To what extent do disease severity and illness perceptions explain depression, anxiety and quality of life in hidradenitis suppurativa?

Blanco, A. Pavon; Turner, Mark A.; Petrof, Gabriela; Weinman, John

doi:10.1111/bjd.17123

Cited by 36 publications

(26 citation statements)

References 52 publications

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“…Studies report a higher prevalence of depression and poorer quality of life for HS compared with dermatological conditions such as psoriasis, acne and chronic urticaria . Although research to date has determined that there are negative social and emotional consequences associated with HS, the psychological processes underpinning the experience of distress have not yet been looked at.…”

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confidence: 99%

A qualitative analysis of psychological distress in hidradenitis suppurativa

2019

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Summary Background Hidradenitis suppurativa (HS) can negatively impact on patients’ quality of life and is associated with a higher risk of depression, as well as difficulties in employment and relationships. Objectives This study sought to evaluate the lived experience of psychological distress in HS. Methods Structured interviews were conducted with 12 participants. These were later transcribed and analysed using thematic analysis. The transcripts and analysis were reviewed by an independent researcher. Results The results indicated that there were three main themes: shame, pain and coping mechanisms. Participants indicated that their feelings of shame were due to disgust at their symptoms. They feared that others would be disgusted if their symptoms were obvious. Participants reported feeling invalidated when others did not understand the severity of their pain. Additionally, they reported that pain left them with a sense of powerlessness over their own bodies. Regarding coping mechanisms, adaptive strategies included social support while maladaptive strategies included social withdrawal. Conclusions These findings are discussed in the context of the existing research on shame, chronic pain and psoriasis. The implications for psychological support for individuals with HS are evaluated. Additionally, the limitations of this study are considered and recommendations for future research are given. This study has highlighted that feelings of shame and physical pain are associated with psychological distress in HS. What's already known about this topic? Hidradenitis suppurativa (HS) has been shown to be associated with physical pain, a higher risk of depression, difficulties in sustaining employment and difficulties in relationships. Additionally, studies using quality‐of‐life measures have found more impairment in HS than in other dermatological conditions. What does this study add? Although the research to date has determined that there are negative social and emotional consequences associated with HS, the psychological processes underlying these impairments have not yet been looked at. This study aims to get a deeper understanding of the lived experience of psychological distress in HS and how individuals with HS attempt to manage this distress. What are the clinical implications of the work? This study has identified shame as a key feature that underlies the psychological difficulties experienced as a consequence of HS. When deciding upon appropriate psychological interventions for HS, approaches that specifically focus on reducing feelings of shame should be considered.

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confidence: 99%

A qualitative analysis of psychological distress in hidradenitis suppurativa

2019

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“…The relationship of serum zinc levels with QoL and disease severity in HS was studied: low zinc levels were associated with DLQI

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9 . Self‐reported depression, anxiety and impaired QoL were strongly associated in HS with illness perceptions . QoL impairment was considered to be a predictor of the self‐evaluated health status of HS patients …”

Section: Resultsmentioning

confidence: 99%

“…86 Self-reported depression, anxiety and impaired QoL were strongly associated in HS with illness perceptions. 87 QoL impairment was considered to be a predictor of the self-evaluated health status of HS patients. 88…”

