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Ishak N, Mukhtar F, Munawar K, Coudhry FR, Roy M, Jalal FA, Choi CS. Psychological assessment of atopic dermatitis in Asia: a systematic review. PSYCHOL HEALTH MED 2023; 28:1-26. [PMID: 35000520 DOI: 10.1080/13548506.2021.1971727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Atopic dermatitis (AD) is a frequently occurring skin disorder in Asia that substantially impacts the social, financial, and psychological lives of individuals. However, there is uncertainty regarding the psychological instruments for this domain. Hence, this review systematically assessed the existing measurement instruments used, developed, and/or validated for the measurement of psychological outcomes in Asian adult patients with AD as well as the scope of those assessment tools (e.g. validity and reliability). Electronic searches were performed using six databases (inception to February 2020) to identify studies. Thematic analysis of 44 included studies revealed that the commonly employed tools to assess the quality of life were the Dermatology Life Quality Index followed by the Skindex-16 questionnaire, the European Quality of Life-5 Dimensions, and the Quality of Life Hand Eczema Questionnaire. Similarly, the Patient Health Questionnaire, Self-rating depression scale (SDS), and Hospital Anxiety and Depression Scale were frequently employed to assess depressive symptoms. Additionally, symptoms of anxiety were frequently assessed through Interaction Anxiousness Scale and the Spielberger State-Trait Anxiety Inventory. Although a variety of psychological assessment measures have been used in research, data on their reliability and validity is limited. Also, information on the cultural applicability of these instruments is scantier. More research is needed to ascertain the suitability of tools for use in clinical practice.
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Affiliation(s)
- Nurhafidah Ishak
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Firdaus Mukhtar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Khadeeja Munawar
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, Ucsi University Malaysia, Cheras, Kuala Lumpur, Malaysia.,Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Fahad Riaz Coudhry
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur Malaysia
| | - Mollika Roy
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Farah Atiqah Jalal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Chong Seng Choi
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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An Open Trial on the Feasibility and Efficacy of a Mindfulness-Based Intervention with Psychoeducational Elements on Atopic Eczema and Chronic Itch. PSYCH 2022. [DOI: 10.3390/psych4020014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Mindfulness-based interventions (MBI) are psychological group interventions conducted over several weeks. Their effects on reducing stress and improving physical and psychological health have been proven in various clinical populations. Growing evidence suggests that MBIs might be beneficial for dermatology patients. This article reports on a novel Mindfulness-based Training for chronic Skin Conditions (MBTSC) with psychoeducational elements that was developed with the goal of improving self-regulation including stress management and emotion regulation in patients and to help in coping with disease symptoms such as itch and scratching. The intervention was tested in a pilot efficacy trial in order to examine feasibility and to collect preliminary data on the effectiveness of the intervention on disease severity including itch perception and on psychological distress in an atopic dermatitis (AD) sample. (2) Methods: Following an uncontrolled pre-test-post-test design based on standardized self-report measures, nine adult AD patients were recruited from a dermatology clinic. Data were collected at baseline, post-treatment and 3 month follow-up. Patients completed questionnaires assessing disease severity, itch perception, stress, anxiety and depression, mindfulness and intervention acceptability. The 7 week intervention included seven weekly sessions and a daily home-practice requirement, supported by guided audio-meditations and reading material. (3) Results: Quantitative data showed improvements in disease severity, itch perception and stress levels with small to medium effect sizes. Psychological distress increased at post-treatment—significantly in the case of depression. Qualitative data highlighted the mixed effects of MBTSC on symptoms. Treatment acceptability was high and 100% of the participants completed the intervention; (4) Conclusions: These data indicate that MBTSC is feasible and that it might be a useful tool as adjunct therapy for AD. Further studies with larger samples and control groups are needed.
