ObjectiveTo evaluate the clinical reliability and validity of the Chinese version of the Patient Health Questionnaire-9 (C-PHQ-9) in patients with psoriasis.DesignCross-sectional study.SettingTertiary care centre.ParticipantsPatients with psoriasis who have not been diagnosed with depression (n=148; mean age 43.37±17.46 years; 31.19% female).Primary and secondary outcome measuresThe primary outcome measures considered in this study were the C-PHQ-9 and the Hamilton Depression Scale (HAMD). The American Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V) was used as the gold standard for the diagnosis of depression. Cronbach’s α and test–retest reliability after 1 week were evaluated using reliability analysis, and criterion and structural validity were assessed using validity analysis. Receiver operating characteristic (ROC) analysis was performed to identify the best demarcation score and diagnostic accuracy.ResultsCompared with DSM-V (27.27%), both C-PHQ-9 (39.19%) and HAMD (31.01%) had higher rates for detecting depression. The mean completion time for C-PHQ-9 evaluation (2.02±0.84 min) was significantly less than that for HAMD (23.37±3.21 min, p<0.001). The Cronbach’s α coefficient for the C-PHQ-9 was 0.938. The correlation coefficients of the nine items with the total scale ranged from 0.540 to 0.854, and the mean inter-item correlation coefficients ranged from 0.376 to 0.933. After a week, the retest coefficient was 0.955 (p<0.01). Principal component factor analysis showed that C-PHQ-9 identified a unifactorial structure. The best cut-off point was 9 points, with a sensitivity of 98.00% and a specificity of 90.80%. The area under the ROC curve was 0.979 (95% CI 0.968 to 0.991).ConclusionC-PHQ-9 has good reliability and validity in patients with psoriasis and can be used for primary screening of patients with psoriasis and depression. This scale has obvious time and labour advantages over the HAMD and should be considered for use in clinical practice.
tional Chinese medicine-paiteling, which is composed of a crude alcoholic extract of honeysuckle, Folium isatidis, kuh-seng and Brucea javanica among others. Paiteling can quickly cross the epidermal cell space to reach the basal layer of the epidermis without damaging the dermis and the subcutaneous tissue, 5 and promotes the exfoliation of the epidermal cells in GCA. 6 The method of drug administration is also important. Doctors must master the drug penetration concentration, administration times and intervals, among others, in order to optimize the effect of the drug.
Objective Our study sought to investigate the clinical influencing factors of psoriasis patients with depression, and analyze whether the content of monoamine neurotransmitters in plasma was correlated with depression incidence among psoriasis patients. Methods Ninety patients with psoriasis and 40 healthy volunteers (aged from18 to 60) were recruited and interviewed with a piloted questionnaire in both groups to obtain relevant information. The catecholamine in plasma from the two groups was analyzed by radioimmunoassay. The data were analyzed by SPSS statistical software. Results The mean Hamilton Depression Scale (HAMD) and mean Athens Insomnia Scale (AIS) scores of the psoriasis patients were higher than the control group. Dopamine content in the plasma was lower (comparing psoriasis patients without depression and the control group, and was negatively correlated with HAMD, AIS, and Psoriasis Area and Severity Index (PASI) scores in the psoriasis patients with depression. There was no significant difference in the epinephrine and norepinephrine contents in all groups. PASI scores were positively correlated with HAMD scores in psoriasis patients. The low dopamine content, Dermatology Life Quality Index, and high PASI scores were the risk factors for depression among the psoriasis patients. Conclusion Psoriasis patients have a significantly higher risk of depression than healthy people, and higher PASI scores were linked to a higher incidence of depression. The dopamine levels of patients were influenced by both psoriasis and depression. The risk factors for depression in psoriasis patients are low dopamine levels in the plasma, severe skin lesions, and lower quality of life.
Backgroud: This study sought to investigate the clinical influencing factors of patients with psoriasis vulgaris complicated with depression, and to analyze whether the content of monoamine neurotransmitters in plasma was correlated with depression incidence among psoriasis patients. Methods Ninety patients aged 18-60 years with psoriasis vulgaris referred to the dermatology department and 40 healthy volunteers aged 18-60 years referred to the physical examination center of the Affiliated Hospital of Southwest Medical University were included. Questionnaires were administered in both groups to obtain basic patient information, Hamilton Depression Scale(HAMD), and Athens Insomnia Scale(AIS) scores. The questionnaire only for patients with psoriasis vulgaris included the course of disease, Psoriasis Area and Severity Index (PASI), and Dermatology Life Quality Index (DLQI). The catecholamine in plasma from the two groups was analyzed by radioimmunoassay. The data were analyzed by SPSS statistical software. Results: The mean HAMD (P=0.034) and mean AIS scores (P=0.001) of the psoriasis patients were higher than those of the control group, while the mean content of dopamine (P=0.004) and adrenaline in the plasma (P=0.007) of the psoriasis group were lower than those of the control group. Dopamine content in the plasma was lower (comparing psoriasis patients without depression and the control group: P<0.001), and was negatively correlated with HAMD, (P<0.05), AIS (P<0.05), and PASI scores (P<0.05) in the psoriasis patients with depression. There was no significant difference in the epinephrine and norepinephrine contents in all groups. PASI scores were positively correlated with HAMD scores in patients with psoriasis vulgaris, and the mean dopamine content in the patients with depression (P=0.001) was significantly lower than in those without depression. The low dopamine content and high PASI and DLQI scores were the risk factors for depression among the patient population. Conclusion: Psoriasis patients have a significantly higher risk of depression than healthy people, and higher PASI scores were linked to a higher incidence of depression. The dopamine levels of patients were influenced by both psoriasis and depression. The risk factors for depression in psoriasis patients are low dopamine levels in the plasma, severe skin lesions, and lower quality of life.
Objective The present study investigated the clinical characteristics and gender differences of acne vulgaris associated with insulin resistance (IR).Methods The present study was conducted in 100 patients, comprising 52 males and 48 females, having acne vulgaris. Of the total, 18 male patients and 9 female patients exhibited IR, whereas 34 male patients and 39 female patients exhibited non-IR (NIR). The height, weight, acne grade, sex hormone, lipid metabolism, plasma glucose, and insulin levels of all the patients were measured and statistically analyzed.Results In the male group, the body mass index of the group with IR was significantly higher than that of the group with NIR (P < 0.05). No significant difference was observed in the sex hormones and insulin-like growth factor-1 (IGF-1) between female patients having acne associated with IR and those having acne associated with NIR. Levels of testosterone and sex hormone-binding globulin in male patients having acne associated with IR were lower than those in patients having acne associated with NIR, whereas the estrogen and IGF-1 levels in male patients with acne in the IR group were higher than those in the NIR group. Significant differences were observed in the fasting plasma glucose and fasting and 2-h postprandial plasma insulin levels between male and female groups (P < 0.05).Conclusion Disorders of sex hormone in male patients with acne vulgaris are related to IR; however, this correlation is not significant in women. Levels of sex hormones and metabolism in male patients having acne associated with IR must be actively monitored, and appropriate intervention must be administered.
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