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Carretero Hernández G, Ara Martín M, Armesto Alonso S, Belinchón Romero I, Eiris Salvado N, Ferrán Farrés M, Galache Osuna C, García Bustínduy M, García Latasa de Araníbar J, Juliá Manresa M, Llamas Velasco M, López Ferrer A, Roncero Riesco M, Ruiz Genao D, Ruíz-Villaverde R, Salgado Boquete L, Soria Martínez C, Vilarrasa Rull E, Descalzo MA. Measurement Assessment of Minimal Disease Activity In Psoriasis in Spain: A National Cross-Sectional Study. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00507-6. [PMID: 38876209 DOI: 10.1016/j.ad.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/13/2024] [Accepted: 05/05/2024] [Indexed: 06/16/2024] Open
Abstract
INTRODUCTION In 2017, the Spanish Academy of Dermatology and Venereology Psoriasis Working Group (PWG) designed the Minimal Disease Activity (MDA) criteria to determine the level of disease activity. We hereby present the results of an observational, cross-sectional, multicenter study of the nationwide application of these criteria. MATERIAL AND METHODS We conducted a non-randomized sampling, stratified to achieve autonomic and provincial representation of consecutive patients with psoriasis (Ps) vulgaris without active arthritis. A total of 830 patients were included: 493 men (59.5%), with a mean age of 51.4 years (SD, 14.2), from all autonomous regions of Spain (except for Ceuta and Melilla) and 44 (88%) out of the 50 provinces. A questionnaire was obtained with demographic data, DLQI, subjective assessment-on a scale from 0 to 10-of itching, erythema, desquamation, visibility, and the patients' PASI and BSA. RESULTS More than 50% failed to meet the MDA criteria (491; 59.2%), with significant differences being reported by region, sex, and age. Additionally, significant differences were reported based on the therapy used (P<.001). The use of biological therapies was associated with higher MDA compliance compared to other therapies (59.4% vs 23.3%). No differences were reported among various biological therapies. CONCLUSIONS The overall rate of MDA compliance is low, with differences being based on geographic location, sex, age, and drug used, yet none of these factors separately justify them.
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Affiliation(s)
- G Carretero Hernández
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España.
| | - M Ara Martín
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - S Armesto Alonso
- Servicio de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - I Belinchón Romero
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis-ISABIAL-UMH, Alicante, España
| | - N Eiris Salvado
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - M Ferrán Farrés
- Departamento de Dermatología, Hospital del Mar, Barcelona, España
| | - C Galache Osuna
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - M García Bustínduy
- Servicio de Dermatología, Complejo Hospitalario Universitario de Canarias, La Laguna, Tenerife, España
| | | | - M Juliá Manresa
- Servicio de Dermatología, Hospital Universitario de Basurto, Bilbao, Vizcaya, España
| | - M Llamas Velasco
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, España
| | - A López Ferrer
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M Roncero Riesco
- Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - D Ruiz Genao
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - R Ruíz-Villaverde
- Hospital Universitario San Cecilio de Granada, Instituto Biosanitario de Granada, Ibs, Granada, España
| | - L Salgado Boquete
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | | | - E Vilarrasa Rull
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M A Descalzo
- Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, España
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Pistorio ML, Moretta T, Musumeci ML, Russo C, Lacarrubba F, Petralia A, Micali G, De Pasquale C. Impact of Attachment Style and Temperament Traits on the Quality of Life of Patients with Psoriasis. Behav Sci (Basel) 2024; 14:434. [PMID: 38920766 PMCID: PMC11201237 DOI: 10.3390/bs14060434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory skin disease with manifestations that go beyond the visual manifestation, and include psychological aspects. Some mental disorders or personality traits in psoriasis patients have also been highlighted, such as a negative or problematic attitude towards life, impulsive or avoidant behavior, and lower satisfaction with life. The aim of our cross-sectional study was to explore the associations between adult attachment, temperament, and quality of life of patients with psoriasis. METHODS A sample of 75 patients with psoriasis was evaluated with the Attachment Style Questionnaire (ASQ) to study adult attachment, the Temperament Evaluation of Memphis, Pisa, and San Diego Auto-questionnaire (TEMPS-A) to study temperament traits, and the Dermatology Life Quality Index (DLQI) to study the impact of dermatological diseases on patients' lives. RESULTS Depressive, cyclothymic, and irritable temperaments were found to be significantly positively associated with a need for approval and preoccupation with relationships subscales of the ASQ. The severity of skin disease effect on the patient's life was higher in women than in men. Moreover, a statistically significant effect of the need for approval subscale of the ASQ was found. The positive correlation between the severity of skin disease effect on the patient's life with a need for approval was statistically significant and stronger in women than in men. CONCLUSIONS A better understanding of the impact of mental comorbidities on psoriasis and vice versa places an ever-greater responsibility on dermatologists involved in the management of psoriasis to recognize these problems and collaborate with psychologists and psychiatrists to help these patients.
