寻常型银屑病患者焦虑和抑郁的频率及严重程度。

Nasreen Sarwat, Ahmed Ijaz, Effendi Shehla

Department of Dermatology, Ziauddin University, Karachi.

J Coll Physicians Surg Pak. 2008 Jul;18(7):397-400.

OBJECTIVE

To determine the frequency of anxiety and depression in patients with psoriasis.

STUDY DESIGN

Cross-sectional study.

PLACE AND DURATION OF STUDY

Outpatient Departments of Dermatology and Psychiatry, Ziauddin University Hospital, KDLB Campus, Karachi, from October 2005 to September 2006.

PATIENTS AND METHODS

All patients presenting with psoriasis vulgaris above the age of 15 years, of either gender, fulfilling the selection criteria were included in the study. Clinical diagnosis was confirmed by biopsy and histopathology. Documentation of disease severity as mild, moderate and severe was done, using Psoriasis Area Severity Index (PASI). Patients were asked to fill "AKUADS" for their psychiatric assessment and scoring was done on this basis. Patients scoring equal to or above 19 were labeled as having anxiety or depression.

RESULTS

There were 56 males (62%) and 33 females (38%), aged 20 to 65 years in the study. Out of those, 52 (58%) were married; while 37 (42%) were unmarried. The minimum duration of illness was 6 months and maximum 15 years. Thirty-four patients (38%) were suffering from mild disease, 31 (35%) from moderate and the remaining 24 (27%) from severe psoriasis. Twenty-four (27%) were on topical therapy while the other 65 (73%) were receiving systemic as well as topical therapy. Joint involvement was seen in 25 patients (28%) and nail changes in 31 (35%). Psychiatric illness was positive in 34 patients (38%, p<0.05) i.e. 20 males (59%) and 14 females (41%). Twenty-six patients (76%) were married (p<0.05). Anxiety and depression was seen irrespective of the disease duration. The mean "AKUADS" scores in accordance with disease severity were mild psoriasis 20, moderate psoriasis 22 and severe psoriasis 25. Twenty-one patients (62%, p=0.05) with joint involvement and another 23 (68%, p<0.05) with nail involvement had a score above 19. Thirty-one patients (91%) were receiving systemic as well as local therapy, while 3 patients (9%) were on topical treatment (p<0.05).

CONCLUSION

There is an association of psoriasis vulgaris with anxiety and depression. The magnitude of this anxiety and depression can be influenced by variables of disease and life.

目的

确定银屑病患者焦虑和抑郁的发生率。

研究设计

横断面研究。

研究地点及时间

2005年10月至2006年9月，卡拉奇KDLB校区齐亚乌丁大学医院皮肤科和精神科门诊。

患者及方法

纳入所有年龄在15岁以上、符合入选标准的寻常型银屑病患者，男女不限。通过活检和组织病理学确诊临床诊断。使用银屑病面积和严重程度指数（PASI）记录疾病严重程度，分为轻度、中度和重度。要求患者填写“AKUADS”进行精神评估，并据此评分。得分等于或高于19分的患者被标记为患有焦虑或抑郁。

结果

研究中有56名男性（62%）和33名女性（38%），年龄在20至65岁之间。其中，52人（58%）已婚；37人（42%）未婚。病程最短6个月，最长15年。34例患者（38%）患有轻度疾病，31例（35%）患有中度疾病，其余24例（27%）患有重度银屑病。24例（27%）接受局部治疗，其他65例（73%）接受全身及局部治疗。25例患者（28%）有关节受累，31例（35%）有指甲改变。34例患者（38%，p<0.05）精神疾病呈阳性，即20名男性（59%）和14名女性（41%）。26例患者（76%）已婚（p<0.05）。无论病程长短，均可见焦虑和抑郁。根据疾病严重程度，“AKUADS”平均得分分别为：轻度银屑病20分，中度银屑病22分，重度银屑病25分。21例关节受累患者（62%，p=0.05）和另外23例指甲受累患者（68%，p<0.05）得分高于19分。31例患者（91%）接受全身及局部治疗，3例患者（9%）接受局部治疗（p<0.05）。