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Angioedema Coexisting Chronic Spontaneous Urticaria Negatively Influences Patients' Sense of Coherence, What Results in Susceptibility to Anxiety Symptoms Occurrence. J Clin Med 2021; 10:jcm10132852. [PMID: 34203132 PMCID: PMC8268328 DOI: 10.3390/jcm10132852] [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] [Received: 05/21/2021] [Revised: 06/20/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Angioedema coexisting chronic spontaneous urticaria (CSU) is proved to result in patient anxiety occurrence, but the mechanisms and susceptibility patterns are unknown. Sense of coherence (SOC) is one of methods of coping with stress and is defined as a person’s general orientation toward life. We decided to assess SOC disturbances in CSU patients in the context of possible angioedema association. Methods: The study comprised 71 CSU subjects. To analyze disease activity, the Urticaria Activity Score seven-day assessment questionnaire (UAS7) was used. For anxiety assessment, the STAI questionnaire was used. The SOC-29 questionnaire, consisting of questions related to comprehensibility (SOC-C), manageability (SOC-M), and meaningfulness (SOC-Mf), was used to analyze SOC parameters (SOC-T). Results: In patients with coexisting angioedema, we observed statistically significantly lower values of SOC-Mf and SOC-T in comparison to the wheals only group. In the angioedema group, we noticed significant negative correlations between SOC-M and SOC-Mf, as well as SOC-T values and anxiety. In the wheals only group, we proved statistically significant correlations between SOC-Mf and SOC-T and anxiety assessed as a state. Conclusions: It is necessary to identify CSU patients manifesting angioedema as they are more likely to have impaired SOC. Lower SOC in this specific group of patients can be related to anxiety symptoms occurrence and should probably be an indication for psychological support.
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Mento C, Rizzo A, Muscatello MRA, Zoccali RA, Bruno A. Negative Emotions in Skin Disorders: A Systematic Review. Int J Psychol Res (Medellin) 2020; 13:71-86. [PMID: 32952965 PMCID: PMC7498125 DOI: 10.21500/20112084.4078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The main purpose of this study is to describe how negative emotions were investigated in the sphere of dermatological diseases, in order (1) to summarize literature trends about skin disorders and emotions, (2) to highlight any imbalances between the most studied and neglected emotions, (3) and to offer directions for future research. A computerized literature search provided 41 relevant and potentially eligible studies. Results showed that the study of emotions in skin disease is limited to Sadness/depression and Fear/anxiety. The emotions of Anger and Disgust have been poorly explored in empirical studies, despite they could be theoretically considered a vulnerability factor for the development of skin disorders and the dermatological extreme consequences, as negative emotionality toward self and the pathological skin condition. The bibliometric qualitative analysis with VOSViewer software revealed that the majority of the studies have been focused on the relationships between vitiligo and Sadness/depression, dermatitis and Fear/anxiety, psoriasis, and Anger, suggesting the need of future research exploring Disgust and, in general, a wider emotional spectrum.
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Affiliation(s)
- Carmela Mento
- Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
| | - Amelia Rizzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
| | - Rocco Antonio Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
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Duran S, Atar E. Determination of depression, anxiety and stress (DAS) levels in patients with atopic dermatitis: a case-control study. PSYCHOL HEALTH MED 2020; 25:1153-1163. [PMID: 31889448 DOI: 10.1080/13548506.2019.1710545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study was aimed at comparing depression, anxiety and stress (DAS) levels of individuals with atopic dermatitis with those of the individuals without atopic dermatitis, and to examine the DAS levels of the patients with atopic dermatitis in terms of their socio-demographic characteristics. Case control study conducted in a city in western Turkey. The present study in which the relational screening model was used was conducted with patients with atopic dermatitis who presented to the Dermatology Clinic/Polyclinic of a university hospital and healthy subjects, and volunteered to participate in the study. The study conducted between December 2017 and February 2018 included 150 people (75 healthy subjects, 75 patients with atopic dermatitis). To collect the study data, the participants were administered the Socio-demographic Characteristics Questionnaire prepared by the researcher and the Depression, Stress and Anxiety Scale (DASS-42). No significant difference was determined between the mean DASS scores obtained by the atopic dermatitis patients and those obtained by the healthy subjects in the control group (p > 0.05). Of the atopic dermatitis patients, 58.7%, 82.3% and 49.3% were within the normal ranges in terms of the mean scores they obtained from the stress, depression and anxiety subscales respectively. In the present study, the mean scores obtained from the depression and anxiety subscales by working atopic dermatitis patients were higher than those obtained by the nonworking patients (p < 0.05). The mean scores obtained from the stress subscale by the smokers with atopic dermatitis were higher than those obtained by the non-smokers with atopic dermatitis.