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Affiliation(s)
- Maria Luisa Pistorio
- Vascular Surgery and Organ Transplant Unit, Department of General Surgery and Medical-Surgical Specialties, University Hospital of Catania, 95100 Catania, Italy
| | - Tania Moretta
- Department of General Psychology, University of Padova, 35131 Padova, Italy;
| | - Maria Letizia Musumeci
- Dermatology Clinic, Department of General Surgery and Medical-Surgical Specialties, University Hospital of Catania, 95100 Catania, Italy; (M.L.M.); (F.L.); (G.M.)
| | - Claudia Russo
- Department of Educational Sciences, University of Catania, 95100 Catania, Italy; (C.R.); (C.D.P.)
| | - Francesco Lacarrubba
- Dermatology Clinic, Department of General Surgery and Medical-Surgical Specialties, University Hospital of Catania, 95100 Catania, Italy; (M.L.M.); (F.L.); (G.M.)
| | - Antonino Petralia
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, 95100 Catania, Italy;
| | - Giuseppe Micali
- Dermatology Clinic, Department of General Surgery and Medical-Surgical Specialties, University Hospital of Catania, 95100 Catania, Italy; (M.L.M.); (F.L.); (G.M.)
| | - Concetta De Pasquale
- Department of Educational Sciences, University of Catania, 95100 Catania, Italy; (C.R.); (C.D.P.)
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Rogner D, Heimerl L, Heyer S, Biedermann T, Sattler E, Zink A. Patients' perspective, quality of life and treatment goals in Hailey-Hailey disease: Lessons learned from the German National Registry. J Eur Acad Dermatol Venereol 2024; 38:419-429. [PMID: 37863661 DOI: 10.1111/jdv.19583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Hailey-Hailey disease (HHD) remains a difficult-to-treat dermatosis and little is known about the patient's perception of the disease activity, the treatment success and its impact on quality-of-life (QoL). OBJECTIVE To obtain better understanding of HHD patients' needs regarding their medical condition, financial burden, QoL, subjective well-being and treatment thereof as well as satisfaction to evaluate common treatments' 'real-life' relevance. METHODS With initiation of the national registry for Darier's disease (DD; Morbus Darier, MD) and Hailey-Hailey disease (HH) MDHHgermany, patients with HHD diagnosis were included starting June 2020. To assess subjective symptoms, patients filled out questionnaires such as the DLQI (dermatological life quality index), numeric rating scale (NRS) for itch, pain and burning sensation, as well as the SWLS (satisfaction with life scale) questionnaire to quantify overall satisfaction in life. Additionally, data on therapies were collected along with the patients' satisfaction of those and their medical care. Furthermore, patients assessed financial aspects and work ability. RESULTS One hundred and two patients were recruited from dermatology clinics, office-based dermatologists and self-help platforms across Germany between June 2020 and February 2023, 90 were eligible and analysed (mean: 49.91 years, 73.33% females, 26.67% males). 39.77% stated according to the DLQI their life is severely/very severely affected. Satisfaction with life was mediocre. Burning sensation was most pronounced among subjective symptoms (NRS 5.85 ± 2.80). Systemic treatments were rated as ineffective according to 56.92%, 25.56% had never received one. Most prescribed systemic treatments were corticosteroids (73.8%), followed by low-dose naltrexone (LDN) (26.2%), retinoids (15.4%) and antibiotics (13.8%). Satisfaction with medical care was generally low. CONCLUSION Our 'real-life' data state a major disease burden and impact on the QoL for affected individuals, as well as limited disease control due to inadequate therapies. MDHHgermany can provide insights into improvement of healthcare support with this debilitating disease and improve QoL. In the long term, it aims to provide basis for further clinical trials, epidemiological studies and immunological investigations.
