TITLE:
Psychiatric Comorbidity in Patients with Psoriasis, Vitiligo, Acne, Eczema and Group of Patients with Miscellaneous Dermatological Diagnoses
AUTHORS:
Amir Mufaddel, Abdelghani Elsheikh Abdelgani
KEYWORDS:
Psychiatric Comorbidity, Dermatologic Disorders, Anxiety, Depression
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.4 No.3,
June
27,
2014
ABSTRACT: Background: Dermatological
conditions can be associated with high psychiatric comorbidity. Several studies
reported high rates of depression and anxiety particularly for specific
dermatological disorders such as psoriasis and acne. Aim: The aim of this study
was to compare the rates of psychiatric symptoms in patients with psoriasis,
acne, vitiligo, and eczema versus patients who had other dermatological
conditions; and to compare each dermatological group versus healthy control
subjects. Methods: This prospective cross-sectional study was conducted in
dermatology outpatient clinics in Khartoum. Hospital Anxiety and Depression
Scale (HADS) was used to assess symptoms of anxiety (HADS-A) and depression
(HADS-D). ICD-10 criteria were used for clinical psychiatric diagnosis.
Tabulated results were analyzed using Chi-square test. Significance was set at P P = 0.0062), vitiligo (P = 0.0054), acne (P = 0.0103) and eczema (P = 0.0359) compared with healthy
subjects. Similarly, HADS-A scores above the cut off points were significantly
higher in patients with psoriasis (P P =
0.0001), acne (P = 0.0143)
and eczema (P = 0.0281)
compared with healthy subjects. No significant difference between the control
group and patients with other dermatologic conditions regarding both HADS-D and
HADS-A scores. Using ICD-10 criteria for clinical psychiatric diagnoses
indicated that 52.3% of dermatology patients had an associated ICD-10
diagnosis; most commonly anxiety disorders (28.6%), and depression (21.9%).
ICD-10 diagnoses of anxiety disorders included: OCD (13.3%) generalized anxiety
disorder (5.7%), panic disorder (4.8%), phobic anxiety disorder (3.8%) and
post-traumatic stress disorder (0.95%). Conclusion: Dermatological conditions
are associated with high rates of psychiatric comorbidity. Screening for
anxiety and depressive symptoms may be helpful for early diagnosis and
management of associated psychiatric symptoms.