The Chain Mediating Role of Perceived Stress and Psychological Distress: Type D Personality and Quality of Life in Patients With Atopic Dermatitis

Purpose Type D personality, perceived stress, and psychological distress each exert an impact on the quality of life in dermatological patients; nevertheless, their interactive effects on quality of life in this population remain unreported. The study aims to examine how perceived stress and psychological distress mediate the relationship between Type D personality and quality of life in patients with atopic dermatitis (AD). Design and Methods This cross‐sectional study tested a hypothetical model of the interrelationships of Type D personality (DS14 Questionnaire), perceived stress (Perceived Stress Scale), psychological distress (Hospital Anxiety and Depression Scale), and quality of life (Dermatology Life Quality Index) using structural equation modeling (SEM). AD patients ( n = 326) from a tertiary hospital in Shanghai were conveniently recruited from November, 2024, to February, 2025. Results Significant bivariate correlations were found among Type D personality, perceived stress, psychological distress, and quality of life in AD patients ( r = 0.269–0.700, p < 0.001). Moreover, psychological distress played a crucial role in mediating the link between Type D personality and quality of life, with a 95% confidence interval (CI) of 0.040–0.174. Additionally, perceived stress and psychological distress manifested a chain‐mediating effect in this relationship, as indicated by a 95% CI of 0.042–0.166. Practice Implications Type D personality was shown to subtly diminish AD patients’ quality of life, as indicated by heightened stress and psychological distress levels. Therefore, early psychological assessment and targeted interventions aimed at reducing stress, anxiety, and depression are crucial for AD patients with Type D personality. Healthcare professionals should integrate evidence‐based psychological support into routine care to improve the quality of life and disease management in this population.