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Affiliation(s)
- Songül Duran
- Elderly Care Program, İzmir Demokrasi University, Health Services Vocational College , İzmir, Turkey
| | - Emine Atar
- Nursing Department, Trakya Üniversitesi Keşan Hakkı Yörük Sağlık Yüksekokulu , Edirne, Turkey
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Rønnstad ATM, Halling-Overgaard AS, Hamann CR, Skov L, Egeberg A, Thyssen JP. Association of atopic dermatitis with depression, anxiety, and suicidal ideation in children and adults: A systematic review and meta-analysis. J Am Acad Dermatol 2019; 79:448-456.e30. [PMID: 30119868 DOI: 10.1016/j.jaad.2018.03.017] [Citation(s) in RCA: 177] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/06/2018] [Accepted: 03/09/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) has been associated with anxiety and depression, but the magnitude of the alleged association is unknown. OBJECTIVE To perform a systematic review and meta-analysis of the association between AD in children and adults and, respectively, depression, anxiety, and suicidal behavior. METHODS The medical databases PubMed, Embase, and PsychINFO were searched. RESULTS There was a significant association between adult AD and, respectively, depression (pooled odds ratio [OR], 2.19; 95% confidence interval [CI], 1.87-2.57) and anxiety (pooled OR, 2.19; 95% CI, 1.75-2.73). AD was also associated with depression in children (pooled OR, 1.27; 95% CI, 1.12-1.45); few data were available for anxiety. A positive association was found between AD in adults and adolescents and suicidal ideation (pooled OR, 4.32; 95% CI, 1.93-9.66). Only a few studies examined the risk of completed suicide, but the majority showed a positive association between completed suicide and AD. LIMITATIONS Included studies used different definitions of depression and anxiety, and few studies examined the severity of AD. CONCLUSION Depression, anxiety, and suicidal ideation should be considered by doctors when treating patients with AD. Because AD disease improvement appears to reduce these risks, this should be a priority.
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Affiliation(s)
- Amalie Thorsti Møller Rønnstad
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Anne-Sofie Halling-Overgaard
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Carsten R Hamann
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark; National Allergy Research Centre, Herlev and Gentofte Hospital, Hellerup, Denmark.
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Abstract
Atopic dermatitis (AD) is driven by a complex gene-environment interaction. Many of the risk factors and genetic underpinning previously observed for pediatric AD may not apply to adult atopic dermatitis, suggesting that these may largely be different disorders. Whereas AD is classically thought of as a pediatric disease, recent studies have shown high rates of disease in adults as well. Risk factors for persistence of childhood-onset AD, as well as adult-onset AD, are reviewed. Adults with AD are particularly vulnerable to exogenous insults from the outside environment, including climate, ultraviolet exposure, pollution, irritants and pruritogens, and microbes. Finally, adult AD is associated with a substantial health care burden, with increased utilization, direct and indirect costs of care, and lost work productivity.
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Affiliation(s)
- Ryan Sacotte
- Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA
| | - Jonathan I Silverberg
- Department of Dermatology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA; Northwestern Medicine Multidisciplinary AD Center, Chicago, Illinois, USA.
