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Teixeira A, Teixeira M, Gaio R, Torres T, Magina S, Dinis MAP, Sousa-Lobo J, Almeida I, Peixoto M, Almeida V. Influence of Clinical and Psychosocial Factors on the Adherence to Topical Treatment in Psoriasis. Healthcare (Basel) 2024; 12:822. [PMID: 38667584 PMCID: PMC11050139 DOI: 10.3390/healthcare12080822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/27/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: Psoriasis is a common chronic inflammatory skin disease with different manifestations, affecting the quality of life at social, emotional, and professional dimensions and requiring long-term treatment. This study aimed to investigate the effect of psychosocial and clinical factors on adherence to topical treatment in psoriasis. (2) Methods: Self-reported measures and weighing the medicines were used to assess adherence. Psychopathological symptoms were measured using the Brief Symptoms Inventory (BSI). Social and clinical factors were assessed by a sociodemographic and clinical questionnaire. Adherence to treatment with topical medication was assessed using a sample of 102 psoriasis patients. (3) Results: The explanatory models of adherence to topical treatment in psoriasis translated into positive associations between adherence and the education level (higher education) (p = 0.03; φ = 0.23), the single-family household (p = 0.01; φ = 0.44), active employment status (p = 0.05; φ = -0.19), familiar history of psoriasis (p = 0.04; φ = -0.21), and the presence of obsessive-compulsive symptoms (p = 0.01; d = 0.29). (4) Conclusions: In patients who present the characteristics identified that influence non-adherence, instructions should be reinforced to increase adherence. The experimental mortality (39.6%) reduced the sample size, representing a limitation of the study.
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Affiliation(s)
- Ana Teixeira
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences—CESPU, 4585-116 Gandra, Portugal;
- UCIBIO—Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Maribel Teixeira
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences—CESPU, 4585-116 Gandra, Portugal;
- UCIBIO—Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Rita Gaio
- Centro de Matemática da Universidade do Porto, Departamento de Matemática, Faculdade de Ciências, Universidade do Porto, 4169-007 Porto, Portugal;
| | - Tiago Torres
- Serviço de Dermatologia, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, Portugal;
| | - Sofia Magina
- Serviço de Dermatologia, Centro Hospitalar de São João, Departamento de Farmacologia e Terapêutica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal;
| | - Maria Alzira Pimenta Dinis
- Fernando Pessoa Research, Innovation and Development Institute (FP-I3ID), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal;
| | - José Sousa-Lobo
- UCIBIO—Applied Molecular Biosciences Unit, MedTech, Applied Biomolecular Biosciences Unit, Medicines and Healthcare Products, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal; (J.S.-L.); (V.A.)
| | - Isabel Almeida
- UCIBIO—Applied Molecular Biosciences Unit, MedTech, Applied Biomolecular Biosciences Unit, Medicines and Healthcare Products, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal; (J.S.-L.); (V.A.)
| | - Miguel Peixoto
- Instituto Universitário de Ciências da Saúde (IUCS), CESPU—Cooperativa de Ensino Superior Politécnico e Universitário, 4585-116 Gandra, Portugal;
- Psychosocial Rehabilitation Laboratory, Rehabilitation Investigation Center, School of Health, Polytechnic University of Porto, 4200-465 Porto, Portugal
| | - Vera Almeida
- UCIBIO—Applied Molecular Biosciences Unit, MedTech, Applied Biomolecular Biosciences Unit, Medicines and Healthcare Products, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal; (J.S.-L.); (V.A.)
