Pattern of dermatoses and underlying psychopathological disorders in patients attending dermatology clinic in earthquake affected areas of Azad Kashmir

ABSTRACT

Psychological stress such as sexual assault, major earthquake, or plane crash has long been recognized as an etiological or precipitating factor in dermatological disorders. Treatment of these patients comprises of not only management of dermatological disorders but also on treating the underlying psychopathological diseases. These disorders can be identified by the application of the twelve item General Health Questionnaire [GHQ-12] which is a self-administered screening tool requiring only few minutes to complete and score the findings. To recognize different types of dermatoses and screen the patients for associated psychopathological disorders using General Health Questionnaire [GHQ-12] in the earthquake affected areas of Azad Kashmir. Subjects and an outpatient dermatology clinic was set up in the earthquake affected area of Muzaffarabad for four days. As it was advertised to be a dermatology specific clinic, so all patients presenting with some dermatological disorder were enrolled using non-probability convenient sampling technique. Demographic data was filled by social workers and clinical data was recorded by dermatologists on a specially designed pro forma. The patients were asked to complete 12 items General Health Questionnaire [GHQ] which was filled by patients who were literate while for others social workers assisted. Chi-Square test was used for data analysis. A total of 522 patients with different skin diseases were enrolled Dermatological infestations were seen in 207 [39%] cases followed by eczemas 90 [17.3%] and infections 80 [15.3%]. Stress mediated dermatological problems like acne 40 [7.6%] and psoriasis 27[5%] were found in these cases. Overall 192 [36.8%] patients were living in shelter based homeless situation and psychiatric morbidity was seen in 55% [173] cases having dermatological illness. Infestations, infections and eczemas were the most common skin diseases seen in earthquake victims and increased psychiatric morbidity may be responsible for rise in stress related dermatological disorders