Department of Dermatology, Venereology and Allergology, UMC Leipzig, Leipzig, Germany.
LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.
Int Arch Allergy Immunol. 2022;183(4):409-414. doi: 10.1159/000520159. Epub 2021 Dec 3.
Atopic eczema (AE) is known to be associated with depression and anxiety. We aimed at investigating the occurrence of selected psychological comorbidities in patients with AE under treatment in our university dermatological department.
Monocentric prospective examination of adult AE patients using PO-SCORAD (Patient-Oriented Severity Scoring of AD), EASI (Eczema Area and Severity Index), POEM (Patient-Oriented Eczema Measure), DLQI (Dermatologic Life Quality Index), LSNS-6 (Lubben Social Network Scale 6), CES-D (Center for Epidemiologic Studies Depression Scale), HADS-D and -A (Hospital Anxiety and Depression Scale), and GAD-7 (Generalized Anxiety Disorder Scale-7) was carried out. We looked for correlations between AE severity and psychosocial comorbidities. Data were compared with age- and sex-matched controls from nonatopic subjects.
Mann-Whitney U test and Spearman's rank correlation were used.
Eighty-four patients (44 women, median age 35.0 years, range: 19.4-92.8 years) were included. PO-SCORAD was 40.4 [23.4-55.4] (median [interquartile range]), EASI 9.3 [3.4-18.9], POEM 16 [8-24], and DLQI 10 [4-18]. Compared with 161 from the healthy LIFE-Adult cohort controls, our patients with AE had significantly higher scores for HADS, GAD-7, and CES-D (p < 0.001, respectively), but there was no increase in the LSNS score (18 vs. 19; p = 0.067). Within the group of AE patients, there was a significant correlation of the subjective skin severity and the depression and anxiety values: POEM significantly correlated with GAD-7, CES-D, and HADS-A and -D (p < 0.001). PO-SCORAD significantly correlated with GAD-7 and CES-D (p < 0.05). EASI correlated neither with HADS-A or -D nor with CES-D. Patients with suicidal thoughts, plans, or attempts in the last 12 months had significantly more severe AE than those without (POEM 25 [15.3-26] vs. 15 [7-23]; p = 0.013, and PO-SCORAD 51.6 [40.2-63] vs. 20.5 [20.7-52]; p = 0.014).
Patients with AE being currently under treatment in our department had significantly increased scores indicating depression and anxiety. Suicidal tendency was increased in patients with severe AE.
AE patients may develop depression, anxiety, and suicidal ideation. Patient-oriented scores may help identifying high-risk patients.
特应性皮炎（AE）已知与抑郁和焦虑有关。我们旨在研究在我们大学皮肤科接受治疗的 AE 患者中出现的某些心理合并症的发生率。
使用 PO-SCORAD（AD 患者的以患者为中心的严重程度评分）、EASI（湿疹面积和严重程度指数）、POEM（以患者为中心的湿疹测量）、DLQI（皮肤病生活质量指数）、LSNS-6（Lubben 社会网络量表 6）、CES-D（中心流行病学研究抑郁量表）、HADS-D 和 -A（医院焦虑和抑郁量表）以及 GAD-7（广泛性焦虑障碍量表-7）对成年 AE 患者进行单中心前瞻性检查。我们寻找 AE 严重程度与社会心理合并症之间的相关性。将数据与非特应性受试者的年龄和性别匹配的对照进行比较。
使用曼-惠特尼 U 检验和斯皮尔曼秩相关进行分析。
共纳入 84 名患者（44 名女性，中位年龄 35.0 岁，范围：19.4-92.8 岁）。PO-SCORAD 为 40.4[23.4-55.4]（中位数[四分位数范围]），EASI 为 9.3[3.4-18.9]，POEM 为 16[8-24]，DLQI 为 10[4-18]。与健康 LIFE-Adult 队列对照的 161 名患者相比，我们的 AE 患者的 HADS、GAD-7 和 CES-D 评分明显更高（分别为 p<0.001），但 LSNS 评分没有增加（18 对 19；p=0.067）。在 AE 患者组中，主观皮肤严重程度与抑郁和焦虑值之间存在显著相关性：POEM 与 GAD-7、CES-D 和 HADS-A 和 -D 显著相关（p<0.001）。PO-SCORAD 与 GAD-7 和 CES-D 显著相关（p<0.05）。EASI 与 HADS-A 或 -D 以及 CES-D 均无相关性。在过去 12 个月内有自杀念头、计划或尝试的患者与无自杀念头、计划或尝试的患者相比，AE 严重程度明显更高（POEM 25[15.3-26]对 15[7-23]；p=0.013，PO-SCORAD 51.6[40.2-63]对 20.5[20.7-52]；p=0.014）。
目前在我们科室接受治疗的 AE 患者的抑郁和焦虑评分明显升高。严重 AE 患者的自杀倾向增加。
AE 患者可能会出现抑郁、焦虑和自杀意念。以患者为中心的评分可能有助于识别高危患者。
