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Silva A, Marzo J, García Del Castillo JA. Relationship between quality of life, emotional symptomology and perceived emotional intelligence in a sample of burn victims. Burns 2024; 50:1330-1340. [PMID: 38494394 DOI: 10.1016/j.burns.2024.02.034] [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: 09/16/2022] [Revised: 02/16/2024] [Accepted: 02/27/2024] [Indexed: 03/19/2024]
Abstract
The main objective of this study is to analyse the association between Quality of Life (QOL), Emotional Symptomology and perceived Emotional Intelligence (EI) in burn patients. Additionally, it is intended determine the predictor models of QOL, and confirm the mediating effect of emotional symptomology between QOL and perceived EI. This is a transversal study developed in the Hospital da Prelada, Porto, Portugal, with a sample of 92 patients that were hospitalized in the Burn Unit and the Reconstructive Plastic Surgery Service. The assessment protocol consisted of a sociodemographic and clinical data sheet. To assess the perception of QOL of the burn patient it was used the Burn Specific Health Scale - Revised (BSHS-R), the emotional symptomology was measured by the Brief Symptom Inventory (BSI) and Trait Met-Mood Scale-24 (TMMS) was used to assess Emotional Intelligence (EI). The cross-sectional and correctional data were analysed through descriptive statistics, correlations, regressions and simple mediations. The results obtained suggest significant associations between QOL, perceived EI and Emotional Symptomology in burn patients. The results of the predictor models of the QOL domains encompass the Positive Symptom Distress Index (PSDI of Emotional Symptomology), where the total variance is explained mainly by the models of QOL Affect and Body Image 46% and Treatment 31%. The mediating effect of the PSDI in the relationship between QOL in the Affect and Body Image dimension and the Mood Repairs (MR) was also tested, having proved to have a total mediation (the Mood Repairs loses its contribution in the QOL model when the PSDI variable is introduced). This study underscores the importance of perceived Emotional Intelligence and its association with the burn impact in the different dimensions of QOL of the patients. The intention of this study is to alert health professionals for patient support in the search for strategies that aim for positive adaptation which promotes QOL and emotional adjustment of burn patients to their new condition.
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Affiliation(s)
- A Silva
- the Prelada Hospital and Doctorate from Miguel Hernández University of Elche in the Doctoral Program in Sport and Health, Spain.
| | - J Marzo
- Miguel Hernández University of Elche, Spain
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Messele F, Hinchee-Rodriguez K, Kraus CN. Vulvar dermatoses and depression: A systematic review of vulvar lichen sclerosus, lichen planus, and lichen simplex chronicus. JAAD Int 2024; 15:15-20. [PMID: 38371668 PMCID: PMC10869279 DOI: 10.1016/j.jdin.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Affiliation(s)
- Feben Messele
- School of Medicine, University of California Irvine, Irvine, California
| | | | - Christina N. Kraus
- Department of Dermatology, University of California Irvine, Irvine, California
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Zhang H, Wang M, Zhao X, Wang Y, Chen X, Su J. Role of stress in skin diseases: A neuroendocrine-immune interaction view. Brain Behav Immun 2024; 116:286-302. [PMID: 38128623 DOI: 10.1016/j.bbi.2023.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/16/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Psychological stress is a crucial factor in the development of many skin diseases, and the stigma caused by skin disorders may further increase the psychological burden, forming a vicious cycle of psychological stress leading to skin diseases. Therefore, understanding the relationship between stress and skin diseases is necessary. The skin, as the vital interface with the external environment, possesses its own complex immune system, and the neuroendocrine system plays a central role in the stress response of the body. Stress-induced alterations in the immune system can also disrupt the delicate balance of immune cells and inflammatory mediators in the skin, leading to immune dysregulation and increased susceptibility to various skin diseases. Stress can also affect the skin barrier function, impair wound healing, and promote the release of pro-inflammatory cytokines, thereby exacerbating existing skin diseases such as psoriasis, atopic dermatitis, acne, and urticaria. In the present review, we explored the intricate relationship between stress and skin diseases from a neuroendocrine-immune interaction perspective. We explored the occurrence and development of skin diseases in the context of stress, the stress models for skin diseases, the impact of stress on skin function and diseases, and relevant epidemiological studies and clinical trials. Understanding the relationship between stress and skin diseases from a neuroendocrine-immune interaction perspective provides a comprehensive framework for targeted interventions and new insights into the diagnosis and treatment of skin diseases.
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Affiliation(s)
- Hanyi Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Mi Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China; Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Xue Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Yujie Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
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Orzechowska A, Maruszewska P, Gałecka M, Hyland P, Boduszek D, Gałecki P, Bliźniewska-Kowalska K. Emotional control in selected somatic and psychiatric diseases. BMC Psychiatry 2023; 23:802. [PMID: 37924065 PMCID: PMC10623861 DOI: 10.1186/s12888-023-05321-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/29/2023] [Indexed: 11/06/2023] Open
Abstract
THE AIM was to assess the level of subjective control of emotional states among patients treated for dermatological and gastrointestinal somatic diseases compared to those with depressive and anxiety disorders. The results were related to the analyzed dimensions of emotion regulation in healthy subjects. MATERIALS AND METHODS The reports of the conducted studies were compiled for a total of 310 people, including 120 patients diagnosed with a somatic disease (psoriasis, rosacea, irritable bowel syndrome, and gastroesophageal reflux), as well as 96 patients diagnosed with depressive disorders and 30 patients with anxiety disorders. The control group consisted of healthy subjects (64 individuals). To assess the psychological variables analyzed, the subjects completed the Emotion Regulation Questionnaire developed by J. Brzeziński. RESULTS The study showed that the patients suffering from a chronic somatic symptom disorder, similarly to those treated for depression and anxiety disorders, differed from the healthy individuals in most aspects of emotional control. The patients with dermatological and gastrointestinal diseases differed statistically significantly from the patients with depression and the patients with anxiety disorders in relation to three dimensions of emotional control. Patients with a somatic disease are characterized by higher emotional and rational motivation, lower emotional resilience and lower emotional arousal. CONCLUSIONS A chronic disease co-occurs with the emotional sphere of a person's daily functioning. Regardless of the diagnosis in terms of somatic disorders and mental illnesses, the way in which emotional states are controlled can be an important factor in the onset of the disease, coping with it as well as the treatment process.
