Zalewski Adam, Krajewski Piotr K, Szepietowski Jacek C
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland.
J Clin Med. 2023 Sep 3;12(17):5741. doi: 10.3390/jcm12175741.
Hand eczema (HE) is a chronic inflammatory disease with a high prevalence, negatively influencing patients' quality of life (QoL). It may also affect patients' psychological status. The aim of this study was to assess and characterize the psychological burden of HE, its influence on patients' QoL, and the presence and severity of anxiety and depressive disorders in HE patients.
The study group consisted of 100 adult HE individuals. To assess the severity of the disease, two instruments were used: the Investigator Global Assessment for Chronic Hand Eczema (IGA-CHE) scale and the Hand Eczema Severity Index (HECSI). Assessment of patients' quality of life (QoL) was obtained with the use of the DLQI tool. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) questionnaires were employed to assess depression and anxiety, respectively, as well as a modified version of the Hospital Anxiety and Depression Scale (HADS-M).
The mean DLQI value for the whole group reached 11.62 ± 6.35 points (13.27 ± 6.67 points in females and 9.15 ± 4.95 points in males; = 0.023). A decrease in QoL correlated positively with the severity of the disease and the severity of itch and pain. In 17 patients (17%), a possible diagnosis of depressive disorder was found. Patients scoring higher results on the PHQ-9 and HADS-M depression (D) questionnaires reported greater intensity of the itch (r = 0.363, < 0.001, and r = 0.237, = 0.017, respectively) and the pain (r = 0.445, < 0.001, and r = 0.287, = 0.004, respectively). The anxiety disorder might possibly be diagnosed in 25% of patients (n = 25). This study revealed a positive correlation between the severity of the anxiety symptoms, measured with the use of both GAD-7 and HADS-M anxiety (A) tools, and the intensity of the pain (r = 0.248, = 0.013, and r = 0.342, = 0.001, respectively). The severity of depressive and anxiety symptoms correlated positively with the severity of the disease.
The psychosocial burden of HE is an undeniable phenomenon. The disorder influences patients' QoL and may cause mental disturbances such as depression and anxiety disorders.
手部湿疹（HE）是一种患病率很高的慢性炎症性疾病，对患者的生活质量（QoL）有负面影响。它也可能影响患者的心理状态。本研究的目的是评估和描述手部湿疹的心理负担、其对患者生活质量的影响以及手部湿疹患者焦虑和抑郁障碍的存在情况及严重程度。
研究组由100名成年手部湿疹患者组成。为评估疾病的严重程度，使用了两种工具：慢性手部湿疹研究者整体评估（IGA-CHE）量表和手部湿疹严重程度指数（HECSI）。使用DLQI工具评估患者的生活质量（QoL）。分别采用患者健康问卷-9（PHQ-9）和广泛性焦虑障碍-7（GAD-7）问卷以及医院焦虑抑郁量表修订版（HADS-M）来评估抑郁和焦虑。
整个组的平均DLQI值达到11.62±6.35分（女性为13.27±6.67分，男性为9.15±4.95分；P = 0.023）。生活质量的下降与疾病的严重程度以及瘙痒和疼痛的严重程度呈正相关。在17名患者（17%）中，发现可能患有抑郁症。在PHQ-9和HADS-M抑郁（D）问卷中得分较高的患者报告瘙痒强度更大（分别为r = 0.363，P < 0.001和r = 0.237，P = 0.017）和疼痛强度更大（分别为r = 0.445，P < 0.001和r = 0.287，P = 0.004）。25%的患者（n = 25）可能被诊断为焦虑症。本研究揭示，使用GAD-7和HADS-M焦虑（A）工具测量的焦虑症状严重程度与疼痛强度之间存在正相关（分别为r = 0.248，P = 0.013和r = 0.342，P = 0.001）。抑郁和焦虑症状的严重程度与疾病的严重程度呈正相关。
手部湿疹的社会心理负担是一个不可否认的现象。该疾病影响患者的生活质量，并可能导致抑郁和焦虑症等精神障碍。
