The Psychological Burden of Skin Diseases: A Cross-Sectional Multicenter Study among Dermatological Out-Patients in 13 European Countries

Florence J. Dalgard, Uwe Gieler, Lucia Tomas-Aragones, Lars Lien, Francoise Poot, Gregor B E Jemec, Laurent Misery, Csanad Szabo, Dennis Linder, Francesca Sampogna, Andrea W M Evers, Jon Anders Halvorsen, Flora Balieva, Jacek Szepietowski, Dmitry Romanov, Servando E. Marron, Ilknur K. Altunay, Andrew Y. Finlay, Sam S. Salek, Jörg Kupfer

Research output: Contribution to journalArticle

Abstract

The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants - 3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67-3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68-2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33-2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications.

Original languageEnglish
Pages (from-to)984-991
Number of pages8
JournalJournal of Investigative Dermatology
Volume135
Issue number4
DOIs
Publication statusPublished - Apr 20 2015

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ASJC Scopus subject areas

  • Dermatology
  • Biochemistry
  • Cell Biology
  • Molecular Biology

Cite this

Dalgard, F. J., Gieler, U., Tomas-Aragones, L., Lien, L., Poot, F., Jemec, G. B. E., Misery, L., Szabo, C., Linder, D., Sampogna, F., Evers, A. W. M., Halvorsen, J. A., Balieva, F., Szepietowski, J., Romanov, D., Marron, S. E., Altunay, I. K., Finlay, A. Y., Salek, S. S., & Kupfer, J. (2015). The Psychological Burden of Skin Diseases: A Cross-Sectional Multicenter Study among Dermatological Out-Patients in 13 European Countries. Journal of Investigative Dermatology, 135(4), 984-991. https://doi.org/10.1038/jid.2014.530