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Affiliation(s)
- Agata Orzechowska
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, 91-229, Poland
| | - Paulina Maruszewska
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, 91-229, Poland
| | - Małgorzata Gałecka
- Department of Psychotherapy, Medical University of Lodz, Lodz, 91-229, Poland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Daniel Boduszek
- Faculty of Psychology, SWPS University, Wrocław, 53-238, Poland
- Department of Psychology, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Piotr Gałecki
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, 91-229, Poland
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Cortés H, Cariño-Calvo L, Reyes-Hernández OD, Rojas-Márquez M, Magaña JJ, Vizcaino-Dorado PA, Villegas-Vazquez EY, Quintas-Granados LI, Jiménez-Islas E, Cortés-Mollinedo VA, Leyva-Gómez G, González-Del Carmen M. High Levels of Anxiety, Depression, Risk of Suicide, and Implications for Treatment in Patients with Lamellar Ichthyosis. Healthcare (Basel) 2023; 11:2071. [PMID: 37510511 PMCID: PMC10380064 DOI: 10.3390/healthcare11142071] [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: 06/14/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Lamellar ichthyosis (LI) is a genodermatosis that injures the structure and function of the skin, affecting the appearance and self-esteem of patients, which may seriously impair their mental health and quality of life. In the present study, we determined anxiety, depression, and suicidal risk levels in patients with LI through the Beck anxiety and depression inventories (BAI and DBI-II, respectively) and the SAD PERSONS scale (SPS). We observed that anxiety, depression, and suicidal ideation were strongly associated with the LI (Cramér's V = 0.429, 0.594, and 0.462, respectively). Furthermore, patients with LI showed a significant increase in the scores of anxiety, depression, and suicidal risk (p = 0.011, <0.001, and 0.001, respectively) compared to individuals without the disease. Additionally, the suicide risk increased even more in patients who presented comorbidity of anxiety and depression than in patients who presented only anxiety or depression (p = 0.02). Similarly, the increase in the BAI scores correlated with the score observed on the SPS. Our results indicate that patients with LI have higher levels of anxiety and depression compared to individuals without the disease, which could be associated with suicidal risk. Therefore, the collaborative involvement of skin and mental health professionals is necessary to manage patients with LI appropriately. We believe that psychiatric studies and individual evaluations must be performed in LI patients to determine a treatment that, in addition to reducing skin symptoms, focuses on reducing the levels of depression and anxiety and improving the quality of life to reduce the risk of suicide.
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Affiliation(s)
- Hernán Cortés
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | | | - Octavio D Reyes-Hernández
- Laboratorio de Biología Molecular del Cáncer, UMIEZ, FES Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México 09230, Mexico
| | - Martín Rojas-Márquez
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Secretaría de Salud, Ciudad de México 14080, Mexico
| | - Jonathan J Magaña
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | - Pablo A Vizcaino-Dorado
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | - Edgar Y Villegas-Vazquez
- Laboratorio de Farmacogenética, UMIEZ, FES Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México 09230, Mexico
| | | | - Elizabeth Jiménez-Islas
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | | | - Gerardo Leyva-Gómez
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
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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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Depression among people with chronic skin disease at Boru Meda Hospital in Northeast Ethiopia. PLoS One 2023; 18:e0282022. [PMID: 36827301 PMCID: PMC9955985 DOI: 10.1371/journal.pone.0282022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND The comorbidity of depression with chronic skin disease negatively affects the quality of life and disease prognosis, creating an immense burden on patients, families, and the wider community. However, there are limited studies conducted on the prevalence of depression and associated factors among people with chronic skin disease in Ethiopia. OBJECTIVE This study aimed to assess the prevalence and associated factors of depression among people with chronic skin disease at Boru Meda Hospital, Northeast Ethiopia. METHODS An institutional-based cross-sectional study was carried out from March 10- April 18, 2021, among a total of 381 people with chronic skin disease. The Patient Health Questioner-9 was used to assess depression. A logistic regression analysis model with an adjusted odds ratio was used to assess the strength of associations between the outcome and predictor variables. P-value < 0.05 was considered statistically significant. RESULT The magnitude of depression among people with chronic skin disease was 23.6% (95%Cl: 19.8%, 28.6%). We identified significantly increased odds of depression among participants with rural residence (AOR = 3.45, 95% CI: 1.64, 7.28), duration of illness above 5 years (AOR = 3.59, 95% CI: 1.31, 9.85), comorbid medical illness AOR = 2.51, 95% CI: 1.06, 5.98), family history of mental illness (AOR = 3.39, 95% CI: 1.11, 10.41), non-adherence to chronic skin disease medications (AOR = 3.53, 95% CI: 1.20, 10.41), low self-image (AOR = 4.69, 95% CI: 2.25, 9.77), and perceived stigma (AOR = 4.61, 95% CI: 2.14, 9.92). CONCLUSION Depression was common among patients with chronic skin diseases. This study has indicated a need for proper screening of depression in the current medical treatment of patients with chronic skin disease in Boru Meda Hospital, Northeast Ethiopia.
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Cognitive behavior therapy as dermatological treatment: a narrative review. Int J Womens Dermatol 2022; 8:e068. [PMID: 36601597 PMCID: PMC9788967 DOI: 10.1097/jw9.0000000000000068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/02/2022] [Indexed: 12/24/2022] Open
Abstract
Cognitive behavior therapy (CBT) is efficacious in treating numerous psychological disorders. It is also effective in combination with medication for chronic pain, diabetes, and other diseases. Patients with skin disease report high levels of stress, anxiety, and negative feelings. Objective To summarize the findings on the utility of CBT for the improvement of skin status and quality of life in patients with dermatological conditions. Methods PubMed and Google Scholar databases were searched for relevant articles from database inception to the time of search (October 20, 2021). A total of 30 included studies featured 10 on psoriasis, 11 on atopic dermatitis, 4 on vitiligo, 4 on acne, and 1 study on alopecia areata. Results Several studies, including randomized controlled trials with large study samples, support the effectiveness of CBT and Internet CBT for a number of dermatological conditions. Patients who completed CBT courses were less likely to rely on dermatological healthcare during follow-up. Limitations There are a limited number of studies discussing the implementation of CBT for alopecia, acne, and vitiligo. Conclusion Patients who underwent CBT or Internet CBT in addition to skin care demonstrated improvement with quality of life and severity of skin disease as compared to controls only receiving standard of care treatment.
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Tamschick R, Navarini A, Strobel W, Müller S. Insomnia and other sleep disorders in dermatology patients: A questionnaire-based study with 634 patients. Clin Dermatol 2021; 39:996-1004. [PMID: 34920837 DOI: 10.1016/j.clindermatol.2021.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Insufficient sleep duration and quality are associated with various adverse health outcomes. Whereas sleep disorders have been studied in a few skin conditions, data in a more comprehensive dermatology population are lacking. We sought to describe the prevalence, causes, and consequences of sleep disorders in dermatology patients. In this cross-sectional, single-center study, dermatology patients completed a questionnaire addressing skin-related and non-skin-related health, sleep behavior, causes, and consequences of sleep disorders. According to the Regensburg Insomnia Scale, 27.92% of the 634 participants had insomnia (177 of 634 patients). Of these 177 patients, 115 (64.97%) were subjectively sleep disturbed, with skin-related causes accounting for 55.65% (64 of 115 patients), non-skin-related accounting for 33.04% (38 of 115 patients), and combined accounting for 11.30% (13 of 115 patients). Itch was the leading cause of skin-related sleep disorders (64.49%, 50 of 77 patients), followed by skin-related pain (55.84%, 43 of 77 patients) and skin-related fearful thoughts (54.55%, 42 of 77 patients). Sleep disorders reduced daytime performance in 68.70% (79 of 115 patients) and sleep quality of relatives in 20.87% (24 of 115 patients). The prevalence of insomnia among different diagnostic categories ranged from 20.31% to 50.00%. The most common strategy to improve sleep was taking sleep medication (57.39%, 66 of 115 patients). We conclude that sleep disorders are highly prevalent in dermatology patients, often leading to reduced daytime performance, impaired sleep among the patients' relatives, and increased use of substances.
