Department of Dermatology and Venereology, Skåne University Hospital, Lund University, Malmö, Sweden; Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hospital Innlandet Trust, Brumundal, Norway.
Department of Dermatology and Venereology, Skåne University Hospital, Lund University, Malmö, Sweden.
J Invest Dermatol. 2020 Mar;140(3):568-573. doi: 10.1016/j.jid.2019.05.034. Epub 2019 Sep 3.
Itch is a highly prevalent and multidimensional symptom. We aimed to analyze the association between itch and mental health in dermatological patients. This multicenter study is observational and cross-sectional and was conducted in dermatological clinics across 13 European countries. A total of 3,530 patients and 1,094 healthy controls were included. Patients were examined clinically. Outcome measures were itch (presence, chronicity, and intensity), the Hospital Anxiety and Depression Scale, EQ-5D visual analogue scale, sociodemographics, suicidal ideation, and stress (negative life events and economic difficulties). Ethical approval was obtained. Results showed significant association between the presence of itch in patients and clinical depression (odds ratio, 1.53; 95% confidence interval, 1.15-2.02), suicidal ideation (odds ratio, 1.27; 95% confidence interval, 1.01-1.60), and economic difficulties (odds ratio, 1.24; 95% confidence interval, 1.10-1.50). The mean score of reported generic health status assessed by the EQ-5D visual analogue scale was 65.9 (standard deviation = 20.1) in patients with itch, compared with 74.7 (standard deviation = 18.0) in patients without itch (P < 0.001) and 74.9 (standard deviation = 15.7) in controls with itch compared with 82.9 (standard deviation = 15.6) in controls without itch (P < 0.001). Itch contributes substantially to the psychological disease burden in dermatological patients, and the management of patients should include access to multidisciplinary care.
瘙痒是一种高度普遍且多维的症状。我们旨在分析皮肤科患者瘙痒与心理健康之间的关系。这项多中心研究是观察性和横断面研究,在欧洲 13 个国家的皮肤科诊所进行。共纳入 3530 名患者和 1094 名健康对照者。患者接受了临床检查。结局指标为瘙痒(存在、慢性和强度)、医院焦虑抑郁量表、EQ-5D 视觉模拟量表、社会人口统计学、自杀意念和压力(负面生活事件和经济困难)。获得了伦理批准。结果显示,患者瘙痒的存在与临床抑郁(优势比,1.53;95%置信区间,1.15-2.02)、自杀意念(优势比,1.27;95%置信区间,1.01-1.60)和经济困难(优势比,1.24;95%置信区间,1.10-1.50)之间存在显著关联。通过 EQ-5D 视觉模拟量表报告的通用健康状况平均得分在瘙痒患者中为 65.9(标准差=20.1),而在无瘙痒患者中为 74.7(标准差=18.0)(P<0.001),在瘙痒对照者中为 74.9(标准差=15.7),而在无瘙痒对照者中为 82.9(标准差=15.6)(P<0.001)。瘙痒在皮肤科患者的心理疾病负担中占很大比重,患者的管理应包括获得多学科护理。