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Antipruritic Effect of Acupuncture in Patients with Atopic Dermatitis: Feasibility Study Protocol for a Randomised, Sham-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2017:1926806. [PMID: 29358961 PMCID: PMC5735323 DOI: 10.1155/2017/1926806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 09/27/2017] [Indexed: 12/03/2022]
Abstract
This study aims to test the feasibility of a randomised clinical trial to evaluate how acupuncture affects atopic dermatitis (AD) symptoms and quality of life and to explore potential biomarkers that may be associated with AD. It is a sham-controlled trial in which 30 eligible patients will be randomly allocated in a 1 : 1 : 1 ratio to one of three groups: verum acupuncture (VA) group 1 (3 times weekly for 4 weeks); VA group 2 (twice weekly for 4 weeks); or sham acupuncture group (SA; twice weekly for 4 weeks). SA will consist of nonpenetrating acupuncture. Outcome measures will include the Visual Analogue Scale for itch, SCORing Atopic Dermatitis, and Eczema Area and Severity Index to evaluate AD symptoms improvement along with the Patient Oriented Eczema Measure and Dermatology Life Quality Index to assess quality of life. Measures will be collected at baseline, once weekly during the treatment period, and after a 4-week follow-up period. Blood collection will be at baseline and 4 and 8 weeks after treatment and compared with healthy controls. Illumina sequencing will be used to profile microRNA expression in each group to explore candidate microRNA biomarkers for specific effects of acupuncture in patients with AD. This trial is registered via US National Institutes of Health Clinical Trials registry (ClinicalTrials.gov) on 15 July 2016, identifier: NCT02844452.
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Magin P. Aggression and its associations in patients with skin disease. Br J Dermatol 2017; 176:1118-1119. [DOI: 10.1111/bjd.15485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P. Magin
- School of Medicine and Public Health; University of Newcastle; Newbolds Building, University of Newcastle University Drive Callaghan NSW 2308 Australia
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Association of Perceived Stress with Atopic Dermatitis in Adults: A Population-Based Study in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080760. [PMID: 27472355 PMCID: PMC4997446 DOI: 10.3390/ijerph13080760] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/22/2016] [Accepted: 07/25/2016] [Indexed: 01/24/2023]
Abstract
Atopic dermatitis (AD) is a widely prevalent skin disease that affects both children and adults. The aim of the study was to assess the association of perceived stress (single-item, self-reported) with AD (self-reported) in a sample of Korean adults using a cross-sectional research design. A cross-sectional study was conducted using data from 33,018 adults aged 20 years and older collected in the 2007-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). An increased level of self-reported stress was positively associated with an increased prevalence of AD in Korean adults (p for trend <0.001). After adjusting for covariates, the odds ratios (ORs) of AD among participants reporting high and very high levels of stress were 1.81 (95% confidence interval (CI): 1.22, 2.67) and 2.17 (95% CI: 1.38, 3.42), respectively, compared with those who reported low levels of stress. This study found a statistically significant association between perceived stress and AD among Korean adults.
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Kim SH, Hur J, Jang JY, Park HS, Hong CH, Son SJ, Chang KJ. Psychological Distress in Young Adult Males with Atopic Dermatitis: A Cross-Sectional Study. Medicine (Baltimore) 2015; 94:e949. [PMID: 26061325 PMCID: PMC4616482 DOI: 10.1097/md.0000000000000949] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The relationship between atopic dermatitis (AD) and psychological distress has been well established for children and adolescents. However, it is unclear whether this relationship exists in young adults. This study aimed to assess the relationship between AD and psychological distress in young male adults in South Korea. A cross-sectional study was conducted using regional conscription data from 2008 to 2012. A dermatologist diagnosed AD based on historical and clinical features, and determined severity using the eczema area and severity index. A psychiatrist used medical records, an interview, and a psychological test to examine psychological distress (depression, anxiety, and somatization). The relationship between psychological distress and AD was assessed by multivariate logistic regression analyses. Among the 120,508 conscripts, 1517 (1.2%) presented with AD. The odds of having each type of psychological distress were significantly greater for individuals with AD compared with those without AD. The adjusted odds ratios for depression, anxiety, and somatization were 1.79 (95% CI 1.40-2.29), 1.38 (95% CI 1.08-1.76), and 1.75 (95% CI 1.40-2.20), respectively. Moderate-to-severe AD was significantly related to depression and somatization to a greater extent compared with mild AD. Depression, anxiety, and somatization are strongly and independently associated with AD in young adult males. Early treatment of skin inflammation might modify the risk of psychiatric problems. Prospective cohort studies are needed to verify causal relationships.
