Psychiatric Comorbidity and Quality of Life in Patients with Dermatologic Diseases

By Arbabi, Mohammad; Zhand, Naista et al. | Iranian Journal of Psychiatry, Summer 2009 | Go to article overview

Psychiatric Comorbidity and Quality of Life in Patients with Dermatologic Diseases


Arbabi, Mohammad, Zhand, Naista, Samadi, Zahra, Ghaninejad, Hayede, Golestan, Banafshe, Iranian Journal of Psychiatry


Objective: The aim of this study was to evaluate the prevalence of psychiatric disorders in patients with dermatologic disease and its relationship to the patients' quality of life.

Method: This study was cross-sectional. A total of 414 patients with various dermatologic diseases participated in this study. The participants were recruited from an outpatient clinic and inpatient ward of a referral dermatologic hospital using a simple random sampling method. Demographic variables, duration and characteristics of disease and admission status were recorded. Patients were asked to complete two questionnaires: GHQ-28 (General Health Questionnaire) ,and DLQI (Dermatologic Life Quality Index).

Results: The estimated prevalence of psychiatric comorbidity in dermatologic patients was %51.3.There was a significant relationship between GHQ score and educational level, marriage statues, type and course of dermatologic disease and admission status (p<0.05). The probability of psychiatric disorders increased among patients with lower educational level, married subjects, patients with relapse of the disease and those having some special skin diseases such as Psoriasis and Pemphigus. However, no significant relationship was observed between the GHQ score and duration of disease and sex. Moreover, there was a significant relationship between quality of life and educational level, marriage status, type of dermatologic disease, course of disease and admission status (p<0.05). Higher quality of life was observed among participants with higher educational level, those who were unmarried, patients with first episode and milder diseases. This study shows a significant relationship between quality of life and mental health (p<0.05). The lower probability of concomitant mental disorder, the higher the quality of life.

Conclusion: Psychiatric disorders are frequent among patients with dermatologic diseases. These disorders have a negative effect on quality of life. Psychiatric consultation, liaison services and education in dermatologic wards can help the diagnosis, treatment and follow up of psychiatric comorbidity in dermatologic patients.

Keywords: Comorbidity, Mental disorders, Quality of life, Skin Diseases

Iran J Psychiatry 2009; 4: 102-106

Dermatologic diseases are often accompanied by changes in patients' appearances which are visible to others. This could have negative impacts on patients' self image, self-esteem and interpersonal interaction. The psychosocial burden of skin diseases should not be ignored as it can potentially affect the overall disability experienced by the patient (1).

The relation between psychiatry and skin diseases can be evaluated from two aspects: On one hand, psychiatric comorbidity influences the development and course of dermatologic diseases via the effects of stress, depression, and anxiety (2). On the other hand, cosmetically disfiguring dermatologic diseases may cause significant psychosocial distress for patients (3).

Comorbid mental illness play a substantial role in course, severity, response to therapy and therefore the psychosocial well-being of the dermatologic patients. It seems that comorbid mental illness and its consequences on patients' quality of life have been underappreciated. Therefore, understanding the prevalence of psychiatric comorbidity and its potential effects on patients' lives may lead to changes in management approaches and ultimately to improve the patients' outcome.

Most of the previous studies have worked on specific diseases such as: psoriasis, acne, vitiligo, genital herpes, alopecia areata, hirsutism and their association with psychiatric comorbidity. Nevertheless, little research has been conducted on the effects of different variables in this field, alongside with its impact on the patients' quality of life (4). Mecri and his colleagues found that a decreased quality of life in vitiligo patients is mainly related to the psychiatric co morbidity (5). …

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