Yew Yik Weng, Kuan Amanda Hui Yu, Ge Lixia, Yap Chun Wei, Heng Bee Hoon
Department of Dermatology, National Skin Centre, Singapore, Singapore.
Health Services and Outcomes Research, National Healthcare Group Pte Ltd, Singapore, Singapore.
PLoS One. 2020 Dec 31;15(12):e0244765. doi: 10.1371/journal.pone.0244765. eCollection 2020.
While it is well established that skin disease places significant psychosocial burden on a patient's wellbeing, its effects have rarely been examined in Asian populations.
Evaluate the psychosocial burden of skin disease among community-dwelling adults in Singapore.
This cross-sectional study included 1510 participants interviewed on their history of thirteen skin diseases. The Patient Health Questionnaire (PHQ-9), Lubben Social Network Scale-6 (LSNS-6), University of California Los Angeles (UCLA) Loneliness Scale, and European Quality of Life-5 Dimensions- 5 Level (EQ-5D-5L) were used as measures for depressive symptoms, social isolation, loneliness and quality of life respectively. Multiple linear regression analysis was used to examine the association of skin diseases with each of the four measured outcomes.
Participants with skin diseases reported significantly higher PHQ-9 and UCLA Loneliness scale scores, and lower LSNS-6 and EQ-5D-5L scores when compared to their healthy counterparts. The presence of skin disease was positively associated with depressive symptoms (B = 0.40, SE = 0.11), and negatively associated with quality of life (B = -0.03, SE = 0.01). As disease severity was not evaluated in this study, we were unable to ascertain the associations between disease severity and measured outcomes.
Participants with skin diseases were more likely to have depressive symptoms, social isolation, loneliness and lower quality of life. Unemployed, single and elderly patients were at higher risk of developing depressive symptoms. More emphasis should be placed on the psychosocial aspect of care to reduce the burden of skin disease. Some considerations include monitoring patients for mood-related changes and implementing early psychosocial interventions.
虽然皮肤病给患者的身心健康带来巨大的心理社会负担这一点已得到充分证实，但其影响在亚洲人群中很少被研究。
评估新加坡社区居住成年人中皮肤病的心理社会负担。
这项横断面研究纳入了1510名参与者，就其13种皮肤病病史进行了访谈。分别使用患者健康问卷（PHQ - 9）、鲁本社会网络量表 - 6（LSNS - 6）、加利福尼亚大学洛杉矶分校（UCLA）孤独量表和欧洲生活质量五维度五水平量表（EQ - 5D - 5L）作为抑郁症状、社会隔离、孤独感和生活质量的测量工具。采用多元线性回归分析来检验皮肤病与四个测量结果之间的关联。
与健康对照者相比，患有皮肤病的参与者报告的PHQ - 9和UCLA孤独量表得分显著更高，而LSNS - 6和EQ - 5D - 5L得分更低。皮肤病的存在与抑郁症状呈正相关（B = 0.40，标准误 = 0.11），与生活质量呈负相关（B = -0.03，标准误 = 0.01）。由于本研究未评估疾病严重程度，我们无法确定疾病严重程度与测量结果之间的关联。
患有皮肤病的参与者更有可能出现抑郁症状、社会隔离、孤独感且生活质量较低。失业、单身和老年患者出现抑郁症状的风险更高。应更加重视护理的心理社会方面，以减轻皮肤病的负担。一些考虑因素包括监测患者情绪相关变化并实施早期心理社会干预。
