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620 - Association Between Poorer Quality of Life and...

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Association Between Poorer Quality of Life and Psychiatric Morbidity in Patients With Different Dermatological Conditions F RANCESCA S AMPOGNA , BD, MPH, A NGELO P ICARDI , MD, M ARY -M ARGARET C HREN , MD, C. F RANCO M ELCHI , MD, P AOLO P ASQUINI , MD, MPH, C INZIA M ASINI , MD, AND D AMIANO A BENI , MD, MPH Objective: To determine the relationship between skin-related quality of life and psychiatric morbidity in patients with different skin conditions. Methods: We recruited all adults attending the outpatient clinics of the Dermatological Institute IDI-IRCCS, Rome, Italy, during 14 predetermined days. Eligible patients, who gave their informed consent, completed the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12). We used a stringent cut-off threshold ( 5 on the GHQ-12) for identification of psychiatric morbidity. Skindex-29 scale scores were computed separately for GHQ noncases and GHQ cases. Results: A total of 2,136 patients were included in the analysis. For all skin conditions, GHQ cases had substantially poorer score in all 3 domains of quality of life, Symptoms, Emotions, and Functioning. Most differences remained significant after adjusting for clinical severity, age, sex, and education in multiple regression models. These differences were not as marked in the Symptoms scale for some conditions known to be nearly asymptomatic (eg, alopecia, vitiligo, nevi), suggesting that, although patients with psychiatric morbidity might be more burdened by their symptoms, nevertheless they do not perceive nonexistent symptoms. Conclusion: In most skin conditions we considered, psychiatric morbidity was strongly associated with poorer quality of life. Although the cross-sectional nature of our study does not allow identification of the direction of this association, care for the psychological condition of patients might have an impact on their quality of life. Key words: quality of life, psychiatric morbidity, dermatology, Skindex-29, GHQ-12. GHQ-12 12-item General Health Questionnaire. INTRODUCTION M any studies pointed out complex, mutual relationships between psyche and skin. There is extensive literature on the relationship between emotional stress and skin diseases (1). Furthermore, dermatologists commonly think that psychi- atric disorders are frequent in their patients (2), and several studies confirm this opinion (3–7). In addition to any causal mechanism linking psychiatric morbidity and dermatological diseases, it is important to consider the consequences of the interrelation between these two conditions. For example, psy- chiatric morbidity is associated with increased subjective per- ception of pruritus (8), is higher among patients whose skin condition does not improve with treatment (9), and may affect treatment adherence (10). Regardless of psychiatric morbidity, skin diseases can greatly affect patients’ quality of life (11). For example, eczema and psoriasis have been found to have an impact on quality of life comparable to that of cardiovascular diseases (12). Until now, studies on the association between psychiatric
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