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Affiliation(s)
- D Rogner
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Heimerl
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Pharmacology and Toxicology, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - S Heyer
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - E Sattler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Sommer R, Mrowietz U, Gaarn Du Jardin K, Kasujee I, Martini E, Daudén E, Fabbrocini G, Zink A, Griffiths CEM, Augustin M. Implementing well-being in the management of psoriasis: An expert recommendation. J Eur Acad Dermatol Venereol 2024; 38:302-310. [PMID: 37822008 DOI: 10.1111/jdv.19567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/30/2023] [Indexed: 10/13/2023]
Abstract
Psoriasis causes detriment in a person's physical, mental and social health which impairs their quality of life (QoL). However, the current psoriasis management may not adequately address all relevant health domains. Since the goal of healthcare is to restore or maintain health, health outcomes should include all areas of the patient's overall health. Life satisfaction, QoL and patient well-being are essential to a comprehensive approach to the disease. With the inclusion of more people-centred policies, care of patients with psoriasis should evolve towards a holistic and integrated assessment of the disease impact, including subjective measures of well-being in order to encompass all aspects of health. The main objective of this expert review is to give the concept of well-being a place as an entity within the holistic therapeutic approach for patients with psoriasis. Identifying and defining common goals beyond the skin with the patient and testing them throughout the course of treatment will benefit and enhance treatment success. We propose a series of recommendations for application in clinical practice, providing tangible clinical guidance for implementing well-being in the management of psoriasis. Among the recommendations are the need to initially listen to the patient, to know their level of empowerment or what they want to achieve, their preferences in decision making, the evaluation of not only the physical but also the emotional impact of the disease (well-being), the definition of the aspects that can generate a cumulative deterioration of the disease throughout life, and a continuous assessment of the patient's preferences with the opinion of the expert clinician and the integration of the knowledge of external clinical evidence.
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Affiliation(s)
- Rachel Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ulrich Mrowietz
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | | | | | - Esteban Daudén
- La Princesa University Hospital, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical, Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Germany
| | - Christopher E M Griffiths
- The Dermatology Centre, NIHR Manchester Biomedical Research Centre, Salford Royal Hospital, The University of Manchester, Manchester, UK
- Department of Dermatology, King's College Hospital, King's College London, London, UK
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Tian R, He Q, Yang Y, Nong X, Wang S. Associations of polysocial risk score, lifestyle and genetic factors with incident psoriasis: a larger-scale prospective cohort study. Public Health 2023; 225:320-326. [PMID: 37972495 DOI: 10.1016/j.puhe.2023.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES The impact of polysocial risk score (PsRS), a composite measure of multiple social risk factors, on the development of psoriasis remains unclear. Moreover, the potential modifying effects of lifestyle and genetic susceptibility on the relationship between PsRS and psoriasis risk require further exploration. STUDY DESIGN This was a prospective cohort study conducted among UK Biobank. METHODS In this study, we analyzed 331,631 participants enrolled in the UK Biobank cohort. To derive the PsRS, we utilized a summative strategy, amalgamating six social determinants of health derived from three domains: socio-economic status, psychosocial factors, and neighborhood and living environment consistently linked to incident psoriasis. Cox proportional hazard models were used to assess the associations between PsRS and psoriasis incidence. Furthermore, we constructed a lifestyle score and a genetic risk score to explore the potential modifying effects of these factors on the relationship between PsRS and psoriasis risk. RESULTS Compared with individuals with a low PsRS (≤1), those with intermediate PsRS (2-4) and high PsRS (≥5) had 1.20 (95% confidence interval [CI], 1.06-1.36) and 1.53 (95% CI, 1.31-1.78) times higher risks of developing psoriasis, respectively. Our findings revealed an additive interaction between PsRS and genetic susceptibility. Moreover, it was found that individuals with high PsRS and unhealthier lifestyles had a 2.60 times higher risk of developing psoriasis than those with lower PsRS and healthier ones. CONCLUSIONS Our study results imply that an elevated PsRS is linked to a heightened risk of psoriasis, which is further influenced by genetic factors. Our results also indicate that greater social vulnerability and unhealthier lifestyle may synergistically contribute to the additional risk of psoriasis.