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Affiliation(s)
- Rianna Tamschick
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland.
| | - Alexander Navarini
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Werner Strobel
- Sleep Unit, Respiratory Medicine, Department of Internal Medicine, University Hospital of Basel, Basel, Switzerland
| | - Simon Müller
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
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10
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Isotretinoin and neuropsychiatric side effects: Continued vigilance is needed. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6. [PMID: 37168254 PMCID: PMC10168661 DOI: 10.1016/j.jadr.2021.100230] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Isotretinoin (13-cis-retinoic acid, marketed under the names Accutane, Roaccutane, and others) is an effective treatment for acne that has been on the market for over 30 years, although reports of neuropsychiatric side effects continue to be reported. Isotretinoin is an isomer of the active form of Vitamin A, 13-trans-retinoic acid, which has known psychiatric side effects when given in excessive doses, and is part of the family of compounds called retinoids, which have multiple functions in the central nervous system. Methods The literature was reviewed in pubmed and psychinfo for research related to isotretinoin and neuropsychiatric side effects including depression, suicidal thoughts, suicide, mania, anxiety, impulsivity, emotional lability, violence, aggression, and psychosis. Results Multiple case series have shown that successful treatment of acne with isotretinoin results in improvements in measures of quality of life and self esteem However, studies show individual cases of clinically significant depression and other neuropsychiatric events that, although not common, are persistent in the literature. Since the original cases of depression were reported to the United States Food and Drug Administration, numerous cases have been reported to regulatory agencies in the United Kingdom, France, Ireland, Denmark, Australia, Canada, and other countries, making isotretinoin one of the top five medications in the world associated with depression and other neuropsychiatric side effects. Clinicians are advised to warn patients of the risks of neuropsychiatric side effects with isotretinoin which may arise from the medication itself, and not just as a side effect of acne or youth.
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Pourali SP, Gutierrez Y, Kucharik AH, Rajkumar JR, Jones ME, Ortiz I, David M, Armstrong AW. Bullous Dermatoses and Depression: A Systematic Review. JAMA Dermatol 2021; 157:1487-1495. [PMID: 34668929 DOI: 10.1001/jamadermatol.2021.4055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
IMPORTANCE There is a lack of evidence synthesis on the association between bullous skin disease and depression. OBJECTIVE To synthesize and interpret the current evidence on the association between bullous skin disease and depression. EVIDENCE REVIEW This review was conducted according to PRISMA guidelines and reviewed literature related to bullous skin disease and depression in the PubMed, Embase, PsycInfo, and Cochrane databases published between 1945 and February 2021. The quality of each included article was assessed via the Newcastle-Ottawa Scale. This review was registered with PROSPERO (CRD42021230750). FINDINGS A total of 17 articles were identified that analyzed a total of 83 910 patients (55.2% female; specifically, 6951 patients with bullous pemphigoid, 1669 patients with pemphigus, and 79 patients with epidermolysis bullosa were analyzed). The prevalence of depressive symptoms among patients with bullous dermatoses ranged from 40% to 80%. The prevalence of depression diagnosis among patients with bullous dermatoses ranged from 11.4% to 28%. CONCLUSIONS AND RELEVANCE In this systematic review, high rates of depression and depressive symptoms existed among patients with bullous skin disease. Adequate treatment of bullous dermatoses may be associated with a decrease in mental health burden on patients.
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Affiliation(s)
- Sarah P Pourali
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | | | - Alison H Kucharik
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton
| | | | - Madison E Jones
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Isabela Ortiz
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Michelle David
- Keck School of Medicine, University of Southern California, Los Angeles
| | - April W Armstrong
- Keck School of Medicine, University of Southern California, Los Angeles
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12
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The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin. PATHOPHYSIOLOGY 2020; 27:14-27. [PMID: 35366252 PMCID: PMC8830443 DOI: 10.3390/pathophysiology27010003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 12/29/2022] Open
Abstract
Diabetes mellitus is associated with impairment in cognitive functions which can complicate adherence to self-care behaviors. We evaluated the incidence of cognitive impairment in patients with diabetes mellitus to determine the strength of the association between diabetic foot (a complication that occurs in about 10% of diabetic patients), adherence to the clinician’s recommendations, glycemic control, and cognitive function. A prospective study was carried out in a probabilistic sample of older patients with diabetic foot living in three nursing homes. Cognitive functions were evaluated by the MMSE (Mini-Mental State Examination), the Trail Making test (TMT), and the Michigan neuropathy screening instrument (MNSI). There were no significant associations between cognitive function and neuropathy or foot alterations, although glycated hemoglobin (HB1Ac > 7%) significantly (p < 0.05) associated with MMSE and adherence to treatment in the 1 month follow-up visit. Receiver operating characteristic curve analysis showed that both HB1Ac and the MNSI score significantly (p < 0.05) discriminate subsequent adherence to treatment for foot complication, with a sensitivity of 80.0–73.3% and specificity 70.6–64.7%, respectively. Proper control of foot complications in diabetic patients involves appropriate glycemic control and less severe neuropathy, and seems to be unrelated to cognitive dysfunction, and warrants further studies in order to tailor appropriate treatments to central and peripheral nervous system disorders. Poor glycemic control (Hb1Ac level > 7%) and a neuropathy score of 5.5 in the MNSI are the best-cut off points to discriminate poor adherence to the clinician’s recommendations for self-care behaviors in people with diabetic foot complication. In this study, we observed that foot disorders were associated with impaired global cognitive function in elderly patients (aged ≥ 65). Podiatrists and physicians should consider cognitive dysfunction as an important chronic complication in the management of diabetic foot.
