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J Invest Dermatol. 2015 Apr;135(4):984-991. doi: 10.1038/jid.2014.530. Epub 2014 Dec 18.

The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries.

Author information

1
National Center for Dual Diagnosis, Innlandet Hospital Trust, Brumundal, Norway. Electronic address: florence.dalgard@medisin.uio.no.
2
Department of Dermatology, Justus Liebig University, Giessen, Germany.
3
Department of Psychology, University of Zaragoza, Zaragoza, Spain.
4
Department of Public Health, Hedmark University College, Elverum, Norway.
5
Department of Dermatology, Universite Libre de Bruxelles, Brussels, Belgium.
6
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
7
Department of Dermatology, University Hospital of Brest, Brest, France.
8
Department of Dermatology, University of Szeged, Szeged, Hungary.
9
Department for Dermatology, Padua University Hospital, Padua, Italy.
10
Health Services Research Unit, Istituto Dermopatico dell'Immacolata, Rome, Italy.
11
Institute of Psychology Health, University of Leiden, Leiden, Netherlands.
12
Department of Dermatology, University of Oslo, Oslo, Norway.
13
Department of Dermatology, Stavanger University Hospital, Stavanger, Norway.
14
Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland.
15
Department of Psychiatry and Psychosomatic Medicine, Sechenov First Moscow State Medical, Moscow, Russia.
16
Department of Dermatology, Alcaniz Hospital, Alcaniz, Spain.
17
Department of Dermatology, Sisli Etfal Teaching and Research Hospital, Istanbul, Turkey.
18
Department of Dermatology, Cardiff University School of Medicine, Cardiff, UK.
19
Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
20
Institute of Medical Psychology, Justus Liebig University, Giessen, Germany.

Abstract

The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants--3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67-3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68-2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33-2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications.

PMID:
25521458
PMCID:
PMC4378256
DOI:
10.1038/jid.2014.530
[Indexed for MEDLINE]
Free PMC Article

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