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Affiliation(s)
- Rongqian Tian
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qida He
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou City, Jiangsu Province, China
| | - Yi Yang
- Department of Health Statistics, School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Xiang Nong
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China.
| | - Suzhen Wang
- Department of Health Statistics, School of Public Health, Weifang Medical University, Weifang, Shandong, China.
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Luna PC, Chu CY, Fatani M, Borlenghi C, Adora A, Llamado LQ, Wee J. Psychosocial Burden of Psoriasis: A Systematic Literature Review of Depression Among Patients with Psoriasis. Dermatol Ther (Heidelb) 2023; 13:3043-3055. [PMID: 37995052 PMCID: PMC10689612 DOI: 10.1007/s13555-023-01060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/18/2023] [Indexed: 11/24/2023] Open
Abstract
Psoriasis is associated with various comorbidities with a notable psychosocial burden. This systematic literature review explores the burden of depression in patients with psoriasis, comparing it with that experienced by patients with other chronic medical conditions. Embase via Ovid, PubMed, and Cochrane Database of Systematic Reviews via Ovid were searched for peer-reviewed studies published in English between January 1, 2016 and December 6, 2021 that reported real-world evidence or observational studies involving at least 100 adults (age ≥ 18 years) with general (unspecified) or plaque psoriasis experiencing symptoms of depression (but not restricted to patients with a clinical diagnosis). Any report of depression or suicidality was eligible for inclusion. Systematic literature reviews reporting depression/suicidality in other chronic medical conditions were also included. Statistical analysis was not performed; the study was descriptive only. A total of 1744 records were identified, and after several defined screenings by two independent reviewers for publication year, relevance, and sample size, 82 publications were included. Psoriasis was significantly associated with depression. The prevalence of depression in patients with psoriasis ranged from 0.2% to 74.6%, with incidence from 4.83 to 91.9 per 1000 person-years. The prevalence of depression was generally higher among patients with more severe psoriasis than those with less severe disease (as determined by Psoriasis Area Severity Index [PASI] scoring system) and was more prevalent among women than men with psoriasis. Depression in psoriasis significantly reduced quality of life, including factors such as sexual dysfunction, sleep difficulties, subjective well-being, and addictions. Comorbid hypertension, hyperlipidemia, psoriatic arthritis, obesity, inflammatory bowel disease, diabetes, and statin use were all associated with increased depression risk in patients with psoriasis. This systematic literature review found that the burden of depression in psoriasis is no lower than in other chronic medical conditions. Greater awareness of the psychological impact of psoriasis would improve care and management, which should incorporate psychological interventions.
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Affiliation(s)
- Paula C Luna
- Hospital Aleman, Arenales 2557 1a ZC 1425, Buenos Aires, Argentina.
