Amir Ahmed ElKhalifa Mufaddel MD-Sudan Medical Specialisation Board. Adjunct Lecturer, United Arab Emirates University Community Mental Health Services,

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Presentation transcript:

Amir Ahmed ElKhalifa Mufaddel MD-Sudan Medical Specialisation Board. Adjunct Lecturer, United Arab Emirates University Community Mental Health Services, Behavioural Sciences Institute, Al Ain Hospital, P.O. Box 1006, United Arab Emirates Several studies reported high rates of psychiatric comorbidities for specific dermatological disorders such as psoriasis and acne. The aim of this study was to estimate the prevalence of anxiety and depression in patients with diverse dermatological diagnoses compared with healthy control subjects. HADS-D scores above the cut off points were significantly higher in patients with psoriasis (P = ), vitiligo (P = ), acne (P = ), and eczema (P = ) compared with healthy subjects. Similarly, HADS-A scores above the cut off points were significantly higher in patients with psoriasis (P < ), vitiligo (P = ), acne (P = ) and eczema (P = ) compared with healthy subjects. No significant difference between the control group and patients with other dermatologic conditions regarding both HADS-D and HADS-A scores. Using ICD-10 criteria for clinical psychiatric diagnoses indicated that 52.3% of dermatology patients had an associated ICD-10 diagnosis; most commonly anxiety disorders (28.6%), and depression (21.9%). ICD-10 diagnoses of anxiety disorders included: OCD (13.3%) generalized anxiety disorder (5.7%), panic disorder (4.8%), phobic anxiety disorder (3.8%) and post-traumatic stress disorder (0.95%). The findings of this study suggest that dermatological disorders are associated with high psychiatric comorbidity, particularly anxiety and depressive disorders. Screening for anxiety and depressive symptoms may be helpful for early diagnosis and management of associated psychiatric symptoms. The study was conducted in dermatology outpatient clinic in Khartoum. A total of 105 consecutive patients and 105 healthy control subjects were recruited. Hospital Anxiety and Depression Scale (HADS) was used to determine the levels of anxiety and depression. ICD-10 criteria were used for clinical diagnosis of psychiatric comorbidities. OBJECTIVESMETHODS RESULTS CONCLUSIONS REFERENCES Influence of Anxiety and Depression on Diverse Dermatological Conditions Influence of Anxiety and Depression on Diverse Dermatological Conditions HADS scores Depression 8+<8 P value Psoriasis (n=19) 0910 P= Vitiligo (n=24) 12 P< Eczema (n=16) 0907 P= Acne (n=20) 10 P= Others (n=26) 1808 P= Control (n=105) 2184 HADS Scores Anxiety <8 8+ P value Psoriasis (n=19) 0514 P < Vitiligo (n=24) 0915 P = Eczema (n=16) 08 P = Acne (n=20) 10 P= Others (n=26) 1610 P= Control (n=105) 8322 Table1. HADS depression scores in patients with different dermatological conditions compared with control subjects. Table 3. ICD-10 psychiatric diagnoses in psoriasis, vitiligo, eczema and acne compared with patients of other dermatological diagnoses. Table2. HADS-anxiety scores in patients with different dermatological conditions compared with control subjects. N% Depression2321.9% Anxiety Disorders: OCD GAD Phobic anxiety disorder Panic disorder PTSD Total % 05.7% 03.8% 04.8% 0.95% 28.6% Other psychiatric diagnoses % No current psychiatric diagnosis % Total105100% ICD-10 Psychiatric diagnosis YesNo Psoriasis (n=19) % 4 P <0.003 Vitiligo (n=24) % 10 P = Eczema (n=16) % 7 P =0.168 Acne (n=20) 8 40% 12 P = Others (n=26) % 17 Total % 50 Table 4. Types of ICD-10 psychiatric diagnoses in patients presenting with dermatological conditions. 1.Mufaddel, A., Abdelghani, A.E. Psychiatric Comorbidity in Patients with Psoriasis, Vitiligo, Acne, Eczema and Group of Patients with Miscellaneous Dermatological Diagnoses. Open Journal of Psychiatry, 2014; 4,: Picardi A, Abeni D, Melchi CF, Puddu P, Pasquini P. Psychiatric morbidity in dermatological outpatients: an issue to be recognized. Br J Dermatol. 2000;143(5): Osman OT, Mufaddel A, Almugaddam F, Augusterfer E. The psychiatric aspects of skin disorders. Expert Rev. Dermatol. 2011; 6(2): Gupta MA, Gupta AK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol. 2003;4(12): Mufaddel A, Osman, OT, Almugaddam, F. Adverse cutaneous effects of psychotropic medications. Expert Reviews Dermatol. December 2013, Vol. 8, No. 6, Pages Figure 1. ICD-10 diagnosis of depression in patients with psoriasis, vitiligo, acne, and eczema compared with patients presented with other dermatological conditions. ICD-10 diagnosis of depression was most commonly reported in patients with psoriasis (36.8%) followed by eczema (31.2%) and acne (30%). Significantly higher rates of depression were found among psoriasis group of patients compared with the miscellaneous group of patients (P =0.0437). No statistically significant differences were found between, eczema (P= ), acne (P =0.1177) and vitiligo (P=0.7059) compared with the miscellaneous group of dermatological disorders. Figure 2. ICD-10 diagnosis of anxiety disorder in patients with psoriasis, vitiligo, acne, and eczema compared with patients presented with other dermatological conditions. ICD-10 diagnoses of anxiety disorders were most commonly reported in patients with vitiligo (45.8%) and psoriasis (42.1%). Significantly higher rates of anxiety disorders were found in vitiligo group of patients compared with the miscellaneous group of patients (P= ). No statistically significant differences were found between psoriasis (P=0.0945), eczema (P= ) and acne (P=0.3876) compared with the miscellaneous group of dermatological disorders.