TY - JOUR
T1 - The impact of changes in clinical severity on psychiatric morbidity in patients with psoriasis
T2 - A follow-up study
AU - Sampogna, F.
AU - Tabolli, S.
AU - Abeni, D.
AU - Alotto, Massimo
AU - Antonelli, Gianluca
AU - Bolli, Simone
AU - Cavalieri, Rino
AU - Chinni, Massimo Luca
AU - Fazio, Marcello
AU - Girolomoni, Giampiero
AU - Luchetti, Elisabetta
AU - Mazzotti, Eva
AU - Melchi, Carmelo Franco
AU - Salcedo, Nidia Melo
AU - Moscatelli, Paola
AU - Pasquini, Paolo
AU - Piazza, Paolo
AU - Picconi, Orietta
AU - Pilla, Maria Antonietta
AU - Primavera, Grazia
AU - Puddu, Pietro
AU - Ruatti, Paolo
AU - Ruggiero, Giuseppe
AU - Salvatori, Valentina
AU - Sera, Francesco
AU - Simoni, Romeo
AU - Sordi, Donatella
AU - Tiago, Albertina
PY - 2007/9
Y1 - 2007/9
N2 - Background: Psoriasis has a strong impact on quality of life and is correlated to psychopathological states. It is important to investigate the effect of clinical changes on psychological status. Objectives: To analyse the extent of clinical change and its effect on the presence of psychiatric morbidity in a group of patients with psoriasis. Methods: All eligible adults hospitalized with psoriasis in a dermatological hospital (February 2000-February 2002) were given the self-administered Psoriasis Area and Severity Index (SAPASI) to assess clinical severity, the 12-item General Health Questionnaire (GHQ-12) to detect patients with psychological problems (defined as 'cases') and the Skindex-29 to evaluate symptoms. The same questionnaires were completed by the patients a month after hospital discharge. Results: In our population of 414 patients, the incidence of GHQ cases becoming noncases was correlated with the SAPASI percentage improvement, ranging from 17.6% in patients with SAPASI worsened or unchanged at follow-up, to 68.2% in patients with clearance of psoriasis. Also, the proportion of patients who became GHQ noncases was much higher in patients with improvement of ≥ 50% in symptoms, compared with patients with no improvement or worsening (70% vs. 32%, respectively). In a multivariate model the possible determinants of the passage from GHQ case to noncase were: SAPASI improvement, symptom improvement, no localization on the face, and gender (i.e. women were less likely to improve psychologically). Conclusions: The improvement in clinical severity and symptoms was associated with a decreased frequency of psychiatric disturbance. However, dermatologists should be aware that even in the presence of vast clinical improvement patients may still substantially suffer psychologically.
AB - Background: Psoriasis has a strong impact on quality of life and is correlated to psychopathological states. It is important to investigate the effect of clinical changes on psychological status. Objectives: To analyse the extent of clinical change and its effect on the presence of psychiatric morbidity in a group of patients with psoriasis. Methods: All eligible adults hospitalized with psoriasis in a dermatological hospital (February 2000-February 2002) were given the self-administered Psoriasis Area and Severity Index (SAPASI) to assess clinical severity, the 12-item General Health Questionnaire (GHQ-12) to detect patients with psychological problems (defined as 'cases') and the Skindex-29 to evaluate symptoms. The same questionnaires were completed by the patients a month after hospital discharge. Results: In our population of 414 patients, the incidence of GHQ cases becoming noncases was correlated with the SAPASI percentage improvement, ranging from 17.6% in patients with SAPASI worsened or unchanged at follow-up, to 68.2% in patients with clearance of psoriasis. Also, the proportion of patients who became GHQ noncases was much higher in patients with improvement of ≥ 50% in symptoms, compared with patients with no improvement or worsening (70% vs. 32%, respectively). In a multivariate model the possible determinants of the passage from GHQ case to noncase were: SAPASI improvement, symptom improvement, no localization on the face, and gender (i.e. women were less likely to improve psychologically). Conclusions: The improvement in clinical severity and symptoms was associated with a decreased frequency of psychiatric disturbance. However, dermatologists should be aware that even in the presence of vast clinical improvement patients may still substantially suffer psychologically.
KW - Psoriasis
KW - Psychology
KW - Quality of life
KW - Severity
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U2 - 10.1111/j.1365-2133.2007.08071.x
DO - 10.1111/j.1365-2133.2007.08071.x
M3 - Article
C2 - 17627789
AN - SCOPUS:34547865733
VL - 157
SP - 508
EP - 513
JO - British Journal of Dermatology
JF - British Journal of Dermatology
SN - 0007-0963
IS - 3
ER -