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Aslan Kayiran M, Karadag AS, Jafferany M. Psychodermatology of acne: Dermatologist's guide to inner side of acne and management approach. Dermatol Ther 2020; 33:e14150. [DOI: 10.1111/dth.14150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Melek Aslan Kayiran
- Department of Dermatology and Venereology Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital Istanbul Turkey
| | - Ayse Serap Karadag
- Department of Dermatology and Venereology Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital Istanbul Turkey
| | - Mohammad Jafferany
- Department of Psychodermatology Central Michigan University Saginaw Michigan USA
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Streight KL, Dao H, Kim SJ. Dermatology Resident Training on Depression Screening: A Cross-Sectional Survey. Cureus 2020; 12:e8861. [PMID: 32754401 PMCID: PMC7386085 DOI: 10.7759/cureus.8861] [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] [Indexed: 12/02/2022] Open
Abstract
Background Many dermatologic diseases are implicated in the development of depression. Currently, there is no literature addressing the extent of dermatology residency training on depression screening. Objective Our study aimed to determine the extent of dermatology residency training on depression screening to potentially improve education in this area. Methods We designed a 12-question survey to assess the level of resident training and comfort in depression screening for patients with acne vulgaris, atopic dermatitis, psoriasis, hidradenitis suppurativa, and skin cancer. Fifty-six residents completed the survey, and data for each question was analysed in aggregate. Results Participants found depression screening most important for patients with acne vulgaris, psoriasis, and hidradenitis suppurativa (p<0.0001, 95% CI). Ratings of confidence in screening were similar across all conditions. Most residents reported only occasional screening in the setting of these diseases. Sixty-four percent of participants stated that education on depression screening is not included as part of their curriculum or clinical practice, while 23% were uncertain. Conclusions Our results suggest a lack in relevant training during residency, warranting the inclusion of education on depression screening into the dermatology residency curriculum to facilitate better recognition of the mental health comorbidities of dermatologic diseases.
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Affiliation(s)
| | - Harry Dao
- Dermatology, Loma Linda University Health, Loma Linda, USA
| | - Soo Jung Kim
- Dermatology, Baylor College of Medicine, Houston, USA
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Mashayekhi Goyonlo V, Sardabi MS, Tavalaei AM, Khoshnevisan Z, Razmara M. Cognitive behavioral therapy as an adjuvant therapy in acne excoriée: a randomized controlled clinical trial. J DERMATOL TREAT 2020; 33:782-788. [PMID: 32502358 DOI: 10.1080/09546634.2020.1776207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Acne excoriée (AE) is a difficult challenge in dermatology practice. AE is mostly associated with some psychiatric disorders particularly mood disorders. Thus, patients generally continue to manipulate their lesions. It was aimed to compare the effectiveness of cognitive behavioral therapy (CBT) as an adjuvant treatment for AE in a randomized controlled clinical trial.Methods: Thirty-two adults with AE were randomly assigned to CBT or control group. Both the groups received similar standard medication. Furthermore, eight sessions of CBT were held during 2 months in CBT group. Self-reported Skin Picking Scale (SPS), clinical severity rating, beck anxiety and depression inventories were determined at the baseline and after 2-month follow-up.Results: Participants in CBT group showed significantly more improvement on clinical severity score (p=.01) as well as SPS score (p=.02) after 2-month follow-up, in comparison to the control group. Depression and anxiety scores were significantly diminished after two months among CBT group in comparison to controls (p value .01 for both anxiety and depression).Conclusion: CBT constitutes a utile treatment option for AE and should be considered as an adjuvant therapy in clinical setting.
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Affiliation(s)
| | - Maryam Saeidi Sardabi
- Department of Industrial and Organizational Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Arezoo Moradi Tavalaei
- Department of Psychology, Faculty of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | | | - Mahdi Razmara
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Depression mediates cutaneous body image and facial appearance dissatisfaction in insomnia. Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-020-00254-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AbstractThis study examined the relationship between dissatisfaction with cutaneous body image and facial appearance with symptoms of insomnia whilst incorporating the mediating role of anxiety and/or depression after accounting for co-morbid sleep disorder symptoms. Participants (n = 241) completed online measures assessing insomnia symptoms, anxiety and depression symptoms, and satisfaction with cutaneous body image and facial appearance. Symptoms of insomnia were independently related to greater dissatisfaction with cutaneous body image and facial appearance in univariate analyses. However, linear regression analyses determined these relationships to be partially mediated by depression, but not anxiety. Expanding on prior research, these findings suggest that whilst increased symptoms of insomnia may influence dissatisfaction with cutaneous and facial features, these relationships may be partially attributed to the experience of depressive symptoms often co-morbid with both insomnia and dermatological complaints. Treatment approaches for individuals with insomnia may benefit from targeting and improving negatively appraised aspects of physical self-perception.
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Abstract
Background: Chronic skin conditions can have a profound impact on people’s lives, both physically and psychologically, and may predispose to mental health disorders. Providing sufferers with appropriate psychological support is important. Objective: In this study, we captured the views of people suffering from a chronic skin condition who were attending the “Skin Matters” conference, held on 20 May 2017, in London. Methods: Delegates were provided with a 5-point questionnaire to complete. Questions related to the impact of their chronic skin condition on their life, the nature of any psychological support they had found helpful and whether they felt they could benefit from greater support in managing their condition. Results: 59% of the delegates completed the questionnaire. The survey results showed that skin conditions can have an impact of many areas of daily living as well as on mental well-being. The most popular source of psychological support was the Internet. The majority of survey participants felt they would benefit from increased psychological support in managing their condition. Conclusions: In the United Kingdom, there is a need to improve the availability of resources for people/patients with skin conditions in order to provide better support.
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Affiliation(s)
- A Kanji
- Department of Dermatology, The Royal Free Hospital, London, UK
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18
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Miot HA, Penna GDO, Ramos AMC, Penna MLF, Schmidt SM, Luz FB, Sousa MAJ, Palma SLL, Sanches Junior JA. Profile of dermatological consultations in Brazil (2018). An Bras Dermatol 2019; 93:916-928. [PMID: 30484547 PMCID: PMC6256211 DOI: 10.1590/abd1806-4841.20188802] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 10/01/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Dermatological diseases are among the primary causes of the demand for basic health care. Studies on the frequency of dermatoses are important for the proper management of health planning. OBJECTIVES To evaluate the nosological and behavioral profiles of dermatological consultations in Brazil. METHODS The Brazilian Society of Dermatology invited all of its members to complete an online form on patients who sought consultations from March 21-26, 2018. The form contained questions about patient demographics, consultation type according to the patient's funding, the municipality of the consultation, diagnosis, treatments and procedures. Diagnostic and therapeutic decisions were compared between subgroups. RESULTS Data from 9629 visits were recorded. The most frequent causes for consultation were acne (8.0%), photoaging (7.7%), nonmelanoma skin cancer (5.4%), and actinic keratosis (4.7%). The identified diseases had distinct patterns with regard to gender, skin color, geographic region, type of funding for the consultation, and age group. Concerning the medical conducts, photoprotection was indicated in 44% of consultations, surgical diagnostic procedures were performed in 7.3%, surgical therapeutic procedures were conducted in 19.2%, and cosmetic procedures were performed in 7.1%. STUDY LIMITATIONS Nonrandomized survey, with a sample period of one week. CONCLUSION This research allowed us to identify the epidemiological profiles of the demands of outpatients for dermatologists in various contexts. The results also highlight the importance of aesthetic demands in privately funded consultations and the significance of diseases such as acne, nonmelanoma skin cancer, leprosy, and psoriasis to public health.
