Investigation of stressful life events in patients with systemic sclerosis

Chen, Yue; Huang, Jingqiu; Yu, Qiang; Wang, Jin; Han, Mao-mao

doi:10.1631/jzus.b0820069

Cited by 10 publications

(5 citation statements)

References 15 publications

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“…In the main group ‘primary skin disorders linked with mental health’, the pathophysiological link with psychological stress was documented in the following disorders: some autoimmune bullous dermatoses (pemphigus vulgaris), 46 acne, 47 alopecia areata, 48 atopic dermatitis, 49 chronic spontaneous urticaria, 50 dermatomyositis, 51 hyperhidrosis, 52 infectious diseases (herpesviruses and warts), 53,54 lichen planus, 55 lupus erythematosus, 56 psoriasis, 57 rosacea, 58 systemic sclerosis, 59 seborrheic dermatitis, 60 telogen effluvium 61 and vitiligo 62 . These primary dermatoses are also associated with secondary psychiatric comorbidities which is a relevant aspect in other primary dermatoses that do not seem to present a pathophysiological link with stress, such as some examples of autoimmune bullous dermatoses (dermatitis herpetiformis, IgA bullous dermatosis), androgenetic alopecia, hidradenitis suppurativa, lichen sclerosus, toxic epidermal necrolysis, Stevens–Johnson syndrome, genodermatoses and cicatricial alopecias, particularly, primary neutrophilic cicatricial alopecias, such as folliculitis decalvans and dissecting cellulitis of the scalp 63–66 .…”

Section: Discussionmentioning

confidence: 99%

Classification of psychodermatological disorders: Proposal of a new international classification

Ferreira,

Vulink,

Mostaghimi

et al. 2023

Acad Dermatol Venereol

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IntroductionSeveral classifications of psychodermatology disorders have been proposed, with most of them based on two to four main disorder category groups. However, there is, to date, no classification that has resulted from a consensus established by psychodermatology experts. The DSM‐5‐TR (Diagnostic and statistical manual of mental disorders (5th ed.), Text Revision) and the ICD‐11 (International classification of diseases (11th revision)) also do not provide a systematized approach of psychodermatology disorders. Taking into consideration that classifications are a key pillar for a comprehensive approach to the pathologies of each branch of medicine, the proposal of a classification in psychodermatology appeared as a central need for the recognition of psychodermatological disorders, in an attempt to improve their recognition and, in that sense, to find a common language for the development of this subspecialty that crosses dermatology and psychiatry.MethodsPreviously published classifications in psychodermatology were critically reviewed and discussed by expert opinion from an international multidisciplinary panel of 16 experts in psychodermatology and a new classification system is proposed, considering classical concepts in general dermatology and psychopathology.ResultsTwo main categories of disorders are presented (a main group related to primary mental health disorders and another main group related to primary skin disorders), which are subsequently subdivided into subgroups considering pathophysiological and phenomenological similarities, including key aspects of dermatological examination, namely the presence of visible skin lesions (primary and secondary skin lesions) and psychopathological correlates.ConclusionThis new classification aims to unify previous classifications, systematize the disorders that belong to psychodermatology and highlight their tenuous boundaries, to improve their management. It has been built and approved by the Psychodermatology Task Force of the European Academy of Dermatology and Venereology (EADV), the European Society for Dermatology and Psychiatry (ESDaP) and the Association for Psychoneurocutaneous Medicine of North America (APMNA).

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Section: Discussionmentioning

confidence: 99%

Classification of psychodermatological disorders: Proposal of a new international classification

Ferreira,

Vulink,

Mostaghimi

et al. 2023

Acad Dermatol Venereol

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“…Focusing on biology, researchers suspect these attacks may initially be triggered by infection with a virus, perhaps picked up early in life. However, social and psychological factors are welldocumented to play a role in the causation of immune disorders, and there might be a connection of stress to SSc as well [2]. An adverse life event may be important in understanding the mode of onset of SSc.…”

Section: Discussionmentioning

confidence: 99%

“…Yet the psychological problems of SSc often cause more suffering than the physical effects. We recommend that more attention should be paid to this aspect of the disease in terms of both clinical care and research [2].…”

