Talamonti Marina, Galluzzo Marco, Silvaggio Dionisio, Lombardo Paolo, Tartaglia Chiara, Bianchi Luca
Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
Department of "Experimental Medicine", University of Rome "Tor Vergata", 00133 Rome, Italy.
J Clin Med. 2021 Mar 21;10(6):1298. doi: 10.3390/jcm10061298.
Atopic dermatitis (AD) is a dermatological disorder that affects patients' mental health and psychological state in complex ways. The importance of understanding the entire scope of this burden is well recognized, but there is limited comprehensive information about the resulting stress on adult patients with AD. This study aimed to determine the degree of psychological stress in patients with AD compared to healthy participants. A total of 352 adult patients participated in this cross-sectional study-174 with AD and 178 healthy participants. Demographic and clinical data were collected. Itch and sleep disturbance were assessed using a numeric rating scale and a visual analogue scale. The 20-item Toronto Alexithymia Scale (TAS-20) and Beck Depression Inventory (BDI) questionnaires were administered to assess the symptoms of alexithymia and depression. Quality of life (QOL) was assessed in AD patients using the Dermatology Quality Index. In our study, we found high TAS-20 and BDI scores among patients with AD. The prevalence of alexithymic personality features was 56.3% in patients with AD versus 21.3% in healthy controls ( < 0.001). Based on BDI scoring (BDI-21 > 13), depression was suspected in a significantly higher number of patients with AD than in the control group (56.9% (99/174) vs. 15.7% (28/178); < 0.0001). Eczema Area and Severity Index (EASI) score did not show any significant correlations with psychological parameters. Among clinical parameters, only sleep disturbance was positively correlated with depression (R = 0.307, < 0.005). Our data show that the severity index score as a representative factor of skin involvement has a limited role in predicting the effect of skin diseases on mental status. Screening and assessment for psychiatric disorders, QOL, and sleep disturbance in patients with atopic dermatitis cannot be neglected by physicians and they should be treated in clinical practice with the consideration of psychosomatic approaches.
特应性皮炎（AD）是一种皮肤病，以复杂的方式影响患者的心理健康和心理状态。人们已经充分认识到了解这一负担全貌的重要性，但关于AD成年患者由此产生的压力的全面信息有限。本研究旨在确定AD患者与健康参与者相比的心理压力程度。共有352名成年患者参与了这项横断面研究，其中174名患有AD，178名是健康参与者。收集了人口统计学和临床数据。使用数字评分量表和视觉模拟量表评估瘙痒和睡眠障碍。采用20项多伦多述情障碍量表（TAS - 20）和贝克抑郁量表（BDI）问卷来评估述情障碍和抑郁症状。使用皮肤病生活质量指数评估AD患者的生活质量（QOL）。在我们的研究中，我们发现AD患者的TAS - 20和BDI得分较高。AD患者中述情障碍人格特征的患病率为56.3%，而健康对照组为21.3%（<0.001）。根据BDI评分（BDI - 21>13），疑似患有抑郁症的AD患者数量明显高于对照组（56.9%（99/174）对15.7%（28/178）；<0.0001）。湿疹面积和严重程度指数（EASI）评分与心理参数未显示出任何显著相关性。在临床参数中，只有睡眠障碍与抑郁呈正相关（R = 0.307，<0.005）。我们的数据表明，作为皮肤受累代表性因素的严重程度指数评分在预测皮肤病对精神状态的影响方面作用有限。医生不能忽视对特应性皮炎患者的精神疾病、生活质量和睡眠障碍进行筛查和评估，在临床实践中应采用身心同治的方法对其进行治疗。
