Association between skin conditions and depressive disorders in community-dwelling older adults

Skin health of community-living older people: a scoping review

The population of older people is steadily increasing and the majority live at home. Although the home and community are the largest care settings worldwide, most of the evidence on dermatological care relates to secondary and tertiary care. The overall aims were to map the available evidence regarding the epidemiology and burden of the most frequent skin conditions and regarding effects of screening, risk assessment, diagnosis, prevention and treatment of the most frequent skin conditions in older people living in the community. A scoping review was conducted. MEDLINE, Embase and Epistemonikos were systematically searched for clinical practice guidelines, reviews and primary studies, as well as Grey Matters and EASY for grey literature published between January 2010 and March 2023. Records were screened and data of included studies extracted by two reviewers, independently. Results were summarised descriptively. In total, 97 publications were included. The vast majority described prevalence or incidence estimates. Ranges of age groups varied widely and unclear reporting was frequent. Sun-exposure and age-related skin conditions such as actinic keratoses, xerosis cutis, neoplasms and inflammatory diseases were the most frequent dermatoses identified, although melanoma and/or non-melanoma skin cancer were the skin conditions investigated most frequently. Evidence regarding the burden of skin conditions included self-reported skin symptoms and concerns, mortality, burden on the health system, and impact on quality of life. A minority of articles reported effects of screening, risk assessment, diagnosis, prevention and treatment, mainly regarding skin cancer. A high number of skin conditions and diseases affect older people living at home and in the community but evidence about the burden and effective prevention and treatment strategies is weak. Best practices of how to improve dermatological care in older people remain to be determined and there is a particular need for interventional studies to support and to improve skin health at home.

The Effects of Laughter Therapy for the Relief of Employment-Stress in Korean Student Nurses by Assessing Psychological Stress Salivary Cortisol and Subjective Happiness

Objectives

Korean student nurses may be exposed to stress caused by their future employment (employment stress). The aim of this study was to investigate the effects of a Laughter Program on psychological stress, by assessing salivary cortisol and the subjective happiness of student nurses in order to relieve employment stress.

Methods

A quasi-experimental, non-equivalent, control-group, and pre-test/post-test was conducted in 4^th year student nurses (n = 48) from 2 universities in Korea at a time when participants’ final exams and job searches were simultaneously occurring. Physiological stress (salivary cortisol), and psychological stress measured using modified Cornell Medical Index questionnaire and the Subjective Happiness Scale were used to determine the effects of the program.

Results

The results of the study showed that the Laughter Program was effective in relieving employment stress and increasing the subjective well-being of student nurses. Psychological stress (p < 0.001), salivary cortisol levels (p < 0.001), and subjective happiness (p < 0.001) were statistically significantly improved after the intervention compared with before the Laughter Program.

Conclusion

This study is an effective evidence-based intervention to reduce student nurses employment stress and improve subjective happiness.

Prevalence and predictors of depression among dermatology clinic patients in a teaching hospital, Jeddah, Saudi Arabia

Context:

Depression in patients with a skin condition can lead to severe consequences that affect the quality of life. To our knowledge, the estimated prevalence of depression in patients who visited dermatological clinics in Jeddah remains unknown.

Aims:

To assess the prevalence of depression among patients with dermatological conditions and evaluate the association between clinical and demographic characteristics and depressive symptoms.

Settings and Design:

A cross-sectional study was conducted among dermatological patients at King Abdulaziz University Hospital in Jeddah, Saudi Arabia.

Materials and Methods:

The Patient Health Questionnaire-9 (PHQ-9) was used for screening depression.

Statistical Analysis Used:

Chi-square test and odds ratios (ORs) were used to determine the association among variables.

Results:

The study included 273 participants. More than two-thirds (194) of the participants were women (71.1%). Depressive symptoms were prevalent in 43 (15.8%) participants. Depression was the most prevalent among patients with psoriasis (39.5%, P < 0.001), followed by those with acne (30.2% P = 0.04).

Conclusion:

Psychosocial assessment should be addressed when evaluating and treating dermatological diseases. Screening tools, including PHQ-9, can facilitate the early detection of depressive symptoms and improve clinical outcomes. Addressing psychosocial aspects of skin conditions may help in reducing exacerbation of symptoms, mainly for conditions aggravated by stress, including dermatitis and psoriasis.