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Affiliation(s)
| | - Hélio Amante Miot
- Board of directors of the Sociedade Brasileira de Dermatologia, Rio
de Janeiro (RJ), Brasil
| | - Gerson de Oliveira Penna
- Tropical Medicine Nucleus, Universidade de Brasília,
Brasília (DF), Brasil
- Fiocruz School of Government, Fundação Oswaldo Cruz,
Brasília (DF), Brasil
| | | | | | - Sílvia Maria Schmidt
- Board of directors of the Sociedade Brasileira de Dermatologia, Rio
de Janeiro (RJ), Brasil
| | - Flávio Barbosa Luz
- Board of directors of the Sociedade Brasileira de Dermatologia, Rio
de Janeiro (RJ), Brasil
| | | | - Sérgio Luiz Lira Palma
- Board of directors of the Sociedade Brasileira de Dermatologia, Rio
de Janeiro (RJ), Brasil
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Önen Ö, Kundak S, Özek Erkuran H, Kutlu A, Çakaloz B. Quality of life, depression, and anxiety in Turkish children with vitiligo and their parents. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1454385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Özlem Önen
- Department of Child and Adolescent Psychiatry, Izmir Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
| | - Selcen Kundak
- Department of Dermatology, Izmir Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
| | - Handan Özek Erkuran
- Department of Child and Adolescent Psychiatry, Izmir Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
| | - Ayşe Kutlu
- Department of Child and Adolescent Psychiatry, Izmir Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
| | - Burcu Çakaloz
- Department of Child and Adolescent Psychiatry, Pamukkale University Medical School Hospital, Denizli, Turkey
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20
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Kouris A, Platsidaki E, Christodoulou C, Armyra K, Korkoliakou P, Stefanaki C, Tsatovidou R, Rigopoulos D, Kontochristopoulos G. Quality of life, depression, anxiety and loneliness in patients with bullous pemphigoid. A case control study. An Bras Dermatol 2017; 91:601-603. [PMID: 27828632 PMCID: PMC5087217 DOI: 10.1590/abd1806-4841.20164935] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 10/10/2015] [Indexed: 11/21/2022] Open
Abstract
Background Bullous pemphigoid (BP) is a chronic, autoimmune blistering skin disease that
affects patients' daily life and psychosocial well-being. Objective The aim of the study was to evaluate the quality of life, anxiety, depression
and loneliness in BP patients. Methods Fifty-seven BP patients and fifty-seven healthy controls were recruited for
the study. The quality of life of each patient was assessed using the
Dermatology Life Quality Index (DLQI) scale. Moreover, they were evaluated
for anxiety and depression according to the Hospital Anxiety Depression
Scale (HADS-scale), while loneliness was measured through the Loneliness
Scale-Version 3 (UCLA) scale. Results The mean DLQI score was 9.45±3.34. Statistically significant
differences on the HADS total scale and in HADS-depression subscale (p=0.015
and p=0.002, respectively) were documented. No statistically significant
difference was found between the two groups on the HADS-anxiety subscale.
Furthermore, significantly higher scores were recorded on the UCLA Scale
compared with healthy volunteers (p=0.003). Conclusion BP had a significant impact on quality of life and the psychological status
of patients, probably due to the appearance of unattractive lesions on the
skin, functional problems and disease chronicity.
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21
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Psychiatric disorders associated with some chronic dermatologic diseases among a group of Egyptian dermatology outpatient clinic attendants. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2017. [DOI: 10.1097/01.ewx.0000503397.22746.bd] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kumar A, Kumar K, Swarup P, Goel S, Tomar AS. A study to find depression in patients attending dermatological OPD in a teaching hospital. J Family Med Prim Care 2016; 5:449-452. [PMID: 27843859 PMCID: PMC5084579 DOI: 10.4103/2249-4863.192317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: The relationship between skin and the brain exists because the brain, as the center of psychological functions, and the skin have the same ectodermal origin and are affected by the same hormones and neurotransmitters. Skin disorder can be a potential source of emotional distress and psychiatric illness leading to impaired psychosocial adjustments. Aims and Objectives: The aim and objective of this study was to find psychiatric depression in patients attending dermatology outpatient department (OPD). Materials and Methods: The study was conducted in the department of psychiatry. A total of 200 patients of both gender were consecutively taken who referred to psychiatry OPD from skin OPD after meeting inclusion and exclusion criteria. Results: A total of 33.3% patients scored high on GHQ-12 Scale (General Health Questionnaire-12) and also clinically found that they were suffering from depression. Conclusion: Co-morbid Depression found in patients suffering from skin disorders. Proper screening and appropriate referral required for better prognosis.
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Affiliation(s)
- Abhinit Kumar
- Department of Psychiatry, School of Medical Sciences and Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India
| | - Kunal Kumar
- Department of Psychiatry, School of Medical Sciences and Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India
| | - Praneta Swarup
- Department of Pediatrics, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Shitiz Goel
- Department of Skin and VD, School of Medical Sciences and Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India
| | - Abhay Singh Tomar
- Department of Psychiatry, School of Medical Sciences and Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India
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23
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Spirituality and mood pathology in severe skin conditions: a prospective observational study. Arch Dermatol Res 2016; 308:521-5. [PMID: 27377294 PMCID: PMC4982877 DOI: 10.1007/s00403-016-1672-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 06/17/2016] [Accepted: 06/27/2016] [Indexed: 01/14/2023]
Abstract
Although the association between spirituality and parameters of psychological health and disease has been investigated extensively, little evidence is available for its potential role in dermatology. In a single-centre observational prospective study, 149 outpatients (107 women) with systemic sclerosis (SSc; n = 44), lupus erythematosus (LE; n = 48), or early stage malignant melanoma (MM; n = 57) were investigated using the multidimensional inventory for religious/spiritual well-being together with the Brief Symptom Inventory for psychiatric symptoms (BSI-18). SSc patients reported the highest amount of Somatization in comparison with LE and MM patients (p < 0.05). Furthermore, in line with the previous research, spiritual dimensions, such as Hope for a better future (p < 0.01) or Hope for a better afterlife (p < 0.01), proved to be especially negatively predictive for the global amount of psychiatric symptom burden in these dermatological patient groups. Our findings suggest that greater attention should be given to spiritual issues, such as encouraging patients, imbuing them with optimism, and offering interventions that address spiritual well-being.
