Psychiatric morbidity in dermatological outpatients: An issue to be recognized

Angelo Picardi, D. Abeni, C. F. Melchi, P. Puddu, P. Pasquini

Research output: Contribution to journalArticle

Abstract

Background: There is a high prevalence of psychiatric disorders in dermatological outpatients. Objectives: To estimate the magnitude of this problem and to identify a set of variables associated with the presence of psychiatric disorder. Methods: All adults attending the outpatient clinics of a dermatological hospital on predetermined days were given a questionnaire comprising the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12). Results: In total, 4268 questionnaires were given at admission, and 3125 were returned. Of these, 546 were blank or incomplete, leaving 2579 respondents (response rate 60.4%). Using a stringent cut-off threshold (≥ 5) for psychiatric case identification with the GHQ-12, scored in the conventional way, the overall prevalence of psychiatric morbidity was 25.2% (95% confidence interval 23.6-27.0%). We found a higher prevalence of psychiatric disorders in women and in widows/widowers, controlling for age. Health-related quality of life was a much stronger predictor of psychiatric morbidity than physician-rated clinical severity. High prevalence rates (> 30%) were observed among patients with acne, pruritus, urticaria, alopecia and herpesvirus infections, and in subjects without objective signs of dermatological disease. Conclusions: Our study has depicted the situation that is actually faced by dermatologists in their everyday practice, where they are in a unique position to recognize psychiatric morbidity and to take appropriate measures. The GHQ-12, being easy for patients to compile and for physicians or nurses to score, may be a practical tool to increase identification of patients with substantial psychological distress or formal psychiatric disorder in order to provide more comprehensive and appropriate intervention.

Original languageEnglish
Pages (from-to)983-991
Number of pages9
JournalBritish Journal of Dermatology
Volume143
Issue number5
DOIs
Publication statusPublished - 2000

Keywords

  • GHQ-12
  • Prevalence
  • Psychiatric disorders
  • Psychological distress
  • Skin disease

ASJC Scopus subject areas

  • Dermatology

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