Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL, USA.
Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
Arch Dermatol Res. 2020 Oct;312(8):587-593. doi: 10.1007/s00403-020-02046-5. Epub 2020 Feb 20.
Prurigo nodularis (PN) and lichen simplex chronicus (LSC) are debilitating chronic pruritic diseases that can lead to and be exacerbated by psychosocial distress. However, little is known about the mental health (MH) comorbidities of PN/LSC. We sought to evaluate the likelihood and cost-burden of MH comorbidities and emergencies associated with PN/LSC. Data were examined from the 2002-2012 Nationwide Inpatient Sample, including a representative ~ 20% sample of US hospitalizations (n = 87,053,155 admissions). Inpatients with vs. without PN/LSC had higher odds of MH disorders overall (39.4% vs. 20.0%; adjusted odds ratio [95% confidence interval, CI] 2.26 [2.13-2.41]) and in all 15 individual MH disorders examined. Inpatients with vs. without PN/LSC were more likely to be admitted with a primary diagnosis of a MH disorder (4.5% vs. 2.2%; 2.16 [1.91-2.45]), particularly developmental, psychotic, and mood disorders, history of MH disorders or substance abuse, and cognitive disorders. PN/LSC were associated with prolonged inpatient length of stay, and an excess $0.69 million in inpatient costs of care indirectly related to hospitalization for MH disorders. In conclusion, inpatients with PN/LSC had increased likelihood of comorbid MH disorders and emergencies requiring hospitalization. Optimized approaches are needed for screening and managing MH comorbidities in PN/LSC.
结节性痒疹(PN)和慢性单纯性苔藓(LSC)是两种使人虚弱的慢性瘙痒性疾病,可导致心理社会困扰,并使这种困扰恶化。然而,对于 PN/LSC 的心理健康(MH)合并症知之甚少。我们旨在评估与 PN/LSC 相关的 MH 合并症和急症的可能性和费用负担。该研究数据来自 2002 年至 2012 年全国住院患者样本,包括美国住院患者的代表性样本(n=87053155 例)。与没有 PN/LSC 的患者相比,患有 PN/LSC 的患者更有可能患有总体 MH 障碍(39.4% vs. 20.0%;调整后的优势比[95%置信区间,CI]为 2.26[2.13-2.41])和所有 15 种单独的 MH 障碍。与没有 PN/LSC 的患者相比,患有 PN/LSC 的患者更有可能因 MH 障碍的主要诊断而入院(4.5% vs. 2.2%;2.16[1.91-2.45]),特别是发育、精神病和情绪障碍、MH 障碍或物质滥用的病史以及认知障碍。PN/LSC 与住院时间延长有关,并且与 MH 障碍住院治疗间接相关的医疗费用增加了 69 万美元。总之,患有 PN/LSC 的住院患者更有可能合并 MH 障碍和需要住院治疗的急症。需要优化方法来筛查和管理 PN/LSC 中的 MH 合并症。