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24
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Manzoni APDDS, Weber MB, Nagatomi ARDS, Pereira RL, Townsend RZ, Cestari TF. Assessing depression and anxiety in the caregivers of pediatric patients with chronic skin disorders. An Bras Dermatol 2014; 88:894-9. [PMID: 24474096 PMCID: PMC3900338 DOI: 10.1590/abd1806-4841.20131915] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 01/08/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The literature has shown that the presence of emotional disturbances in
caregivers of children with skin diseases affects the course and treatment of the
disease. Anxiety and depression are among the most frequently reported psychiatric
diagnoses related to this fact. OBJECTIVE To evaluate the presence of anxiety and depression in caregivers of pediatric
patients with chronic skin disorders, exemplified by atopic dermatitis, psoriasis
and vitiligo, and correlate them to the quality of life of the patients. METHODS The sample consisted of 118 patients with atopic dermatitis, vitiligo and
psoriasis, monitored by their main caregiver. The levels of anxiety and depression
in the caregivers were assessed using the Hamilton Anxiety Scale and the Beck
Depression Inventory, respectively. The Children's Dermatology Life Quality Index
was applied. RESULTS Anxiety was observed in 36% of the caregivers of the patients with atopic
dermatitis, in 36% of those of children affected by psoriasis, and in 42% of those
responsible for pediatric patients with vitiligo. Depression occurred in 36% of
the caregivers of patients with atopic dermatitis, in 36% of those of children
affected by psoriasis and in 26% of those responsible for pediatric patients with
vitiligo. There was a significant correlation between poor quality of life scores
in patients with vitiligo and the presence of depression and anxiety in their
caregivers. CONCLUSION Emotional disorders tend to be present among close family members of children
with the chronic skin diseases studied and their prevention can help in
controlling and treating these diseases.
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Affiliation(s)
- Ana Paula Dornelles da Silva Manzoni
- Universidade Federal do Rio Grande do Sul, Porto AlegreRS, Brazil, PhD Universidade Federal do Rio Grande do Sul (UFRGS) - Collaborating Professor at the Universidade Federal de Ciencias da Saude de Porto Alegre (UFCSPA) - Porto Alegre (RS), Brazil
| | - Magda Blessmann Weber
- Universidade Federal do Rio Grande do Sul, Porto AlegreRS, Brazil, PhD Universidade Federal do Rio Grande do Sul (UFRGS) - Assistant Professor of the Universidade Federal de Ciencias da Saude de Porto Alegre (UFCSPA) - Porto Alegre (RS), Brazil
| | | | | | | | - Tania Ferreira Cestari
- Universidade Federal do Rio de Janeiro, Porto AlegreRS, Brazil, PhD Universidade Federal do Rio de Janeiro (UFRJ) - Associate Professor at the Universidade Federal do Rio Grande do Sul (UFRGS) - Porto Alegre (RS), Brazil
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25
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Oztürk P, Orhan FÖ, Ozer A, Karakaş T, Oksüz AN, Yetişir NY. Assessment of temperament and character profile with anxiety and depression in patients with acne. Balkan Med J 2013; 30:161-6. [PMID: 25207094 DOI: 10.5152/balkanmedj.2012.101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 10/15/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Acne is the most common skin disease, affecting nearly 85% of the population as well as their lives. Acne can severely affect social and psychological functioning. Patients with acne may have anxiety, depression, decreased self-esteem, interpersonal difficulties, unemployment, social withdrawal, and even suicidal intent. AIMS The aim of this study was to evaluate the temperament and character inventory (TCI) of patients with acne and to compare the results with those of healthy controls. STUDY DESIGN Case-control study. METHODS The study population consisted of 47 patients with acne, and 40 healthy control subjects. All participants were instructed to complete a self-administered 240-item TCI and the Hospital Anxiety and Depression Scale. RESULTS In this study, the scores for the temperament properties Worry and pessimism (HA1) and Dependence (RD4) and the character properties Social acceptance (C1) and Integrated conscience (C5) were found to be higher in acne patients than in healthy controls (p<0.05). Compared to the controls, depression and anxiety scores were found to be markedly higher in the patients with acne. Acne type correlated positively with the Disorderliness (NS4) subscale of Novelty seeking (NS) and anxiety. Additionally, acne type correlated negatively with the Attachment (RD3) subscale of Reward Dependence (RD), with the Transpersonal identification (ST2) and Spiritual acceptance (ST3) subscales of Self-Trancendence (ST), and with the Compassion (C4) sub-scale of Cooperativeness (C). CONCLUSION Studies in this area may lead to the development of specific and focused interventions for TCI in patients with acne vulgaris. We suggest that the evaluation and treatment of acne should also include psychosomatic approaches in clinical practice.
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Affiliation(s)
- Perihan Oztürk
- Department of Dermatology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Fatma Özlem Orhan
- Department of Psychiatry, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Ali Ozer
- Department of Public Health, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Tuğba Karakaş
- Department of Dermatology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Ali Nuri Oksüz
- Department of Psychiatry, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Nur Yalçın Yetişir
- Department of Psychiatry, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
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26
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Ellis CN, Mancini AJ, Paller AS, Simpson EL, Eichenfield LF. Understanding and managing atopic dermatitis in adult patients. ACTA ACUST UNITED AC 2013; 31:S18-22. [PMID: 23021781 DOI: 10.1016/j.sder.2012.07.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Atopic dermatitis (AD) in adults is an important dermatologic disease. Even in patients in whom the clinical presentation is mild, the burden of disease can be considerable. Relatively little has been published on adult AD compared to the body of literature devoted to AD in children, although adults with severe AD are greatly affected by the disease. Even when AD is a mild clinical disease in adults, the psychosocial and economic burden of the disease can be profound. Patients are likely to find it useful if these nondermatologic comorbidities of AD are addressed by health care providers in clinical encounters. The treatment options for AD in adults are the same as those for children with AD, with some modifications.
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Affiliation(s)
- Charles N Ellis
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI 48109-5314, USA.
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27
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Gascón MRP, Ribeiro CM, Bueno LMDA, Benute GRG, Lucia MCSD, Rivitti EA, Festa Neto C. Prevalence of depression and anxiety disorders in hospitalized patients at the dermatology clinical ward of a university hospital. An Bras Dermatol 2012; 87:403-7. [DOI: 10.1590/s0365-05962012000300008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 06/28/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: The objective of this study was to estimate the prevalence of depression and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in São Paulo, Brazil. OBJECTIVE: To assess the prevalence of mood and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in São Paulo. METHOD: A total of 75 patients, men and women, aged between 18 and 76 years, took part in the research. The study employed a descriptive, cross sectional and correlational method. The data was collected by means of a social demographic questionnaire and the PRIME-MD. RESULTS: It was found that 45.3 percent of the subjects presented with depressive symptoms, and 52 percent presented with symptoms of anxiety and that this survey showed moderate and high significant correlations (p<0,01; r= 0,616) for depression and anxiety. CONCLUSION: These facts could evidence the relationship between physical and psyche, just as the literature presents.