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University College of Medicine, Taipei, Taiwan
| | - Mohammad Fatani
- Dermatology Department, Hera General Hospital, Makkah, Saudi Arabia
| | | | - Anna Adora
- Department of Internal Medicine, National Kidney and Transplant Institute, Quezon City, Metro Manila, Philippines
- Department of Adult Cardiology, Philippine Heart Center, Quezon City, Metro Manila, Philippines
| | | | - James Wee
- Pfizer Inc., Makati City, Philippines
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Ishikawa S, Konta T, Susa S, Ishizawa K, Makino N, Ueno Y, Okuyama N, Iino M. Associations between subjective well-being, number of teeth, and self-rated mastication in Japanese adults: A cross-sectional study. Medicine (Baltimore) 2023; 102:e36354. [PMID: 38050319 PMCID: PMC10695613 DOI: 10.1097/md.0000000000036354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/07/2023] [Indexed: 12/06/2023] Open
Abstract
This cross-sectional study aimed to investigate the risk factors for low levels of subjective well-being (SWB) in the general population of Japan, specifically, the impact of the number of teeth and self-rated mastication. The surveyed population consisted of individuals aged between 40 and 79 years from Yamagata prefecture, Japan. A postal self-administered questionnaire survey of respondents lifestyles, medical history, oral health, and dietary intake, was conducted from 2017 to 2021. We included 6846 participants to confirm the independent associations between SWB and several parameters using multivariate ordinal logistic regression analysis to estimate adjusted odds ratios and 95% confidence intervals. Individuals with < 20 teeth and poor mastication ability had a 1.3-fold risk for low levels of SWB compared with individuals with ≥ 20 teeth with good mastication ability (adjusted odds ratios = 1.300, 95% confidence intervals = 1.043-1.621, P = .020). There were no differences between individuals with good mastication ability, regardless of the number of remaining teeth. Our study emphasizes not only the importance of having ≥ 20 teeth and good mastication ability for high levels of SWB but also the importance of restoring mastication ability using some form of prosthesis, to facilitate a high level of SWB when the number of remaining teeth is < 20.
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Affiliation(s)
- Shigeo Ishikawa
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tsuneo Konta
- Department of Public Health and Hygiene, Yamagata University Graduate School of Medicine, Yamagata, Japan
| | - Shinji Susa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, Yamagata, Japan
- Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Naohiko Makino
- Yamagata University Health Administration Center, Yamagata, Japan
| | - Yoshiyuki Ueno
- Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Naoki Okuyama
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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Wojciechowska M, McFarlane O, Betyna-Białek M. Impact of Mental State on the Severity of Psoriasis Symptoms: A Study on Patient's Emotional Well-Being. Med Sci Monit 2023; 29:e941636. [PMID: 37853681 PMCID: PMC10595041 DOI: 10.12659/msm.941636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/10/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Psoriasis is a chronic systemic skin disease affecting approximately 2% of the global population. In addition to the characteristic inflammatory changes on the skin, patients with psoriasis often experience comorbidities, including depressive symptoms and anxiety. This study aimed to investigate the relationship between the course of psoriasis and the mental state of patients. MATERIAL AND METHODS The study was conducted among 70 patients with psoriasis. An interview was conducted to assess the course of psoriasis. The Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS) were used. CRP concentration as well as VAS, NRS, and PASI scales were measured. The results were subjected to statistical analysis. RESULTS Psoriasis was severe in 50% of the patients. Most (52.8%) of patients had moderate pruritis (VAS) and 58.5% had moderate pain (NRS). Moderate depressive symptoms (BDI) were present in 60% of patients, 18.6% had pathological anxiety (HADS-A), and 18.6% had pathological depression (HADS-D). CRP levels were significantly associated with PASI, VAS, and NRS. CONCLUSIONS The mental state of the patient plays an essential role in the course of psoriasis, and negative emotions affect the severity of skin symptoms. Emotional stress to patients with psoriasis should be limited, which will undoubtedly contribute to overall improvement of health.
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Affiliation(s)
- Milena Wojciechowska
- Department of Social Sciences, University of Nicolaus Copernicus in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Oliwia McFarlane
- Department of Social Sciences, University of Nicolaus Copernicus in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Monika Betyna-Białek
- Center for Specialized Languages in Medicine, University of Nicolaus Copernicus in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
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Stepaniuk A, Baran A, Flisiak I. Kynurenine Pathway in Psoriasis-a Promising Link? Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00958-4. [PMID: 37326759 PMCID: PMC10366053 DOI: 10.1007/s13555-023-00958-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
Psoriasis is a common dermatosis which affects the patient's skin and general well-being because of its link to diseases such as depression, kidney disease and metabolic syndrome. Pathogenesis remains unknown; however, genetic, environmental and immunological factors seem to play a role in the development of the disease. Due to a lack of complete understanding of the psoriasis pathology, effective treatment is yet to be developed. The kynurenine pathway is one of the ways amino acid tryptophan is metabolised. In comorbidities typical for psoriasis such as chronic kidney disease, depression and atherosclerotic alterations in the activation of the kynurenine pathway were observed, which were mainly characterised by higher activity compared to that in healthy individuals. However, the kynurenine pathway has not been thoroughly studied among patients with psoriasis even though increased levels of L-kynurenine, one of the enzymes in the kynurenine pathway, were found in psoriatic skin lesions. Given the unknown pathogenesis of the disease, this finding seems to be a potential new field of study and shows a possible link between psoriasis and its comorbidities that could also lead to novel effective treatment for this chronic condition.
