Psychiatric morbidity, stress and quality of life among geriatric dermatology patients: Therapeutic considerations from an Indian perspective

Abstract

We aimed to determine the prevalence of psychiatric morbidities, stress and quality of life, the pattern of skin diseases and associated psychosocial factors in geriatric population. Patients aged 60 years and older were recruited. Demographics and dermatological history and findings were collected using a preset Proforma. Geriatric depression scale (GDS), hospital anxiety and depression scale (HADS), perceived stress scale (PSS), and dermatology life quality index (DLQI) were instituted in all the patients. A total of 310 patients were included in the study, 173 males and 137 females. Infectious diseases (39.6%), papulosquamous diseases (17.1%), and eczema (15.5%) were common disorders. 45.5% were depressed and 43.2% had anxiety (hospital anxiety and depression scale). 55.8% had depression (geriatric depression rating scale), 20.3% had high stress and 11% had extremely large effect on DLQI. Divorced/widowed patients experienced more depression (p = 0.037) and had more impairment in quality of life (p = 0.05). Patients living in three generation family experienced more impairment in quality of life (p = 0.000). Our study demonstrated high prevalence of psychiatric morbidities in geriatric dermatology patients. It implies the need of special care with more attention to psychiatric co morbidities. The role of psychiatry-dermatology liaison clinic may benefit these patients.

Perceived stress in patients with inflammatory and non‐inflammatory skin conditions. An observational controlled study among 255 Norwegian dermatological outpatients

“…Less knowledge exists on a larger range of skin conditions and in an outpatient setting, except for one study in older outpatients. 10 Sampogna et al likewise report that older patients with psoriasis experienced higher distress, 23 where multiple health issues were more prevalent. We adjusted for age and comorbidities to control for these factors.…”

“…Less knowledge exists on a larger range of skin conditions and in an outpatient setting, except for one study in older outpatients 10 . Sampogna et al.…”

“…12,36,37 One dimension is related to perceived stress, another to coping ability and stress resilience. 29 In our study we used a simplistic approach and were interested in the general perceived stress using cut-offs as described by Cohen et al 12 and also used in other studies, 10 where values are considered: 'experiencing low stress' (0-13), 'moderate stress' (14-26) and 'high stress' (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). Individuals who did not give valid responses to all questions were excluded from calculations on perceived stress.…”

“…6 Later, other inflammatory skin diseases were investigated as to their association to stress. [7][8][9][10][11] By the late 1980s, instruments for measuring stress had been validated, 12 marking the beginning of robust and valid studies on stress. 12 During the last 2 decades multiple studies have shown that patients with skin disease have a lower HRQoL, 4,13 higher risk for depression, anxiety, 14 stress 15 and issues with body image.…”

“…Already in 1945 Wittkover investigated the relationship between stress and psoriasis, 5 stress is regularly reported to play an important role in the onset or exacerbation of psoriasis 6 . Later, other inflammatory skin diseases were investigated as to their association to stress 7–11 . By the late 1980s, instruments for measuring stress had been validated, 12 marking the beginning of robust and valid studies on stress 12 …”