Department of Dermatology, Venereology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany.
J Dermatol. 2021 Jun;48(6):794-806. doi: 10.1111/1346-8138.15721. Epub 2020 Dec 22.
Psoriasis has a strong impact on patients' lives and is closely linked to psychiatric disorders such as depression, anxiety and substance-related disorders, especially dependence on alcohol and nicotine. The aim of our study was to systematically assess the psychiatric comorbidity and possible associations between psychological factors, disease severity and dermatology-related quality of life in psoriatic patients from a high-need university hospital dermatology department. Consecutive psoriatic patients (new and permanent patients) at the Department of Dermatology, University Hospital Essen, Germany, were asked to fill out a paper-based questionnaire. In the first part of the questionnaire, baseline demographics, pre-existing mental disorders and data on substance abuse were collected. In the second part of the questionnaire, mental and physical health was explored using different validated self-rating tests. The current Psoriasis Area and Severity Index (PASI) was documented by a dermatologist. Patients with signs of mental disorders were offered an appointment with a board-certified psychiatrist. Between August 2016 and February 2019, 228 consecutive psoriatic patients (138 men [60.5%], 90 women [39.5%]; mean age, 48.3 years [standard deviation, 13.6; range, 18-80]) participated in the study. Approximately 50% of the patients had evidence of suffering from mental health problems, mostly depression and anxiety, as well as alcohol dependence. Patients with a PASI of 3 or more showed a statistically significant reduced Dermatology Life Quality Index (DLQI) and a significantly impaired psychological as well as physical quality of life. DLQI correlated with all psychological test results. The data indicate a significant psychological burden in a tertiary psoriatic population. Our findings underscore the importance of screening psoriatic patients for psychiatric disorders, with a focus on depression, anxiety as well as alcohol and nicotine dependence, in a multidimensional approach involving psychiatrists and psychologists.
银屑病对患者的生活有很大影响，与精神障碍密切相关，如抑郁、焦虑和物质相关障碍，特别是对酒精和尼古丁的依赖。我们的研究目的是系统评估来自高需求大学医院皮肤科的银屑病患者的精神共病情况以及心理因素、疾病严重程度和皮肤病相关生活质量之间的可能关联。德国埃森大学医院皮肤科连续招募银屑病患者（新患者和复诊患者）填写纸质问卷。问卷的第一部分收集基线人口统计学数据、既往精神障碍和物质滥用数据。问卷的第二部分使用不同的验证自评量表探讨心理健康和身体健康。由皮肤科医生记录当前银屑病面积和严重程度指数（PASI）。有精神障碍迹象的患者会被安排与认证的精神科医生预约。2016 年 8 月至 2019 年 2 月，228 例连续银屑病患者（138 名男性[60.5%]，90 名女性[39.5%]；平均年龄 48.3 岁[标准差 13.6；范围 18-80]）参与了这项研究。大约 50%的患者有心理健康问题的证据，主要是抑郁和焦虑，以及酒精依赖。PASI 为 3 或更高的患者的皮肤病生活质量指数（DLQI）显著降低，心理和身体生活质量显著受损。DLQI 与所有心理测试结果相关。这些数据表明，在一个三级银屑病人群中存在显著的心理负担。我们的发现强调了对银屑病患者进行多维度筛查的重要性，包括精神病医生和心理学家对抑郁、焦虑以及酒精和尼古丁依赖的关注。
