Fabrazzo Michele, Romano Francesca, Arrigo Marzia, Puca Rosa Valentina, Fuschillo Antonietta, De Santis Valeria, Sampogna Gaia, Giordano Giulia Maria, Catapano Francesco, Lo Schiavo Ada
Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138 Naples, Italy.
Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy.
Int J Environ Res Public Health. 2022 Feb 12;19(4):2060. doi: 10.3390/ijerph19042060.
The literature reported higher depression rates in psoriasis patients compared to the general population. Our study aimed to verify whether variability in depression prevalence was due to using different diagnostic tools. We also aimed to determine whether dysfunctional coping strategies might increase the depression burden. We assessed psoriasis severity by the Psoriasis Area Severity Index (PASI) and PSOdisk. We analyzed mental alterations of 120 outpatients by Hamilton Depression and Anxiety Rating Scales (HAM-D and HAM-A), Symptom Checklist-90-Revised (SCL-90-R), plus coping strategies and quality of life by Coping Orientation to Problems Experienced (COPE) Inventory and 36-Item Short Form Health Survey (SF-36). We divided our cohort into five subgroups from minimal to severe psoriasis using the PSOdisk total score. Depression prevalence varied according to the assessment criteria for specificity, frequency, and severity. Different mood disorders other than major depression emerged when we used DSM-IV-TR criteria. Correlation analysis of the criteria we used to diagnose depression or depressed mood indicated that a dysfunctional coping strategy was highly and positively correlated only in patients of the severe subgroup. Differently, a negative correlation emerged between the SF-36 Mental Summary Component (MSC) and behavioral disengagement, thus suggesting that psychopathological distress might induce patients with a marked/severe psoriasis to adopt dysfunctional coping strategies. Dermatologists are fundamental in detecting comorbid depression, referring psoriasis patients to mental health specialists to achieve adequate treatments, and preventing suicide risk.
文献报道，与普通人群相比，银屑病患者的抑郁症发病率更高。我们的研究旨在验证抑郁症患病率的差异是否归因于使用了不同的诊断工具。我们还旨在确定功能失调的应对策略是否可能增加抑郁症负担。我们通过银屑病面积和严重程度指数（PASI）和PSOdisk评估银屑病严重程度。我们通过汉密尔顿抑郁和焦虑评定量表（HAM-D和HAM-A）、症状自评量表-90修订版（SCL-90-R）分析了120名门诊患者的心理变化，此外，还通过应对问题的应对取向（COPE）量表和36项简短健康调查（SF-36）分析了应对策略和生活质量。我们使用PSOdisk总分将我们的队列分为从轻度到重度银屑病的五个亚组。抑郁症患病率根据特异性、频率和严重程度的评估标准而有所不同。当我们使用DSM-IV-TR标准时，出现了除重度抑郁症以外的不同情绪障碍。我们用于诊断抑郁症或抑郁情绪的标准的相关性分析表明，功能失调的应对策略仅在重度亚组患者中呈高度正相关。不同的是，SF-36心理总结成分（MSC）与行为脱离之间呈负相关，因此表明心理病理困扰可能促使中重度银屑病患者采取功能失调的应对策略。皮肤科医生在检测合并症抑郁症、将银屑病患者转诊至心理健康专家以获得充分治疗以及预防自杀风险方面至关重要。
