Background: Pruritus, commonly referred to as itching, is a distressing sensory symptom that significantly affects physical comfort, emotional well-being, and social functioning. Chronic itching has been associated with multiple dermatological and systemic disorders, yet its broader psychosocial consequences within the general population remain insufficiently explored. This study was designed to evaluate the prevalence of pruritus and determine its association with insomnia, depression, anxiety, emotional distress, and health-related quality of life among middle-aged adults from a large Finnish birth cohort.

Aim: The primary objective of this study was to assess the psychosocial burden associated with localized and generalized pruritus in the general population. The study further aimed to examine whether increasing frequency of itching was associated with worsening psychological symptoms and impaired quality of life.

Materials and Methods: A cross-sectional population-based study was conducted with total of 6,809 participants aged 45–47 years were included in the analysis. Participants completed detailed self-administered questionnaires assessing the frequency and extent of pruritus along with validated psychological assessment tools. Sleep disturbances were evaluated using the Athens Insomnia Scale (AIS), depressive symptoms using the Beck Depression Inventory-II (BDI-II), anxiety using the Generalized Anxiety Disorder Screener (GAD-7) and State-Trait Anxiety Inventory (STAI), and emotional distress using the Hopkins Symptom Checklist-25 (HSCL-25). Health-related quality of life was assessed using the 15D HRQoL instrument. Multivariate regression analyses were performed after adjusting for potential confounding variables including smoking, alcohol consumption, body mass index, physical activity, socioeconomic status, and history of skin disease.

Results: Pruritus was found to be highly prevalent in the study population, with approximately 19.9% of participants reporting weekly itching symptoms and 7.2% reporting daily pruritus. Females demonstrated a significantly higher prevalence of both localized and generalized pruritus compared with males (p<0.001). Increasing frequency of pruritus was strongly associated with worsening psychosocial health outcomes. Participants with frequent itching exhibited significantly higher insomnia scores, increased depressive and anxiety symptoms, greater emotional distress, and lower quality of life scores. Individuals with daily generalized pruritus demonstrated more than a four-fold increased risk of depressive symptoms and over a three-fold increased likelihood of anxiety symptoms after adjustment for confounding variables. Furthermore, the severity of psychological impairment progressively increased with increasing frequency of itching episodes.

Conclusion: Pruritus exerts a substantial negative impact on mental health and overall quality of life in the general population. Frequent itching is strongly associated with insomnia, anxiety, depression, and emotional distress, highlighting the multidimensional burden of this symptom. These findings emphasize the importance of recognizing psychosocial comorbidities in individuals with chronic pruritus. Comprehensive management strategies addressing both dermatological and psychological aspects may improve patient outcomes and enhance quality of life.