorbidity were controlled for, sequential regression analyses showed that disease duration, disease severity and physical symptoms (itch, pain and fatigue) were significant predictors of psychosocial well-being. The psychosocial well-being of patients with skin diseases in primary care is lower than that of the general population. Special attention has to be directed to those patients with lowered psychosocial well-being who might be at risk of developing severe psychosocial impairments such as clinical depression.
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Papers by Peter Kerkhof