Title: Evaluation of anxiety, depression and suicidal ideation among dermatology patients with cosmetic concerns: A pilot cross sectional study in India
Authors: Masarat Jabeen, Reeta Sood, Manmeet Singh, Shveta Lukhmana, Deepika Sodhi
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.225
Abstract
Background: Cosmetic concerns can negatively affect a person’s psychological well being. There is paucity of literature about psychological morbidity in Indian dermatological patients especially those with cosmetic concerns
Methods: This cross-sectional study with consecutive sampling (n=299) was done in the Department of Dermatology at an Indian hospital to find out the prevalence of psychological disorders in patients with cosmetic concerns. Patients were evaluated on validated performas namely 9 item Patient Health Questionnaire (PHQ-9) and 7 –item Generalized Anxiety Disorder Questionnaire (GAD-7), used commonly to assess the presence of psychiatric symptoms in patients.
Results: The patients age ranged between 16-67 years with mean age of 25.76 ± 16.6 years (mean ± 2S.D). More than half of the participants were females (63.5) %. Majority of patients (90.3 %) belonged to urban areas. The commonest diagnosis were pigmentary disorders(25.8 %) including melasma, tanning, ephelids, post inflammatory hyperpigmentation followed by acne ( 23.4) % and scars (11.7%). Prevalence rates of depression and anxiety were 38.5% and 40.1 % respectively. Female patients and office goers were more likely to suffer from anxiety and depression, respectively.
Conclusions: Emotional and psychological assessment is important in dermatology patients with cosmetic concerns. Psychiatric illnesses often go unaddressed in dermatological patients. This lacuna should be taken care of by implementing specific training programmes for dermatologists and developing rational consultation-liaison services with mental health services.
References
- Osman OT, Mufaddel A, Almugaddam F et al. The psychiatric aspects of skin disorders. Expert Rev Dermatol. 2011; 6:195–209
- Gupta MA, Gupta AK. Psychiatric and psychological co morbidity in patients with dermatologic disorders: Epidemiology and management. Am J Clin Dermatol 2003; 4:833–42
- Koo J, Lebwohl A. Psycho dermatology: The mind and skin connection. Am Fam Physician 2001; 64:1873-8.
- Spitzer RL, Kroenke K, Williams JB et al. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med 2006; 166:1092-7
- Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med 2001; 16:606-13
- Gascón MR, Ribeiro CM, Bueno LM et al. Prevalence of depression and anxiety disorders in hospitalized patients at the dermatology clinical ward of a university hospital. An Bras Dermatol. 2012; 87(3):403-7.
- Chamoun A, Goudetsidis L, Poot F et al.Psoriasis and depression. Rev Med Brux. 2015; 36(1):23-8
- Lakshmy S, Balasundaram S, Sarkar S et al. A cross-sectional study of prevalence and implications of depression and anxiety in psoriasis. Indian J Psychol Med. 2015; 37(4):434-40
- Dieris-Hirche J, Gieler U, Kupfer JP et al. Suicidal ideation, anxiety and depression in adult patients with atopic dermatitis. Hautarzt. 2009; 60:641–6.
- Linnet J, Jemec GB. An assessment of anxiety and dermatology life quality in patients with atopic dermatitis. Br J Dermatol. 1999; 140:268–72
- Golpour M, Hosseini SH, Khademloo M et al. Depression and anxiety disorders among patients with psoriasis: A hospital-based case-control study. Dermatol Res Pract. 2012; 2012:381905.
- Mufaddel A, Abdelgani AE. Psychiatric co morbidity in patients with psoriasis, vitiligo, acne, eczema and group of patients with miscellaneous dermatological diagnoses. Open J Psychiatr. 2014; 4:168–75.
- Al Shahwan MA. The prevalence of anxiety and depression in Arab dermatology patients. J Cutan Med Surg. 2015; 19:297–303.
- Balieva F, Lien L, Kupfer J et al .Are common skin diseases among Norwegian dermatological outpatients associated with psychological problems compared with controls? An observational study. Acta Derm Venereol. 2016; 96:227–31
- Dalgard FJ, Gieler U, Tomas-Aragones L et al. The psychological burden of skin diseases: A cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015; 135:984–91
- Al-Harbi M. Prevalence of depression in vitiligo patients. Skinmed. 2013; 11:327–30
- Klokk M, Gotestam KG, Mykletun A. Factors accounting for the association between anxiety and depression, and eczema: The Hordaland health study (HUSK). BMC Dermatol 2010; 10:3.
- Kimata H. Prevalence of suicidal ideation in patients with atopic dermatitis. Suicide Life Threat Behav 2006; 36:120-4.
- Rehn LM, Meririnne E, Höök-Nikanne J et al. Depressive symptoms, suicidal ideation and acne: a study of male Finnish conscripts. J Eur Acad Dermatol Venereol. 2008; 22(5):561-7.