open access publication

Article, 2024

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 of the European Academy of Dermatology and Venereology, ISSN 1468-3083, 0926-9959, 10.1111/jdv.19913

Contributors

Zeidler, Claudia (Corresponding author) [1] Kupfer, J. [2] Dalgard, Florence J 0000-0002-5740-6541 [3] [4] Bewley, A. [5] Evers, A. W. M. [6] Gieler, Uwe [7] Lien, Lars 0000-0002-0480-9208 [8] [9] Sampogna, Francesca 0000-0002-7624-3290 [10] Aragones, Lucía Tomas 0000-0001-5891-628X [11] [12] Vulink, Nienke N C C [13] Finlay, A. Y. [14] Legat, Franz Josef [15] Titeca, Geraldine [16] Jemec, Gregor B E 0000-0002-0712-2540 [17] [18] Misery, Laurent 0000-0001-8088-7059 [19] Szabó, C. [20] Panovska, Vesna Grivcheva [21] van Koulil, S. Spillekom [22] Balieva, Flora Nicol 0000-0002-1939-2142 [23] [24] Szepietowski, Jacek Cezary 0000-0003-0766-6342 [25] Reich, Adam Andrzej 0000-0002-5573-1754 [26] Ferreira, Bárbara Roque 0000-0002-4808-6398 [27] [28] [29] Lvov, Andrey N [30] [31] Romanov, D V Romanov 0000-0002-1822-8973 [32] [33] [34] Marron, Servando Eugenio 0000-0001-5632-0351 [12] [35] Cazaña, Tamara Gracia [35] Elyas, Amna 0000-0003-1523-0653 [4] Altunay, İlknur Kıvanç 0000-0002-1354-7123 [36] Thompson, Andrew R [14] Van Beugen, Sylvia 0000-0001-8220-1807 [6] Ständer, Sonja 0000-0003-3612-7786 [1] Schut, Christina 0000-0001-5366-6285 [2]

Affiliations

  1. [1] University Hospital Münster
    2. [NORA names: Germany; Europe, EU; OECD];
  2. [2] University of Giessen
    3. [NORA names: Germany; Europe, EU; OECD];
  3. [3] Sykehuset i Vestfold
    4. [NORA names: Norway; Europe, Non-EU; Nordic; OECD];
  4. [4] Skåne University Hospital
    5. [NORA names: Sweden; Europe, EU; Nordic; OECD];
  5. [5] Queen Mary University of London
    6. [NORA names: United Kingdom; Europe, Non-EU; OECD];

Abstract

BACKGROUND: 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. RESULTS: 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. CONCLUSION: 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.

Keywords

European, European Society for Dermatology and Psychiatry, European countries, European multi-centre study, analysis, anxiety, assessment, association, attributes, cases, centre, clinic, clinically relevant anxiety, cohort, cohort of patients, connection, countries, depression, dermatitis, dermatologists, dermatology, dermatology patients, dermatoses, differences, duration, elevated anxiety, experiences of stigmatization, experiments, factors, females, frequency, gender, health status, healthcare, healthcare resources, individuals, intensity, intervention, itch duration, itch intensity, itch-related quality of life, itching, itchy dermatosis, levels, levels of anxiety, life, linear regression analysis, multi-centre study, overall health status, patient cohort, patients, perceived stigmatization, perceived stress, perception, perception of stress, psychiatry, psychological assessment, psychological factors, psychological interventions, psychological strain, quality of life, questionnaire, regression analysis, relationship, relevant anxiety, resources, results, rosacea, scores, seborrheic dermatitis, severity, severity of itching, status, stigmatization, stigmatization scores, stigmatizing experiences, strain, stress, study, symptoms, variation

Data Provider: Digital Science

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