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28
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Bremner JD, Shearer KD, McCaffery PJ. Retinoic acid and affective disorders: the evidence for an association. J Clin Psychiatry 2012; 73:37-50. [PMID: 21903028 PMCID: PMC3276716 DOI: 10.4088/jcp.10r05993] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 07/03/2010] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Isotretinoin (13-cis-retinoic acid), approved by the US Food and Drug Administration for the treatment of acne, carries a black box warning related to the risk of depression, suicide, and psychosis. Retinoic acid, the active form of vitamin A, regulates gene expression in the brain, and isotretinoin is its 13-cis isomer. Retinoids represent a group of compounds derived from vitamin A that perform a large variety of functions in many systems, in particular the central nervous system, and abnormal retinoid levels can have neurologic effects. Although infrequent, proper recognition and treatment of psychiatric side effects in acne patients is critical given the risk of death and disability. This article reviews the evidence for isotretinoin's relationships with depression and suicidality. DATA SOURCES The PsycINFO, MEDLINE, and PubMed searchable database indexes were searched for articles published in the English language from 1960 to June 2010 using the key words isotretinoin, retinoids, retinoic acid, depression, depressive disorders, and vitamin A. Evidence examined includes (1) case reports; (2) temporal association between onset of depression and exposure to the drug; (3) challenge-rechallenge cases; (4) class effect (other compounds in the same class, like vitamin A, having similar neuropsychiatric effects); (5) dose response; and (6) biologically plausible mechanisms. STUDY SELECTION All articles in the literature related to isotretinoin, depression, and suicide were reviewed, as well as articles related to class effect, dose response, and biologic plausibility. DATA EXTRACTION Information from individual articles in the literature was extracted, including number of episodes of depression, suicidality, suicide, psychosis, violence and aggression, past psychiatric history, time of onset in relation to isotretinoin usage, medication dosage, duration of treatment, and dechallenge and challenge history. RESULTS The literature reviewed is consistent with associations of isotretinoin administration with depression and with suicide in a subgroup of vulnerable individuals. CONCLUSIONS The relationship between isotretinoin and depression may have implications for a greater understanding of the neurobiology of affective disorders.
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Affiliation(s)
- J Douglas Bremner
- Departments of Psychiatry and Radiology, Emory University School of Medicine, Atlanta, GA, USA.
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Sunay D, Baykir M, Ateş G, Ekşioğlu M. Alexithymia and acne vulgaris: a case control study. Psychiatry Investig 2011; 8:327-33. [PMID: 22216042 PMCID: PMC3246140 DOI: 10.4306/pi.2011.8.4.327] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 05/14/2011] [Accepted: 06/02/2011] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To assess relationship between alexithymia and acne vulgaris in young people. METHODS A hundred and eleven subjects between 15 and 25 years of age referred to out-patient clinic of dermatology with acne and 78 subjects applied to family physician for complaints other than acne were included in patient and control groups of the study, respectively. A questionnaire to determine demographic characteristics, an acne classification to determine severity of acne and Toronto Alexithymic Scale (TAS) to assess alexithymia were used. RESULTS The mean scores of TAS were 52.7±10.8 and 51.7±10.7 in patient and control groups, respectively. Alexitymia was determined in 23.4% of the subjects in acne group and in 24.4% of control group. No significant differences were found between groups in terms of alexithymia, intermediate alexitymia and three-factors of TAS. CONCLUSION Alexithymia does not appear to be related to acne vulgaris.
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Affiliation(s)
- Didem Sunay
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Murat Baykir
- Ministry of Health, Ankara Training and Research Hospital, Clinic of Dermatology, Ankara, Turkey
| | - Gülfem Ateş
- Ministry of Health, Ankara Training and Research Hospital, Clinic of Dermatology, Ankara, Turkey
| | - Meral Ekşioğlu
- Ministry of Health, Ankara Training and Research Hospital, Clinic of Dermatology, Ankara, Turkey
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Havlik RJ, Brennan M, Karpiak SE. Comorbidities and depression in older adults with HIV. Sex Health 2011; 8:551-9. [DOI: 10.1071/sh11017] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Accepted: 05/24/2011] [Indexed: 12/14/2022]
Abstract
Objective
To investigate whether the high rates of depression found in older adults living with HIV are associated with the number and types of comorbidities. Methods: The Research on Older Adults with HIV (ROAH) study collected self-reported health data on ~1000 New York City HIV-positive men and women aged 50 years and older. Participants provided data on health problems experienced in the past year and depressive symptomatology (Center for Epidemiological Studies Depression Scale (CES-D)). Data were analysed using a non-parametric test of association and multiple regression analysis. Results: The correlation between CES-D scores and number of comorbidities was significant (r = 0.24). In multivariate analyses, depression remained a significant covariate of the number of comorbid conditions, in addition to female gender, inadequate income, history of drug and alcohol use, AIDS diagnosis and self-rated health. Correlations of depression with specific comorbidities varied. Significant correlations with sensory loss and dermatological problems were observed. Significant correlations existed with heart and respiratory conditions as well as fractures, but the directionality of these cross-sectional relationships is uncertain. Conclusions: The findings suggest the need for further longitudinal research to understand how high rates of depressive symptoms are related to comorbidities. Focussed clinical care that strives to prevent the collapse of the immune system must evolve into an effective treatment strategy for multimorbidities, where HIV is but one of many other chronic illnesses. If the management of depression continues to be a low priority, the older person with HIV may experience an avoidable reduction in life expectancy.
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Miranda Sivelo A, Nuñez Rodríguez MH. Venlafaxine for depression and glossovulvodynia: a case report. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2010; 12. [PMID: 21085561 DOI: 10.4088/pcc.09l00902blu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Alberto Miranda Sivelo
- Psychiatry Department and Gastroenterology Department , Complejo Asistencial de Palencia, Palencia, Spain
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Abstract
OBJECTIVES The problems of self-image among patients with dermal problems have been seldom explored. As dermal diseases detrimentally affect well-being, functioning and adaptation of dermatology patients, they may decrease the level of self-acceptance. Self-image, on the other hand, may significantly affect the own mental health status and quality of life (QoL) in that group of patients. The aim of our research was to assess mental health status and quality of life of patients with dermal problems in respect of the level of their self-acceptance. MATERIALS AND METHODS The participants were patients of the Occupational Diseases Outpatient Clinic and the Occupational and Environmental Allergy Centre of the Nofer Institute of Occupational Medicine (NIOM). In total, 112 patients were examined, including 37 with diagnosed urticaria, 50 with allergic contact dermatitis and 25 with atopic dermatitis. General Health Questionnaire (GHQ) was used to assess patients' mental health, a Polish version of Dermatology Life Quality Index (DLQI) was employed for the assessment of their life quality, while Self-Acceptance Scale (SAS) served to obtain patients' self-image. RESULTS There were statistically significant differences in the assessment of mental health and quality of life, depending on the level of self-acceptance. People with high self-acceptance are characterised by better mental health condition than those with low self-acceptance (t=4.8; p=0.00). The patients with negative self-image (compared to those with positive self-image) deem also their quality of life to be poor (t=3.1; p=0.00). CONCLUSION A relationship has been found to exist both between mental health condition and the subjective assessment of life quality, and self-image. Thus, both patient's mental health status and his/her self image constitute major determinants of the quality of life that are worth to be monitored in dermatology patients. Their treatment procedure should include also psychological consulting or psychotherapy.
