Dermatological patients with itch report more stress, stigmatization experience, anxiety and depression compared to patients without itch: Results from a European multi-centre study.

Journal: Journal of the European Academy of Dermatology and Venereology : JEADV

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Affiliated Institutions:  Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany. Institute of Medical Psychology, Justus-Liebig-University, Gießen, Germany. Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway. Barts Health NHS Trust & Queen Mary University of London, London, UK. Faculty of Social and Behavioural Sciences, Institute of Psychology, Unit Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands. Vitos Klinik, Gießen, Germany. Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway. Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy. Department of Psychology, University of Zaragoza, Zaragoza, Spain. Department of Psychiatry, Amsterdam UMC, Location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK. Department of Dermatology, Medical University of Graz, Graz, Austria. Clinique Notre Dame de Grâce, Gosselies, Belgium. Department of Dermatology, Zealand University Hospital, Roskilde, Denmark. Department of Dermatology, University Hospital of Brest, Brest, France. Institute of Psychology, University of Szeged, Szeged, Hungary. School of Medicine, PHI University Clinic of Dermatology, University St Cyril and Methodius, Skopje, North Macedonia. Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands. Department of Dermatology, Stavanger University Hospital, Stavanger, Norway. Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland. Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland. Centre for Philosophy of Science of the University of Lisbon, Lisbon, Portugal. Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia. Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. Aragon Psychodermatology Research Group Zaragoza, Zaragoza, Spain. Department of Dermatology, University Hospital Miguel Servet, Zaragoza, Spain. Department of Dermatology, Skåne University Hospital, Malmö, Sweden. Şişli Hamidiye Etfal Training and Research Hospital, Dermatology and Venereology Clinic, University of Health Sciences, Istanbul, Turkey. South Wales Clinical Psychology Training Programme, Cardiff & Vale University Health Board & School of Psychology, Cardiff University, Cardiff, UK.

Abstract summary 

Itch as the most common symptom in dermatology has been shown to be related to psychological factors such as stress, anxiety and depression. Moreover, associations were found between perceived stigmatization and itch. However, studies investigating the differences between patients with dermatoses with and without itch regarding perceived stress, stigmatization, anxiety and depression are missing. Therefore, one of the aims of the second study of the European Society for Dermatology and Psychiatry (ESDaP study II) was to investigate these relationships in a large cohort of patients with different itchy dermatoses.3399 patients with 14 different itchy dermatoses were recruited at 22 centres in 17 European countries. They filled in questionnaires to assess perceived stigmatization, stress, signs of clinically relevant anxiety or depression, itch-related quality of life, the overall health status, itch duration, frequency and intensity. The most significant association between the severity of itching and the perception of stress was observed among individuals with rosacea (correlation coefficient r = 0.314). Similarly, the strongest links between itch intensity and experiences of stigmatization, anxiety, and depression were found in patients with seborrheic dermatitis (correlation coefficients r = 0.317, r = 0.356, and r = 0.400, respectively). Utilizing a stepwise linear regression analysis, it was determined that within the entire patient cohort, 9.3% of the variation in itch intensity could be accounted for by factors including gender, levels of anxiety, depression, and perceived stigmatization. Females and individuals with elevated anxiety, depression, and perceived stigmatization scores reported more pronounced itch intensities compared to those with contrary attributes.This study underscores the connection between experiencing itch and its intensity and the psychological strain it places on individuals. Consequently, psychological interventions should encompass both addressing the itch itself and the interconnected psychological factors. In specific cases, it becomes imperative for dermatologists to direct individuals towards suitable healthcare resources to undergo further psychological assessment.

Authors & Co-authors:  Zeidler Kupfer Dalgard Bewley Evers Gieler Lien Sampogna Tomas Aragones Vulink Finlay Legat Titeca Jemec Misery Szabó Grivcheva Panovska Spillekom van Koulil Balieva Szepietowski Reich Ferreira Lvov Romanov Marron Gracia Cazaña Elyas Altunay Thompson van Beugen Ständer Schut

Study Outcome 

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Statistics
Citations :  Kopyciok ME, Stander HF, Osada N, Steinke S, Stander S. Prevalence and characteristics of pruritus: a one-week cross-sectional study in a German dermatology practice. Acta Derm Venereol. 2016;96(1):50-55.
Authors :  32
Identifiers
Doi : 10.1111/jdv.19913
SSN : 1468-3083
Study Population
Females
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Publication Country
England