Section: Discussionmentioning

confidence: 99%

“…Many factors, such as environmental factors, can lead to immunologic system disturbances and vascular changes. It has been reported on our previous research that social and psychological stresses may trigger these disturbances and changes [2], and conventional thoracic duct lymphatic drainage therapy (TDD) for the SSc patients has been proven effective [3]. Few data relating to a precise psychological event or events underlying the onset of SSc are available, and this study was set up to determine whether life events had been causally related to the onset of SSc and to determine whether psychoeducation combinated with TDD had led to an improvement in the SSc.…”

Section: Introductionmentioning

confidence: 91%

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Life Events and Psychoeducation in Patients with Systemic Sclerosis

Chen¹,

Huang²,

Yu³

et al. 2010

PSYCH

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Objective: The purpose of this study was to assess the impact of psychological/psychoeducational assessment in patients with systemic sclerosis (SSc). Methods: A diagnostic interview was undertaken in order to investigate any temporal connection between an adverse life event and the first appearance of SSc. Following this, the rheumatologist's assessment of subsequent changes in the SSc were noted. The psychoeducation we did, as an adjunct to conventional thoracic duct lymphatic drainage therapy (TDD), started in Dec. 2002, and the primary end point was an improvement in clinical outcome at 1 month after entry. Results: The patients with SSc in the study showed higher percentages of lower education (69.2%) and working class (63.5%), and reported that the most common life event in adults was divorce or separation from spouse, while in adolescent was difficult home conditions. A favourable response was noted in all patients who participated in the study; Remission was achieved in 35, while 17 showed some improvement. Conclusions: We conclude that life events were causally related to the onset of SSc and psychoeducation combinated with conventional TDD led to a remission in the majority of patients.

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“…A few studies found that stress events, emotional stress and recurrent infections were reported before or during onset of scleroderma (Hui, Johnston, Brodsky, Tafur, & Kim Ho, 2007). Stress events were also reported by individuals in the year before onset of scleroderma, with scleroderma patients reporting significantly greater scores on measures of stress experiences, than non-scleroderma participants (Chen, Huang, Qiang, Wang, & Han, 2008).…”

Section: Background To Scleroderma and Its Impactsmentioning

confidence: 99%

Early Nurturing Experiences, Self-Compassion, Hyperarousal and Scleroderma The Way We Relate to Ourselves May Determine Disease Progression

Kearney¹,

Hicks²

2016

IJPS

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Scleroderma is a rare, painful and complex autoimmune connective tissue disease that can lead to death. The physiology of symptom onset and progression and the psychological aspects of living with this chronic disease have been studied fairly extensively. However, there is limited knowledge about scleroderma and negative physiological arousal (hyper-arousal: linked to immune dysfunction resulting in autoimmunity in the face of stressful events) and how levels of hyper-arousal are related to stress experienced at an early age; to emotion regulation coping strategies such as self-compassion; and to when scleroderma is experienced (earlier or later onset). Knowledge about these relationships may be important information for the treatment of scleroderma and related illnesses. This study addressed these relationships for scleroderma by examining how hyper-arousal was linked to these psychosocial experiences of stress, to coping strategies, and to age of disease onset.A within group design was utilized. A total of 122 participants were recruited from Australia (39) the United Kingdom (81) and country not specified (2) and invited to complete an online or a hard copy survey. Lower positive early life experiences, lower levels of self-compassion and an earlier onset of disease were all related to elevated levels of hyper-arousal in individuals diagnosed with scleroderma. A regression equation showed all three contributed significantly to the experienced hyper-arousal. The findings suggest that greater self-compassion may be a determining factor in how earlier emotional experiences are managed and in predicting lower hyper-arousal in terms of this disease.

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Investigation of stressful life events in patients with systemic sclerosis

Cited by 10 publications

References 15 publications

Classification of psychodermatological disorders: Proposal of a new international classification

Classification of psychodermatological disorders: Proposal of a new international classification

Life Events and Psychoeducation in Patients with Systemic Sclerosis

Early Nurturing Experiences, Self-Compassion, Hyperarousal and Scleroderma The Way We Relate to Ourselves May Determine Disease Progression

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