Psychiatric Morbidity Among Dermatological Patients Attending a Tertiary Care Hospital in Central India

Divyani  Aharwal; Richa Changulani; Akshat  Pathak; Durgesh Shukla

doi:10.55489/njcm.140720232918

Authors

Divyani Aharwal G.R. Medical College Gwalior, M.P., India
Richa Changulani G.R. Medical College Gwalior, M.P., India
Akshat Pathak G.R. Medical College Gwalior, M.P., India
Durgesh Shukla G.R. Medical College Gwalior, M.P., India

DOI:

https://doi.org/10.55489/njcm.140720232918

Keywords:

Anxiety, DASS-21 Scale, Duration, Depression, Itching, Stress

Abstract

Background: Aim of the study was to estimate prevalence of depression, anxiety and stress among a large sample of out patients, affected with wider variety of skin problems and also to investigate its association with socio demographic and clinical characteristics so as to recommend for interventions to improve quality of care, in patients attending dermatology OPD.

Material and Methods: Present hospital based cross-sectional study was conducted among 300 patients attending the dermatology OPD. Frequency, Percentage, Odds ratio (OR) were calculated. Chi square test and Logistic regression was applied. P value < 0.05 was considered as statistically significant.

Results: Average age of the participants was 35.5±9.4 years. In the present study 29.67% patients were having at least one of the psychiatric morbidities. Among all the patients 28.7% were having the anxiety; 17.33% were having depression; 9.7% were having the stress. In multivariate analysis Females were observed to have higher risk for anxiety; depression and stress i.e. [OR: 7.54; 95% CI: 3.22-17.63]; [OR: 3.05; 95% CI: 1.75-5.34]; [OR: 14.61; 95% CI: 3.35-63.65] respectively.

Conclusion: Female’s gender; itching problem and dermatitis need a special concern to reduce the psychiatric morbidity. The high prevalence indicates the need for the psycho-social care of the dermatology patients.

References

Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol. 2011 Apr;9(4):244-53. doi: 10.1038/nrmicro2537. Erratum in: Nat Rev Microbiol. 2011 Aug;9(8):626. Doi: https://doi.org/10.1038/nrmicro2537 PMid:21407241 PMCid:PMC3535073

Anatomy of the Skin. University of Rochester Medical Center. Health Encyclopedia. https://www.urmc.rochester.edu/ency-clope-dia/content.aspx?contenttypeid=85&contentid=p01336 (Assesed on Jun 1, 2022)

Vivar KL, Kruse L. The impact of pediatric skin disease on self-esteem. Int J Womens Dermatol. 2017 Dec 12;4(1):27-31 Doi: https://doi.org/10.1016/j.ijwd.2017.11.002 PMid:29872673 PMCid:PMC5986112

Costeris C, Petridou M, Ioannou Y. Psychological Impact of Skin Disorders on Patients'Self-esteem and Perceived Social Support. J Dermatol & Skin Sci. 2021;3(1):14-22

Yang CY, Kourosh AS. Inflammatory skin disorders and self-esteem. Int J Womens Dermatol. 2017 Oct 21;4(1):23-26. Doi: https://doi.org/10.1016/j.ijwd.2017.09.006 PMid:29872672 PMCid:PMC5986113

Ahmed AE, Al-Dahmash AM, Al-Boqami QT, Al-Tebainawi YF. Depression, Anxiety and Stress among Saudi Arabian Derma-tology Patients: Cross-sectional study. Sultan Qaboos Univ Med J. 2016 May;16(2):e217-23. Doi: https://doi.org/10.18295/squmj.2016.16.02.013 PMid:27226914 PMCid:PMC4868522

Lovibond SH, Lovibond PF. Manual for the Depression Anxie-ty Stress Scales. 2nd ed. Sydney: Psychology Foundation; 1995. Doi: https://doi.org/10.1037/t01004-000

Kumar K, Kumar S, Mehrotra D, Tiwari SC, Kumar V, Dwivedi RC. Reliability and psychometric validity of Hindi version of Depression, Anxiety and Stress Scale-21 (DASS-21) for Hindi speaking Head Neck Cancer and Oral Potentially Malignant Disorders Patients. J Cancer Res Ther. 2019;15(3):653-658. Doi: https://doi.org/10.4103/jcrt.JCRT_281_17 PMid:31169235