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Affiliation(s)
- A Stepaniuk
- Department of Dermatology and Venerology, Medical University of Bialystok, Zurawia 14, 15-540, Bialystok, Poland.
| | - A Baran
- Department of Dermatology and Venerology, Medical University of Bialystok, Zurawia 14, 15-540, Bialystok, Poland
| | - I Flisiak
- Department of Dermatology and Venerology, Medical University of Bialystok, Zurawia 14, 15-540, Bialystok, Poland
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Liu L, Lin NX, Yu YT, Wang SH, Wang J, Cai XC, Wang CX, Zhang M, Li X, Li B. Epidemiology of mental health comorbidity in patients with psoriasis: An analysis of trends from 1986 to 2019. Psychiatry Res 2023; 321:115078. [PMID: 36724650 DOI: 10.1016/j.psychres.2023.115078] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND The prevalence of mental disorders such as depression, anxiety, and suicide has increased in patients with psoriasis, although no study has systematically analyzed the epidemiology worldwide. OBJECTIVE To explore the prevalence and incidence of psoriasis with comorbid mental disorders (i.e., depression, anxiety, and suicide). METHODS Five databases from establishment through May 2022 were searched. Stata SE 15.1 was used for the data analysis. Subgroup, meta-regression, and sensitivity analyses were used to evaluate the heterogeneity of pooled studies. RESULTS We evaluated 56 studies in our research. The prevalence of depression, anxiety, and suicide in adults with psoriasis was 20%, 21%, and 0.77%. Patients with psoriasis in North America had a higher prevalence of depression and suicide, whereas those in South America had a higher prevalence of anxiety. The incidence of depression, anxiety, and suicide was 42.1, 24.7, and 2.6 per 1000 person-years in adults with psoriasis, respectively. LIMITATIONS All of the included studies were published in Chinese and English, causing a degree of selection bias. CONCLUSION These findings demonstrate the incidence and prevalence of comorbid mental disorders in patients with psoriasis, which may raise awareness among physicians and patients regarding the mental problems associated with psoriasis.
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Affiliation(s)
- Liu Liu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Nai-Xuan Lin
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yuan-Ting Yu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Si-Han Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiao-Ce Cai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Chun-Xiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Miao Zhang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Bin Li
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China; Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai 200443, China.
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Baldiotti ALP, Amaral-Freitas G, Barbosa MCF, Moreira PR, Machado RA, Coletta RD, Meger MN, Paiva SM, Scariot R, Ferreira FDM. Associations between Anxiety, Depression, Chronic Pain and Oral Health-Related Quality of Life, Happiness, and Polymorphisms in Adolescents' Genes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3321. [PMID: 36834016 PMCID: PMC9967116 DOI: 10.3390/ijerph20043321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Adolescence is marked by changes and vulnerability to the emergence of psychological problems. This study aimed to investigate associations between anxiety/depression/chronic pain and oral health-related quality of life (OHRQoL)/happiness/polymorphisms in the COMT, HTR2A and FKBP5 genes in Brazilian adolescents. A cross-sectional study was conducted with ninety adolescents 13 to 18 years. Anxiety, depression and chronic pain were evaluated using the RDC/TMD. The Oral Health Impact Profile was used to assess oral OHRQoL. The Subjective Happiness Scale was used to assess happiness. Single-nucleotide polymorphisms in COMT (rs165656, rs174675), HTR2A (rs6313, rs4941573) and FKBP5 (rs1360780, rs3800373) were genotyped using the Taqman® method. Bivariate and multivariate logistic regression analyses were performed (p < 0.05). Chronic pain and depression were associated with feelings of happiness (p < 0.05). A significant inverse association was found between anxiety and OHRQoL (p = 0.004). The presence of minor allele C of COMT rs174675 was significantly associated with depression (p = 0.040). Brazilian adolescents with depression and chronic pain considers themselves to be less happy than others and those with anxiety are more likely to have a negative impact on OHRQoL. Moreover, the rs174675 variant allele in the COMT gene was associated with depressive symptoms in Brazilian adolescents.