Section: Validation Of Hs-specific Qol Instrumentsmentioning

confidence: 99%

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

Chernyshov

Zouboulis

Tómas-Aragonés

et al. 2019

Acad Dermatol Venereol

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This paper is organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Quality of Life (QoL) and Patient‐Oriented Outcomes and the EADV TF on acne, rosacea and hidradenitis suppurativa (ARHS). The purpose of this paper was to present current knowledge about QoL assessment in HS, including data on HS‐specific health‐related (HR) QoL instruments and HRQoL changes in clinical trials, and to make practical recommendations concerning the assessment of QoL in people with HS. HS results in significant quimp that is higher than in most other chronic skin diseases. HS impact in published studies was assessed predominantly (84% of studies) by the Dermatology Life Quality Index (DLQI). There is a lack of high‐quality clinical trials in HS patients where HRQoL instruments have been used as outcome measures. One double‐blind randomized placebo‐controlled trial on infliximab with low number of participants reported significantly better HRQoL improvement in the treatment group than in the placebo group. Well‐designed clinical studies in HS patients to compare different treatment methods, including surgical methods and assessing long‐term effects, are needed. Because of lack of sufficient validation, the Task Forces are not at present able to recommend existing HS‐specific HRQoL instruments for use in clinical studies. The EADV TFs recommend the dermatology‐specific DLQI questionnaire for use in HS patients. The EADV TFs encourage the further development, validation and use of other HS‐specific, dermatology‐specific and generic instruments but such use should be based on the principles presented in the previous publications of the EADV TF on QoL and Patient‐Oriented Outcomes.

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“…Dieser Befund steht im Einklang mit früheren Forschungsergebnissen zu chronisch entzündlichen Hauterkrankungen wie Psoriasis und Hidradenitis suppurativa [37–39]. Die Wahrnehmung der Krankheit durch die Patienten entspricht nicht immer dem objektiven Schweregrad der Erkrankung [37–39]. Daher gibt es Patienten mit minimaler Krankheitsaktivität, deren Lebensqualität jedoch aufgrund ihrer Wahrnehmung der Krankheit stark beeinträchtigt ist, was wiederum depressive Symptome auslösen kann.…”

Section: Diskussionunclassified

Zwei Fragen könnten reichen – Früherkennung von Depressionen bei Patienten mit Psoriasis: eine multizentrische Studie

Gerdes

Wilsmann‐Theis²,

Celis³

et al. 2020

J Deutsche Derma Gesell

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Hintergrund : Depressionen werden bei Psoriasis-Patienten häufig nicht diagnostiziert und in ihrem Alltag unzureichend behandelt. Ziel dieser Studie war es, den Einfluss von Patienten-und Krankheitscharakteristika auf Depressionswerte zu untersuchen und zu analysieren. Patienten und Methoden : In dieser multizentrischen Querschnitts-und Kohortenstudie wurden erwachsene Psoriasis-Patienten mit zwei validierten Verfahren auf Depression untersucht: den Whooley-Fragen und dem revidierten Beck-Depressions-Inventar (BDI-II). Ergebnisse : Insgesamt wurden 538 Patienten (medianer PASI 3,0; durchschnittlicher DLQI 5,3) auf Depressionssymptome untersucht (durchschnittlicher BDI-II-Wert 8,3). 24,2 % aller Patienten erreichten einen BDI-II-Wert ≥ 13, der auf eine zumindest leichte Depression hinweist. Die Ergebnisse der Whooley-Fragen waren bei 28,2 % der Patienten positiv. Es zeigte sich eine starke Korrelation zwischen den beiden Verfahren (p < 0,001). In der Teilgruppe mit einem BDI-II-Wert ≥ 13 waren die Krankheitsaktivität (medianer PASI 3,8 vs. 2,8; p = 0,06) und die DLQI-Werte (Mittelwert 10,1 vs. 3,7; p < 0,0001) höher sowie Psoriasis-Arthritis und Diabetes häufiger (52,6 % vs. 37,8 %; p = 0,002 beziehungsweise 16,2 % vs. 10,0 %; p = 0,04) als in der Teilgruppe mit einem BDI-II-Wert < 13. Schlussfolgerungen : In spezialisierten Psoriasis-Ambulanzen wurde trotz eines niedrigen medianen PASI bei fast jedem vierten Patienten ein BDI-II-Wert ≥ 13 festgestellt. Die Whooley-Fragen könnten ein leicht anzuwendendes Verfahren für das Screening auf Depression bei Psoriasis-Patienten darstellen.

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To what extent do disease severity and illness perceptions explain depression, anxiety and quality of life in hidradenitis suppurativa?

Cited by 36 publications

References 52 publications

A qualitative analysis of psychological distress in hidradenitis suppurativa

A qualitative analysis of psychological distress in hidradenitis suppurativa

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

Zwei Fragen könnten reichen – Früherkennung von Depressionen bei Patienten mit Psoriasis: eine multizentrische Studie

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