Platsidaki Eftychia, Efstathiou Vasiliki, Markantoni Vasiliki, Kouris Anargyros, Kontochristopoulos Georgios, Nikolaidou Electra, Rigopoulos Dimitrios, Stratigos Alexandros, Gregoriou Stamatios
1st Department of Dermatology-Venereology, Faculty of Medicine, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, Athens, Greece.
Dermatol Ther (Heidelb). 2023 May;13(5):1127-1136. doi: 10.1007/s13555-023-00915-1. Epub 2023 Mar 30.
Melasma is a common acquired disorder of hyperpigmentation and has a significant effect on quality of life. The aim of this prospective cross-sectional study was to assess the effect of melasma on depression, social anxiety and self-esteem in the Greek population.
The study included a total of 254 participants: 127 patients with melasma and an equal sample of healthy controls. Both participant groups completed the following psychometric measures: the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression and Rosenberg's Self-esteem Scale (RSES) for self-esteem. Furthermore, in patients with melasma, quality of life was assessed using Melasma Quality of Life (MELASQoL).
Melasma patients (7.47 ± 4.53) presented statistically significantly higher anxiety compared to healthy controls (6.06 ± 3.59, p = 0.006), while no differences emerged with regard to depression or self-esteem. It is important to note that the difference regarding anxiety remained significant (b = 1.25, p = 0.003) even after adjusting for age, depression and self-esteem. A higher disease severity (MASI) correlated statistically significantly with longer disease duration (r = 0.24, p < 0.001), higher depression (r = 0.28, p = 0.002), and a more impaired health-related quality of life (MelasQol; r = 0.29, p < 0.001). Notably, a more impaired health-related quality of life was also correlated with higher depression (r = 0.19, p = 0.027) and lower self-esteem (r = - 0.31, p < 0.001).
The results of this study highlight the importance of evaluating quality of life, anxiety and depression in patients with melasma. The therapeutic approach should not be based solely on clinical findings; it should also include an evaluation of the patient's psychological aspects. Dermatologists can further improve their patient care by being supportive or requesting psychological intervention when needed, resulting in better compliance with treatment and an improved social and psychological status.
黄褐斑是一种常见的后天性色素沉着紊乱疾病，对生活质量有显著影响。这项前瞻性横断面研究的目的是评估黄褐斑对希腊人群抑郁、社交焦虑和自尊的影响。
该研究共纳入254名参与者：127名黄褐斑患者以及数量相等的健康对照样本。两组参与者均完成了以下心理测量指标：用于评估焦虑和抑郁的医院焦虑抑郁量表（HADS）以及用于评估自尊的罗森伯格自尊量表（RSES）。此外，对于黄褐斑患者，使用黄褐斑生活质量量表（MELASQoL）评估生活质量。
黄褐斑患者（7.47±4.53）的焦虑程度在统计学上显著高于健康对照（6.06±3.59，p = 0.006），而在抑郁或自尊方面未发现差异。需要注意的是，即使在对年龄、抑郁和自尊进行调整后，焦虑方面的差异仍然显著（b = 1.25，p = 0.003）。更高的疾病严重程度（MASI）在统计学上与更长的病程（r = 0.24，p < 0.001）、更高的抑郁程度（r = 0.28，p = 0.002）以及更差的健康相关生活质量（MelasQol；r = 0.29，p < 0.001）显著相关。值得注意的是，更差的健康相关生活质量也与更高的抑郁程度（r = 0.19，p = 0.027）和更低的自尊（r = - 0.31，p < 0.001）相关。
本研究结果凸显了评估黄褐斑患者生活质量、焦虑和抑郁的重要性。治疗方法不应仅基于临床发现；还应包括对患者心理方面的评估。皮肤科医生可以通过给予支持或在需要时要求进行心理干预来进一步改善患者护理，从而提高患者对治疗的依从性，并改善其社会和心理状态。