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Affiliation(s)
- Ana Luiza Peres Baldiotti
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Gabrielle Amaral-Freitas
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | - Paula Rocha Moreira
- Department of Morphology, Institute of Biological Sciences (ICB), Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Renato Assis Machado
- Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
| | - Ricardo Della Coletta
- Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
| | | | - Saul Martins Paiva
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Rafaela Scariot
- Departament of Oral Surgery and Maxilofacial, Federal University of Paraná, Curitiba 81530-000, PR, Brazil
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Balato A, Zink A, Babino G, Buononato D, Kiani C, Eyerich K, Ziehfreund S, Scala E. The Impact of Psoriasis and Atopic Dermatitis on Quality of Life: A Literature Research on Biomarkers. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122026. [PMID: 36556392 PMCID: PMC9782020 DOI: 10.3390/life12122026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Psoriasis (PSO) and Atopic dermatitis (AD) are common inflammatory skin diseases that affect people of all ages globally. They negatively impact the quality of life (QoL) of patients in health-related aspects such as physical, psychological and mental functioning. Here, we conducted a review of studies relating to candidate biomarkers and indicators associated with QoL impairment in PSO and AD. Data research was performed using PUBMED and SCOPUS databases from inception to September 2022. Most of the included studies reported genomic or proteomic biomarkers associated with disease activity and QoL outcomes. Sociodemographic, clinical and therapeutic factors have also been implicated in deterioration of life quality in these patients. The inclusion of clinical characteristics, QoL impairment and co-diagnosis should be considered in drug development programs, since processing biomarkers based on an increased number of features in addition to drug class and disease will intensify the value of the biomarker itself, thereby maximizing the future clinical utility as a stratification tool.
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Affiliation(s)
- Anna Balato
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany
- Unit of Dermatology, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Graziella Babino
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Dario Buononato
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Charlotte Kiani
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany
| | - Kilian Eyerich
- Unit of Dermatology, Karolinska University Hospital, 17176 Stockholm, Sweden
- Department of Dermatology and Venereology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany
| | - Emanuele Scala
- Department of Dermatology and Venereology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, 17176 Stockholm, Sweden
- Correspondence:
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How important is subjective well-being for patients? A qualitative interview study of people with psoriasis. Qual Life Res 2022; 31:3355-3363. [PMID: 35948788 PMCID: PMC9587968 DOI: 10.1007/s11136-022-03189-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE This qualitative study aimed to investigate the importance of subjective well-being (SWB) as an outcome of psoriasis treatment from patient's perspective. We focused on the affective component of SWB as assessed with the Daily Experience Sampling Questionnaire (DESQ), a validated daily diary. METHODS Semi-structured qualitative telephone interviews were conducted with in-patients of a dermatological rehabilitation clinic, after participants had completed the DESQ for up to seven days to get familiar with the concept of SWB. Patients were asked to reflect on the importance of SWB as treatment goal and on its relative importance as compared with other treatment outcomes. We also addressed whether SWB could be an indirect measure of benefit in that it reflects other important outcomes. Transcripts were analyzed using content analysis. RESULTS Eleven patients participated (24-63 years, mean 53 years, 8 male, 3 female). Participants uniformly confirmed that changes in SWB reflected treatment benefit. All but one considered SWB to be a central aspect of treatment benefit-either as the most important treatment goal or as an indirect benefit indicator. In particular, participants described positive associations of SWB with other outcomes, such as symptoms. They reported that both the disease and the medical treatment had an impact on their SWB, which was reflected in the DESQ. CONCLUSION Our findings suggest that SWB is a relevant indicator of treatment benefit for patients with psoriasis. Therefore, SWB measures, such as the DESQ, could be used to operationalize patient-relevant benefit of psoriasis treatment, complementing outcome measures currently used.
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