Alam, M. N., Husain, A., Quarashi, S. A., (2017). The pattern of skin and venereal disorders among patients attending in the OPD of dermatology and venereology department of a ter-tiary care private hospital, Dhaka, Bangladesh. Journal of Pa-kistan Association of Dermatologists. 27 (1), 10-14 Doi: https://doi.org/10.3329/bjms.v16i3.32846

Seyhan M, Aki T, Karincaoglu Y, Ozcan H. Psychiatric morbidi-ty in dermatology patients: Frequency and results of consul-tations. Indian J Dermatol 2006;51:18-22. Doi: https://doi.org/10.4103/0019-5154.25181

Wessley , S., & Lewis, G. (1989). The Classification of Psychiat-ric Morbidity in Attenders at a Dermatology Clinic. British Journal of Psychiatry, 155(5), 686-691. doi:10.1192/bjp.155. 5.686 Doi: https://doi.org/10.1192/bjp.155.5.686 PMid:2611599

Gupta, M.A., Gupta, A.K., Ellis, C.N and Koblenzer, C.S. (2005). Psychiatric evaluation of the dermatology patient. Dermatol Clinic; 23(4): 591-9. Doi: https://doi.org/10.1016/j.det.2005.05.005 PMid:16112434

Aktan S, Ozmen E, Sanli B. Psychiatric disorders in patients attending a dermatology outpatient clinic. Dermatology. 1998; 197:230-4. Doi: https://doi.org/10.1159/000018002 PMid:9812026

Matoo SK, Handa S, Kaur, Malhotra R,Psychiatric morbidity in psoriasis and vitiligo- a comparative study from India, In-dian Journal of dermatology 2001 ;28:424-32. Doi: https://doi.org/10.1111/j.1346-8138.2001.tb00004.x PMid:11560159

Gupta MA. Gupta AK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemi-ology and management. Am J Clin Dermatol 2003; 4: 833-42. Doi: https://doi.org/10.2165/00128071-200304120-00003 PMid:14640776

Singh P; Mahmood N; Padhi D. A Study of Prevalence of Psy-chiatric Morbidities in Patients with Dermatological Disor-ders.IJCMR; 2020 7(12) L1: L5.

Picardi A, Abeni D, Renzi C, Braga M, Melchi CF, Pasquini P. Treatment outcome and incidence of psychiatric disorders in dermatological outpatients. J Eur Acad Dermatol Venereol. 2003;17:155-9 Doi: https://doi.org/10.1046/j.1468-3083.2003.00619.x PMid:12705743

Muamer Seyhan, Psychiatric morbidity in out- patients of dermatology, Department of dermatology, Inonu university of medical faculty, Turkey, Indian journal of dermatology, 2007,40-44

Ahmed AE, Al-Dahmash AM, Al-Boqami QT, Al-Tebainawi YF. Depression, Anxiety and Stress among Saudi Arabian Derma-tology Patients: Cross-sectional study. Sultan Qaboos Univ Med J. 2016 May;16(2):e217-23. Doi: https://doi.org/10.18295/squmj.2016.16.02.013 PMid:27226914 PMCid:PMC4868522

Aslam, R., Qadir, A., & Asad, F. (2007). Psychiatric morbidity in dermatological outpatients: an issue to be recognized. Journal of Pakistan Association of Dermatologists, 17(4), 235-239.

Picardi A, Abeni D, Melchi CF, Puddu P, Pasquini P. Psychiatric morbidity in dermatological outpatients: an issue to be rec-ognized. British Journal of dermatology. 2000;143(5):983-91. Doi: https://doi.org/10.1046/j.1365-2133.2000.03831.x PMid:11069507

Woodruff PWR, Higgins EM, Vivier AW. Psychiatric illness in patients referred to a dermatology-psychiatry clinic. Gen Hosp Psychiatry. 1997; 19(1):29-35 Doi: https://doi.org/10.1016/S0163-8343(97)00155-2 PMid:9034809

Korabel H, Dudek D, Jaworek A, Wojas-Pelc A. Psychoderma-tology: Psychological and psychiatrical aspects of aspects of dermatology. Przegl Lek. 2008;65:244-8