- UNIPRO—Unidade de Investigação em Patologia e Reabilitação Oral, Instituto Universitário de Ciências da Saúde (IUCS), CESPU—Cooperativa de Ensino Superior Politécnico e Universitário, 4585-116 Gandra, Portugal
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Yi X, Wang X, Fu Y, Luo Y, Wang J, Han Z, Kuang Y, Chen X, Chen BT. Altered brain activity and cognitive impairment in patients with psoriasis. J Eur Acad Dermatol Venereol 2024; 38:557-567. [PMID: 38059666 DOI: 10.1111/jdv.19685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/25/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Patients with psoriasis may have cognitive impairment. However, there is limited information regarding intrinsic brain activity and cognitive function in patients with psoriasis. OBJECTIVES This study aim to assess alterations of intrinsic brain activity and its association with cognitive function in patients with psoriasis. METHODS A total of 222 patients with psoriasis aged 18-70 years and 144 age and gender-matched healthy controls (HCs) were enrolled into this study. All subjects underwent brain resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological testing. The rs-fMRI data were analysed for both intrinsic brain activity as indicated by amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC). Correlative analysis of brain activity with cognitive assessment was performed. RESULTS Compared with the HCs, patients with psoriasis had worse cognitive performance in the Trail Making Test, Digit Span Test and Stroop Color-Word Test (p < 0.05). Patients with psoriasis showed decreased ALFF in the left superior frontal gyrus, the left medial superior frontal gyrus and the right precuneus gyrus; as well as enhanced ALFF in the left paracentral lobule (pFWE < 0.05). Significant correlations were noted between the altered ALFF in the four brain regions and cognitive assessment (p < 0.05). Moreover, patients with psoriasis had increased FC between the four brain regions with altered ALFF (seeds) and the left prefrontal gyrus, the left anterior cingulate gyrus, left superior parietal lobule and default mode network (DMN) regions such as the right precuneus gyrus, left inferior parietal lobule, right angular gyrus and bilateral inferior temporal gyrus (pFWE < 0.05). CONCLUSIONS Patients with psoriasis had altered brain activity and connectivity in the key brain areas within the DMN-prefrontal circuit. These brain changes may be the underlying neural correlates for cognitive functioning in patients with psoriasis.
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Affiliation(s)
- Xiaoping Yi
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xueying Wang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, Hunan, China
| | - Yan Fu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, Hunan, China
| | - Yan Luo
- Department of Dermatology, People's Hospital of Jiangxi Province, Nanchang, Jiangxi, China
| | - Jing Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zaide Han
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yehong Kuang
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiang Chen
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, California, USA
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Jalenques I, Bourlot F, Martinez E, Pereira B, D'Incan M, Lauron S, Rondepierre F. Prevalence and Odds of Anxiety Disorders and Anxiety Symptoms in Children and Adults with Psoriasis: Systematic Review and Meta-analysi. Acta Derm Venereol 2022; 102:adv00769. [DOI: 10.2340/actadv.v102.1386] [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
The magnitude of the association between psoriasis and depression has been evaluated, but not that between psoriasis and anxiety. The aim of this systematic review and meta-analysis was to examine the prevalence and odds of anxiety disorders and symptoms in patients with psoriasis. Five medical databases (Cochrane Database, EMBASE, PubMed, PsychINFO, ScienceDirect) were searched for relevant literature. A total of 101 eligible articles were identified. Meta-analysis revealed different prevalence rates depending on the type of anxiety disorder: 15% [95% confidence interval [CI] 9–21] for social anxiety disorder, 11% [9–14] for generalized anxiety disorder, and 9% [95% CI 8–10] for unspecified anxiety disorder. There were insufficient studies assessing other anxiety disorders to be able to draw any conclusions on their true prevalence. Meta-analysis also showed a high prevalence of anxiety symptoms (34% [95% CI 32–37]). Case-control studies showed a positive association between psoriasis and unspecified anxiety disorder (odds ratio 1.48 [1.18; 1.85]) and between psoriasis and anxiety symptoms (odds ratio 2.51 [2.02; 3.12]). All meta-analyses revealed an important heterogeneity, which could be explained in each case by methodological factors. The results of this study raise the necessity of screening for the presence of anxiety disorders, as previously recommended for depressive disorders, in patients with psoriasis and, if necessary, to refer such patients for evaluation by a mental health professional and appropriate treatment.
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Bu J, Ding R, Zhou L, Chen X, Shen E. Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review. Front Immunol 2022; 13:880201. [PMID: 35757712 PMCID: PMC9226890 DOI: 10.3389/fimmu.2022.880201] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
Psoriasis is a chronic autoimmune inflammatory disease that remains active for a long period, even for life in most patients. The impact of psoriasis on health is not only limited to the skin, but also influences multiple systems of the body, even mental health. With the increasing of literature on the association between psoriasis and extracutaneous systems, a better understanding of psoriasis as an autoimmune disease with systemic inflammation is created. Except for cardiometabolic diseases, gastrointestinal diseases, chronic kidney diseases, malignancy, and infections that have received much attention, the association between psoriasis and more systemic diseases, including the skin system, reproductive system, and oral and ocular systems has also been revealed, and mental health diseases draw more attention not just because of the negative mental and mood influence caused by skin lesions, but a common immune-inflammatory mechanism identified of the two systemic diseases. This review summarizes the epidemiological evidence supporting the association between psoriasis and important and/or newly reported systemic diseases in the past 5 years, and may help to comprehensively recognize the comorbidity burden related to psoriasis, further to improve the management of people with psoriasis.
