Impact of childhood psoriasis on children and parents during transition to adolescence: An interpretative phenomenological analysis

Objectives: Psoriasis is a chronic skin condition that can develop at any age. Childhood psoriasis can lead to stigmatization and reduced quality of life in children and parents. This study aimed to gather a detailed family-level understanding of the experience of childhood psoriasis during the time of transition to adolescence.

Design: A multi-perspectival interpretative phenomenological analysis (IPA) was used.

Methods: Sixteen semi-structured interviews with eight parent-child dyads were conducted and analysed in accordance with IPA principles.

Results: Three superordinate themes and three sub-themes were identified: 1. 'Transition and transaction' including: 1.1 'Shifting responsibilities and self-efficacy'; 2. 'Stigma and social impact'; and 3. 'The treatment journey' including: 3.1 'Finding an effective treatment', 3.2 'Coping with on-going management'. Uncertainties surrounding treatment options were an initial focus of difficulty for families. In adolescence, the difficulty shifted to be more identity focussed as the responsibility for disease management and the increased awareness on body image posed added challenges. Both parents and children described visibility and stigma as the most distressing aspects of living with psoriasis and experienced negative emotions that resurfaced during adolescence.

Conclusions: This study suggests that childhood psoriasis can have a significant impact on children, particularly as they begin to transition to adolescence. Findings also highlight the burden of psoriasis for parents. As such, psychological interventions (such as adapted forms of mindfulness-based Cognitive-Behavioural-Therapy) are needed to target and reduce stress. Such interventions are likely to require a systemic focus and support validation of the real impact and fear of stigmatization.