Picardi A, Abeni D, Melchi C F, Puddu P, Pasquini P
Clinical Epidemiology Unit, 2nd Division of Clinical Dermatology and Dermatoimmunology Department, Dermatological Institute IDI-IRCCS, Via dei Monti di Creta 104, 00167 Rome, Italy.
Br J Dermatol. 2000 Nov;143(5):983-91. doi: 10.1046/j.1365-2133.2000.03831.x.
There is a high prevalence of psychiatric disorders in dermatological outpatients.
To estimate the magnitude of this problem and to identify a set of variables associated with the presence of psychiatric disorder.
All adults attending the outpatient clinics of a dermatological hospital on predetermined days were given a questionnaire comprising the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12).
In total, 4268 questionnaires were given at admission, and 3125 were returned. Of these, 546 were blank or incomplete, leaving 2579 respondents (response rate 60.4%). Using a stringent cut-off threshold (> or = 5) for psychiatric case identification with the GHQ-12, scored in the conventional way, the overall prevalence of psychiatric morbidity was 25.2% (95% confidence interval 23.6-27.0%). We found a higher prevalence of psychiatric disorders in women and in widows/widowers, controlling for age. Health-related quality of life was a much stronger predictor of psychiatric morbidity than physician-rated clinical severity. High prevalence rates (> 30%) were observed among patients with acne, pruritus, urticaria, alopecia and herpesvirus infections, and in subjects without objective signs of dermatological disease.
Our study has depicted the situation that is actually faced by dermatologists in their everyday practice, where they are in a unique position to recognize psychiatric morbidity and to take appropriate measures. The GHQ-12, being easy for patients to compile and for physicians or nurses to score, may be a practical tool to increase identification of patients with substantial psychological distress or formal psychiatric disorder in order to provide more comprehensive and appropriate intervention.
皮肤科门诊患者中精神障碍的患病率很高。
评估该问题的严重程度，并确定一组与精神障碍存在相关的变量。
在预定日期到一家皮肤科医院门诊就诊的所有成年人都收到了一份包含皮肤病生活质量指数-29（Skindex-29）和12项一般健康问卷（GHQ-12）的问卷。
总共发放了4268份问卷，回收3125份。其中，546份为空白或不完整，剩余2579名受访者（回复率60.4%）。使用严格的临界阈值（≥5），按照传统方式对GHQ-12进行评分以识别精神疾病病例，精神疾病的总体患病率为25.2%（95%置信区间23.6 - 27.0%）。在控制年龄的情况下，我们发现女性以及寡妇/鳏夫中精神障碍的患病率更高。与健康相关的生活质量比医生评定的临床严重程度更能有力地预测精神疾病的发生。痤疮、瘙痒症、荨麻疹、脱发和疱疹病毒感染患者以及无皮肤病客观体征的受试者中观察到高患病率（>30%）。
我们的研究描绘了皮肤科医生在日常实践中实际面临的情况，他们处于识别精神疾病并采取适当措施的独特位置。GHQ-12易于患者填写且便于医生或护士评分，可能是一种实用工具，可提高对有严重心理困扰或正式精神障碍患者的识别，以便提供更全面和适当的干预。