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Affiliation(s)
- Jin Bu
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ruilian Ding
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Liangjia Zhou
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Xiangming Chen
- Sino-French Hoffmann Institute, School of Basic Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Erxia Shen
- Sino-French Hoffmann Institute, School of Basic Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
- The State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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Zhu W, Wei Y, Meng X, Li J. The mediation effects of coping style on the relationship between social support and anxiety in Chinese medical staff during COVID-19. BMC Health Serv Res 2020; 20:1007. [PMID: 33148229 PMCID: PMC7609823 DOI: 10.1186/s12913-020-05871-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The COVID-19 has been a pandemic around the world, which affirmatively brought mental health problems to medical staff. We aimed to investigate the prevalence of anxiety in Chinese medical staff and examine the mediation effects of coping styles on the relationship between social support and anxiety. METHODS A cross-sectional study via internet survey was conducted from 15 March to 30 March, 2020. The social demographic data, Self-rated Anxiety Scale, Social Support Rate Scale and Trait Coping Style Scale were collected. Pearson correlation and a structural equation model were performed to examine the relationships of these variables. The bootstrap analysis was conducted to evaluate the mediation effects. RESULTS A total of 453 medical staff participated in this study. The mean score of SAS was 46.1 (SD = 10.4). Up to 40.8% of the participants had anxiety symptoms. The participants lived with family members had lower SAS score (45.1 ± 9.8 vs 49.6 ± 11.8). Social support was negatively associated with anxiety, mediated by positive coping and negative coping partially significantly with an effect size of - 0.183. CONCLUSIONS Chinese medical staff had a high level of anxiety during the COVID-19 pandemic. Coping styles had effects on the association between social support and anxiety. Sufficient social support and training on positive coping skills may reduce anxiety in medical staff.
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Affiliation(s)
- Wei Zhu
- West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Yi Wei
- West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Xiandong Meng
- West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China.
| | - Jiping Li
- West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
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Almeida V, Constante D, Leite A, Almeida IF, Rocha JC, Sá R, Teixeira M, Teixeira A. Influence of disease phase on embitterment and emotional dysregulation in psoriatic patients. PSYCHOL HEALTH MED 2020; 26:242-259. [PMID: 32216602 DOI: 10.1080/13548506.2020.1741655] [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: 12/28/2022]
Abstract
This study aimed to evaluate the psychosocial differences between patients with psoriasis in different phases of the disease. Seventy-one patients in exacerbation and 83 in remission were evaluated regarding sociodemographic, clinical and psychological variables, on the premise that the visibility of lesions (exacerbation phase) may impact the emotional regulation and embitterment. A regression analysis was performed to identify the variables that contribute to explain embitterment: a diagnosis of anxiety and/or depression and psoriasis severity are the identified ones. The results point to higher values of emotional dysregulation and embitterment, as well as more critical clinical variables in patients with active disease, namely, alcohol and coffee consumption, smoking and less satisfaction with current treatment, more diagnoses and more family history of anxiety and depression, more psychology/psychiatry consultations and more use of anxiolytics and antidepressants. However, only the results referring to alcohol consumption and embitterment are significantly higher in subjects in the exacerbation phase of the disease. Particular clinical attention should be provided to patients in exacerbation phase regarding psychotherapeutic approach.
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Affiliation(s)
- V Almeida
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, CESPU , Gandra, Portugal.,UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto , Porto, Portugal
| | - D Constante
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, CESPU , Gandra, Portugal
| | - A Leite
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, CESPU , Gandra, Portugal
| | - I F Almeida
- UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto , Porto, Portugal
| | - J C Rocha
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, CESPU , Gandra, Portugal
| | - R Sá
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, CESPU , Gandra, Portugal
| | - M Teixeira
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, CESPU , Gandra, Portugal
| | - A Teixeira
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, CESPU , Gandra, Portugal.,UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto , Porto, Portugal
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