Gibson John A G, Dobbs Thomas D, Griffiths Rowena, Song Jiao, Akbari Ashley, Bodger Owen, Hutchings Hayley A, Lyons Ronan A, John Ann, Whitaker Iain S
Reconstructive Surgery & Regenerative Medicine Research Centre, Institute of Life Science, Swansea University Medical School, UK; and The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, UK.
Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, UK.
BJPsych Open. 2023 Nov 15;9(6):e212. doi: 10.1192/bjo.2023.547.
Estimates suggest that 1 in 100 people in the UK live with facial scarring. Despite this incidence, psychological support is limited.
The aim of this study was to strengthen the case for improving such support by determining the incidence and risk factors for anxiety and depression disorders in patients with facial scarring.
A matched cohort study was performed. Patients were identified via secondary care data sources, using clinical codes for conditions resulting in facial scarring. A diagnosis of anxiety or depression was determined by linkage with the patient's primary care general practice data. Incidence was calculated per 1000 person-years at risk (PYAR). Logistic regression was used to determine risk factors.
Between 2009 and 2018, 179 079 patients met the study criteria and were identified as having a facial scar, and matched to 179 079 controls. The incidence of anxiety in the facial scarring group was 10.05 per 1000 PYAR compared with 7.48 per 1000 PYAR for controls. The incidence of depression in the facial scarring group was 16.28 per 1000 PYAR compared with 9.56 per 1000 PYAR for controls. Age at the time of scarring, previous history of anxiety or depression, female gender, socioeconomic status and classification of scarring increased the risk of both anxiety disorders and depression.
There is a high burden of anxiety disorders and depression in this patient group. Risk of these mental health disorders is very much determined by factors apparent at the time of injury, supporting the need for psychological support.
据估计，英国每100人中就有1人面部有疤痕。尽管有这样的发病率，但心理支持却很有限。
本研究的目的是通过确定面部疤痕患者焦虑和抑郁障碍的发病率及危险因素，来加强改善此类支持的理由。
进行了一项匹配队列研究。通过二级医疗数据来源识别患者，使用导致面部疤痕的疾病临床编码。通过与患者的初级医疗全科医疗数据关联来确定焦虑或抑郁的诊断。按每1000人年风险（PYAR）计算发病率。使用逻辑回归确定危险因素。
2009年至2018年期间，179079名患者符合研究标准并被确定有面部疤痕，并与179079名对照匹配。面部疤痕组焦虑症的发病率为每1000 PYAR 10.05例，而对照组为每1000 PYAR 7.48例。面部疤痕组抑郁症的发病率为每1000 PYAR 16.28例，而对照组为每1000 PYAR 9.56例。疤痕形成时的年龄、既往焦虑或抑郁病史、女性性别、社会经济地位和疤痕分类增加了焦虑症和抑郁症的风险。
该患者群体中焦虑症和抑郁症的负担很重。这些心理健康障碍的风险很大程度上由受伤时明显的因素决定，这支持了提供心理支持的必要性。
