Department of Dermatology, Royo Villanova Hospital, Aragon Health Sciences Institute (IACS), Zaragoza, Spain.
Department of Psychology, University of Zaragoza, Aragon Health Sciences Institute (IACS), Zaragoza, Spain.
Contact Dermatitis. 2018 Jun;78(6):406-412. doi: 10.1111/cod.12973. Epub 2018 Feb 21.
The essential physical role, visibility and social importance of the hands place a major psychological burden on patients with hand eczema.
The aim of this study was to identify the psychological, social and clinical characteristics of patients with hand eczema, in particular the prevalences of depression, anxiety, suicidal ideation, and comorbidities.
Data on patients with hand eczema were analysed from a large European multicentre study conducted with dermatology outpatients from 13 countries. Groups of patients and controls were compared to analyse the psychological burden of hand eczema.
Female patients with hand eczema had higher Hospital Anxiety and Depression Scale (HADS) scores for anxiety (n = 86, median = 7.0) than controls (n = 900, median = 5.0, P = .02), and for depression (median = 4.0) than controls (3.0, P < .001). Patients with high suicidal ideation, with low socioeconomic status and who were widowed or divorced were more likely to fulfil the HADS criteria for anxiety [odds ratio (OR) > 1, P = .038, P < .001, and P < .001, respectively]. The median Dermatology Life Quality Index score was 7.0 (n = 68).
This study identifies a specific psychological burden experienced by hand eczema patients, highlighting the need for focused psychosocial interventions. Physicians in particular should be aware of the need to identify anxiety and depression in female patients.
手部的重要生理作用、可见性和社会重要性给手部湿疹患者带来了巨大的心理负担。
本研究旨在确定手部湿疹患者的心理、社会和临床特征,特别是抑郁、焦虑、自杀意念和共病的患病率。
对来自 13 个国家的皮肤科门诊患者进行的一项大型欧洲多中心研究中的手部湿疹患者的数据进行了分析。比较患者组和对照组,以分析手部湿疹的心理负担。
手部湿疹女性患者的医院焦虑抑郁量表(HADS)焦虑评分(n=86,中位数=7.0)高于对照组(n=900,中位数=5.0,P=0.02),抑郁评分(中位数=4.0)高于对照组(3.0,P<0.001)。有高自杀意念、社会经济地位低、丧偶或离异的患者更有可能符合 HADS 焦虑标准[优势比(OR)>1,P=0.038、P<0.001 和 P<0.001]。皮肤病生活质量指数的中位数为 7.0(n=68)。
本研究确定了手部湿疹患者特有的心理负担,强调需要进行有针对性的社会心理干预。特别是医生应该意识到需要识别女性患者的焦虑和抑郁。