Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, IT-20122, Milan, Italy.
Acta Derm Venereol. 2021 Nov 10;101(11):adv00590. doi: 10.2340/00015555-3922.
The aim of this study was to detect demographic and clinical factors associated with affective symptoms and quality of life in patients with severe atopic dermatitis. First, one-way analyses of variance and correlations were performed to compare a large set of qualitative and quantitative clinical variables. Three final multivariable regression models were performed, with depression/anxiety subscales and Dermatology Life Quality Index scores as dependent variables, and the factors that were statistically significant on univariate analyses as independent ones. More severe anxiety symptoms and poorer quality of life (p < 0.01) were significantly associated with more severe depressive symptoms. Female sex and disturbed sleep (p = 0.03) were significantly associated with more severe anxiety. Finally, previous treatment with cyclosporine (p = 0.03) or methotrexate (p = 0.04), more severe depressive symptoms (p < 0.01), itch (p = 0.03), impaired sleep (p < 0.01) and perceived severity of dermatological illness (p < 0.01) were significant predictors of low quality of life. This study shows a complex interplay between the severity of atopic dermatitis, poor quality of life and presence of clinically relevant affective symptoms. These results will help dermatologists to identify patients who need psychiatric consultation within the framework of a multidisciplinary approach.
本研究旨在探讨与重症特应性皮炎患者的情感症状和生活质量相关的人口统计学和临床因素。首先,我们进行了单因素方差分析和相关性分析,以比较大量的定性和定量临床变量。然后,我们进行了三个最终的多变量回归模型,将抑郁/焦虑子量表和皮肤病生活质量指数评分作为因变量,将单因素分析中具有统计学意义的因素作为自变量。更严重的焦虑症状和更差的生活质量(p<0.01)与更严重的抑郁症状显著相关。女性和睡眠障碍(p=0.03)与更严重的焦虑显著相关。最后,环孢素(p=0.03)或甲氨蝶呤(p=0.04)的既往治疗、更严重的抑郁症状(p<0.01)、瘙痒(p=0.03)、睡眠受损(p<0.01)和对皮肤病严重程度的感知(p<0.01)是生活质量差的显著预测因素。本研究显示了特应性皮炎严重程度、生活质量差和存在临床相关情感症状之间的复杂相互作用。这些结果将帮助皮肤科医生在多学科方法的框架内识别需要精神科咨询的患者。