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Affiliation(s)
- Si-Heon Kim
- From the Department of Preventive Medicine and Public Health (SHK, JYJ); Department of Allergy and Clinical Immunology (HSP); Department of Psychiatry (CHH, SJS, KJC), Ajou University School of Medicine, Suwon; and Cheonan Soo Skin Clinic (JH), Cheonan, South Korea
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Valtonen M, Raiskila T, Veijola J, Läksy K, Kauhanen ML, Kiuttu J, Joukamaa M, Hintsa T, Tuulio-Henriksson A. Enhancing sense of coherence via early intervention among depressed occupational health care clients. Nord J Psychiatry 2015; 69:515-22. [PMID: 25739527 DOI: 10.3109/08039488.2015.1011230] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Research on interventions improving psychological adjustment has suggested that sense of coherence (SOC) could be improved. AIMS In the present study, we measured the impact of an intervention on the SOC among adults with first-episode depression. We also examined whether rehabilitation, depression, occupational stressors, life situation stressors and socio-demographic characteristics are associated with a change in the SOC. METHODS Occupational health care clients were screened for depression using the Beck Depression Inventory (BDI) and a structured clinical interview (the The Structured Clinical Interview for DSM-IV: SCID-I). The participating subjects were randomized into a rehabilitation group (n = 134) and control group (n = 100) receiving treatment as usual. The Sense of Coherence Scale (SOC-13) was used at the baseline and in a 1-year follow-up to compare the change of the SOC between the groups. RESULTS The increase in the mean SOC score was statistically significant both in the rehabilitation group (54.91 compared with 62.85, P < 0.001) and in the control group (55.29 compared with 61.64, P < 0.001). There was no significant difference in the mean SOC scores between the groups at the follow-up. The improved SOC was associated with less severe depression (P = 0.003) and greater decreasing in BDI (P = 0.041) in the rehabilitation group. CONCLUSIONS The results suggest that both rehabilitation and conventional depression treatment in a first episode of depression may enhance the SOC and that rehabilitation itself enhances the SOC more effectively among those with less severe depression or those whose BDI scores had further decreased at the 1-year follow-up.
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Affiliation(s)
- Mia Valtonen
- a Mia Valtonen, Ph.M., Department of Behavioural Sciences , University of Helsinki , Helsinki ; Occupational Healthcare, Terveystalo, Oulu; and Oulu Deaconess Institute , Oulu , Finland
| | - Tero Raiskila
- b Tero Raiskila, M.D., School of Health Sciences, University of Tampere , Tampere ; Department of Psychiatry , University Hospital of Oulu , Oulu ; and Department of Psychiatry , Institute of Clinical Medicine, University of Oulu , Oulu , Finland
| | - Juha Veijola
- c Juha Veijola, M.D., Ph.D., Department of Psychiatry , University Hospital of Oulu , Oulu , and Department of Psychiatry , Institute of Clinical Medicine, University of Oulu , Oulu , Finland
| | - Kristian Läksy
- d Kristian Läksy, M.D., Ph.D., The Social Insurance Institution of Finland , Helsinki , Finland
| | | | - Jorma Kiuttu
- f Jorma Kiuttu, M.D., Ph.D., The Social Insurance Institution of Finland , Helsinki , Finland
| | - Matti Joukamaa
- g Matti Joukamaa, M.D., Ph.D., School of Health Sciences, University of Tampere , Tampere , and Department of Psychiatry , Tampere University Hospital , Tampere , Finland
| | - Taina Hintsa
- h Taina Hintsa, Ph.D., Department of Behavioural Sciences , University of Helsinki , Helsinki , Finland
| | - Annamari Tuulio-Henriksson
- i Annamari Tuulio-Henriksson, Ph.D., Department of Behavioural Sciences , University of Helsinki , Helsinki , and The Social Insurance Institution of Finland , Helsinki , Finland
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Li W, Leonhart R, Schaefert R, Zhao X, Zhang L, Wei J, Yang J, Wirsching M, Larisch A, Fritzsche K. Sense of coherence contributes to physical and mental health in general hospital patients in China. PSYCHOL HEALTH MED 2014; 20:614-22. [DOI: 10.1080/13548506.2014.952644] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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