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Abstract
BACKGROUND The management of psychodermatologic disease often involves the use of psychotropics by dermatologists. A general approach to the psychopharmacologic management of psychodermatological disease may be of assistance to the dermatologist. OBJECTIVE We review and provide a current psychopharmacologically based approach to management of common psychopathologies associated with psychodermatologic disorders, common side effects, and potential drug interactions that may occur with selected psychotropics. METHODS Using relevant MeSH terms, we performed a review of the literature from 1980 to 2006. RESULTS AND CONCLUSIONS Effective psychopharmacologic management of psychodermatologic disease involves identifying and basing treatment on the associated psychopathology; familiarity with a variety of psychotropic agents, including antidepressants, anxiolytics, and antipsychotics; and the involvement of a psychiatrist when possible.
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Affiliation(s)
- Rahul Shukla
- Department of Dermatology, University of Toronto, ON.
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Prado RBR, Neme CMB. Experiências afetivo-familiares de mulheres com alopecia areata. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2008. [DOI: 10.1590/s0103-166x2008000400003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Este estudo consistiu na análise da dinâmica emocional das experiências afetivas de mulheres com alopecia areata, tendo como eixo as relações de afeto mantidas com os pais e em suas relações conjugais. Foram entrevistadas cinco pacientes, atendidas no Instituto Lauro de Souza Lima, com idade entre 22 e 53 anos. O estudo baseou-se no método clínico de investigação e os dados foram obtidos mediante entrevistas semi-estruturadas. Nos depoimentos foram apontadas experiências dolorosas da relação conjugal e do adoecimento, que foram associadas a vivências traumáticas na infância. As associações realizadas pelas mulheres entre suas experiências passadas, relações conjugais, adoecimento e o impacto da doença na vida atual confirmaram os achados da literatura, e os dados encontrados puderam ser interpretados à luz das contribuições psicanalíticas. Os resultados obtidos podem contribuir para o esclarecimento de aspectos dinâmicos relacionados à alopecia areata e a outras psicodermatoses, bem como favorecer intervenções interdisciplinares e psicoterápicas mais efetivas com pacientes dermatológicos crônicos.
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Magin PJ, Pond CD, Smith WT, Watson AB, Goode SM. A cross-sectional study of psychological morbidity in patients with acne, psoriasis and atopic dermatitis in specialist dermatology and general practices. J Eur Acad Dermatol Venereol 2008; 22:1435-44. [PMID: 18624873 DOI: 10.1111/j.1468-3083.2008.02890.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is considerable evidence for an association of skin diseases with psychological morbidity. This relationship is best established for acne, psoriasis and atopic eczema. Previous studies have mostly been performed in specialist dermatological practice, and there is a lack of studies that include patients from general practice and a lack of controlled studies employing multivariate analysis. AIMS/OBJECTIVES This study aims to examine the relationship of acne, psoriasis and atopic eczema with psychological morbidities in patients recruited from general practice as well as specialist dermatology practice. METHODS AND SUBJECTS In this cross-sectional study, 108 patients from general and specialist dermatology practices with the three diseases had disease severity assessed and completed measures of minor psychological disturbance (General Health Questionnaire-12), anxiety and depression (Hospital Anxiety and Depression Scale), public self-consciousness and social anxiety (Fenigstein Self-Consciousness Scale), and neuroticism and extraversion/introversion (Eysenck Personality Inventory). Demographic data were also collected, along with self-ratings of disease severity. Control subjects were 96 patients without skin disease recruited from the same general practices as the subjects. RESULTS On univariate analyses, patients with skin disease had higher levels of minor psychological disturbance, public self-consciousness and neuroticism than did controls. There were no differences in psychological measures between specialist and general practice patients or between patients with different skin diseases. On multivariate analyses, the significant differences did not persist. CONCLUSIONS This study demonstrates confounding in the relationship of skin diseases with psychological morbidity. The complex relationship of skin disease and psychological morbidity should be re-examined.
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Affiliation(s)
- P J Magin
- Discipline of General Practice, University of Newcastle, Callaghan, NSW, Australia.
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Fried RG, Hussain SH. Nonpharmacologic management of common skin and psychocutaneous disorders. Dermatol Ther 2008; 21:60-8. [DOI: 10.1111/j.1529-8019.2008.00171.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hardy K, Pollard H. The organisation of the stress response, and its relevance to chiropractors: a commentary. CHIROPRACTIC & OSTEOPATHY 2006; 14:25. [PMID: 17044942 PMCID: PMC1629015 DOI: 10.1186/1746-1340-14-25] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Accepted: 10/18/2006] [Indexed: 12/31/2022]
Abstract
The stress response is a natural reaction by the body, against potentially harmful stimuli to enhance the chance for survival. Persistent activation of the stress response can cause changes to homeostatic mechanisms. The study of stress neurophysiology, in the evaluation of the manifestation of disease in the body, suggests that these chronic changes have detrimental effects on sub cortical structures. Furthermore, there is much scientific support for the notion that chronic activation of supraspinal systems will lead to maladaptation of homeostatic mechanisms, causing the impairment of processes within the body, and ultimately leading to visceral disorders. The chiropractic profession for many years has alluded to chronic change of neurophysiological pathways as a potential explanation of visceral disorders, but the profession has typically described these in terms of somatovisceral or viscerosomatic reflex activity. Change in supraspinal neurophysiological efferent activity is increasingly being used to explain "stress" related disease. The chiropractic profession should consider investigating such stress responses by conducting spinal manipulative therapy trials that evaluate supraspinal effects of manipulation. Such research may help elucidate key mechanisms associated with the change of visceral disorders noted by some chiropractors following manipulative therapy.
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Affiliation(s)
- Katie Hardy
- ONE Research Foundation, Encinitas California, USA
| | - Henry Pollard
- ONE Research Foundation, Encinitas California, USA
- Macquarie Injury Management Group, c/o PO Box 448, Cronulla NSW, 2230, Australia
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McMullen E, Cox NH. The British Association of Dermatologists isotretinoin questionnaire for patients: a useful clinical tool. Clin Exp Dermatol 2006; 31:713-4. [PMID: 16901319 DOI: 10.1111/j.1365-2230.2006.02183.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Acne is a ubiquitous affliction that can leave physical and emotional scars that can persist throughout the life of the affected individual. Recent studies have substantiated the psychological impact and support a causal, and at times reciprocal, link between acne and the emotional and functional status of the patient. The present article will examine the recent data substantiating the emotional and functional impact of acne on the affected individual. Criteria to identify high-risk patients are provided. High-risk patients are those at increased risk for psychological and functional impairment or self-injurious behavior.
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Affiliation(s)
- Richard G Fried
- Yardley Dermatology, Yardley Skin Enhancement and Wellness Center Yardley, Pennsylvania, USA.
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