The Psychological Burden of Skin Diseases: A Cross-Sectional Multicenter Study among Dermatological Out-Patients in 13 European Countries

Abstract

The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants––3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67–3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68–2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33–2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications.

Burden of atopic dermatitis in Japanese adults: Analysis of data from the 2013 National Health and Wellness Survey

“…Rates of self‐reported depression, anxiety and sleep disorders were also significantly higher in patients with AD relative to non‐AD controls, corroborating the psychological impact of AD observed in previous studies of European11 and Japanese17 AD patients. It is to be noted that these comorbidities may be in addition to other comorbidities of AD which have been recently identified.…”

“…The multidimensional burden of disease in North American and European AD patients is well documented. Relative to the general population, patients with AD experience increased levels of itch, pain, sleep disturbance, anxiety and depression, as well as an impaired health‐related quality of life (HRQoL) 11, 12, 13, 14, 15. In contrast, published data on the burden of AD in the Japanese patient population is limited to two relatively small studies 16, 17…”

Evaluation of anxiety, depression and suicidal ideation among dermatology patients with cosmetic concerns: A pilot cross sectional study in Ind

“…Psychological factors has been reported in 10 -78 % of dermatology patients. 6,7,8,9,10,11,12,13,14,15 A survey of hospitalized dermatology patients found 45.3 percent of the subjects with depressive symptoms, and 52 percent with symptoms of anxiety . 6 Anxiety as co morbid feature was prevalent among 57 % of Arab vitiligo patients.…”

Repercusión emocional del cáncer de piel y el envejecimiento cutáneo

“…Se ha demostrado que la depresión comórbida, la ansiedad y la ideación suicida son comunes en pacientes con afecciones cutáneas 11 .…”