Subject(s)
Dermatologists , Health Services Needs and Demand , Needs Assessment , Patients , Pemphigoid, Bullous/therapy , Research Personnel , Adult , Aged , Aged, 80 and over , Attitude of Health Personnel , Dermatologists/psychology , Female , Health Care Surveys , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Patients/psychology , Pemphigoid, Bullous/diagnosis , Pemphigoid, Bullous/psychology , Research Personnel/psychology , Stakeholder ParticipationSubject(s)
Autoantibodies/immunology , Dementia/complications , Pemphigoid, Bullous/psychology , Aged, 80 and over , Alzheimer Disease/complications , Alzheimer Disease/immunology , Autoantigens/immunology , Dementia/immunology , Dystonin/immunology , Female , Humans , Non-Fibrillar Collagens/immunology , Pemphigoid, Bullous/immunology , Collagen Type XVIIABSTRACT
BACKGROUND:: Bullous pemphigoid (BP) is a chronic, autoimmune blistering skin disease that affects patients' daily life and psychosocial well-being. OBJECTIVE:: The aim of the study was to evaluate the quality of life, anxiety, depression and loneliness in BP patients. METHODS:: Fifty-seven BP patients and fifty-seven healthy controls were recruited for the study. The quality of life of each patient was assessed using the Dermatology Life Quality Index (DLQI) scale. Moreover, they were evaluated for anxiety and depression according to the Hospital Anxiety Depression Scale (HADS-scale), while loneliness was measured through the Loneliness Scale-Version 3 (UCLA) scale. RESULTS:: The mean DLQI score was 9.45±3.34. Statistically significant differences on the HADS total scale and in HADS-depression subscale (p=0.015 and p=0.002, respectively) were documented. No statistically significant difference was found between the two groups on the HADS-anxiety subscale. Furthermore, significantly higher scores were recorded on the UCLA Scale compared with healthy volunteers (p=0.003). CONCLUSION:: BP had a significant impact on quality of life and the psychological status of patients, probably due to the appearance of unattractive lesions on the skin, functional problems and disease chronicity.
Subject(s)
Anxiety/psychology , Depression/psychology , Loneliness/psychology , Pemphigoid, Bullous/psychology , Quality of Life/psychology , Adult , Aged , Case-Control Studies , Female , Greece , Humans , Male , Middle Aged , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Abstract: Background: Bullous pemphigoid (BP) is a chronic, autoimmune blistering skin disease that affects patients' daily life and psychosocial well-being. Objective: The aim of the study was to evaluate the quality of life, anxiety, depression and loneliness in BP patients. Methods: Fifty-seven BP patients and fifty-seven healthy controls were recruited for the study. The quality of life of each patient was assessed using the Dermatology Life Quality Index (DLQI) scale. Moreover, they were evaluated for anxiety and depression according to the Hospital Anxiety Depression Scale (HADS-scale), while loneliness was measured through the Loneliness Scale-Version 3 (UCLA) scale. Results: The mean DLQI score was 9.45±3.34. Statistically significant differences on the HADS total scale and in HADS-depression subscale (p=0.015 and p=0.002, respectively) were documented. No statistically significant difference was found between the two groups on the HADS-anxiety subscale. Furthermore, significantly higher scores were recorded on the UCLA Scale compared with healthy volunteers (p=0.003). Conclusion: BP had a significant impact on quality of life and the psychological status of patients, probably due to the appearance of unattractive lesions on the skin, functional problems and disease chronicity.
Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Anxiety/psychology , Quality of Life/psychology , Pemphigoid, Bullous/psychology , Depression/psychology , Loneliness/psychology , Severity of Illness Index , Case-Control Studies , Surveys and Questionnaires , GreeceABSTRACT
UNLABELLED: To date, there is little data in the literature describing the anxiety and depressive disorders iatrogenic to corticosteroids. These disorders are common, underestimated, with potentially serious consequences that may jeopardize the patient's prognosis; their management is not consensual. OBJECTIVES: The objective of our work is to determine the prevalence of anxiety and depressive disorders induced by corticosteroids, assessing their accountability to the corticosteroids and studying their risk factors. METHODS: We conducted a prospective longitudinal study over 12months evaluating the prevalence of anxiety and depressive disorders in patients followed for chronic skin diseases treated with prolonged corticosteroid-therapy. Our patients were assessed using standardized instruments: the Mini International Neuropsychiatric Interview (MINI), the Hamilton Anxiety Scale (HAS) and the Beck Depression Inventory (BDI). RESULTS: Of 54 patients included, our study showed a high prevalence of anxiety and depressive disorders estimated at 27%. These disorders were divided into depressive disorder in 16% of cases, and anxiety disorder in 11% of cases. The early onset of these disorders was found during the first weeks of treatment. According to the Beck Depression Inventory (BDI), depression was moderate in 67% of cases; severe with suicide attempts in 22% of cases, and mild in 11% of cases. According to the Hamilton Anxiety Scale (HAS), anxiety was mild in 33% of cases and moderate in 67% of cases. The disorders observed were mainly distributed into: 33% deep pemphigus, 27% lupus, 13% bullous pemphigoid and 13% dermatomyositis. In this study the statistically significant risk factors are dose of corticosteroids and personal psychiatric history of the patient; in addition, there is a high prevalence of disorders in patients whose age exceeds 40 years, female gender, and patients treated for deep pemphigus. The evolution after pharmacological treatment and supportive psychotherapy was favorable in most patients. CONCLUSION: The psychiatric examination prior to prescription of long-term corticosteroid-therapy use should be standard practice to identify patients at risk, discuss the treatment modalities, and provide comprehensive care.
Subject(s)
Adrenal Cortex Hormones/adverse effects , Anxiety Disorders/chemically induced , Depressive Disorder/chemically induced , Adrenal Cortex Hormones/administration & dosage , Adult , Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , Cross-Sectional Studies , Depressive Disorder/diagnosis , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Depressive Disorder, Major/chemically induced , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Dermatomyositis/drug therapy , Dermatomyositis/epidemiology , Dermatomyositis/psychology , Dose-Response Relationship, Drug , Female , Humans , Iatrogenic Disease , Interview, Psychological , Long-Term Care , Longitudinal Studies , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/psychology , Male , Pemphigoid, Bullous/drug therapy , Pemphigoid, Bullous/epidemiology , Pemphigoid, Bullous/psychology , Pemphigus/drug therapy , Pemphigus/epidemiology , Pemphigus/psychology , Personality Inventory , Prospective Studies , Psychotherapy , Risk Factors , Suicide, Attempted/psychologySubject(s)
Humans , Male , Aged, 80 and over , Pemphigoid, Bullous/diagnosis , Pemphigoid, Bullous/drug therapy , Autoimmune Diseases/complications , Autoimmune Diseases/diagnosis , Fluorescent Antibody Technique, Direct/methods , Zinc Sulfate/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Petrolatum/therapeutic use , Vancomycin/therapeutic use , Pemphigoid, Bullous/physiopathology , Pemphigoid, Bullous/psychology , Immunoglobulin G , Vancomycin ResistanceABSTRACT
INTRODUCTION: The aims of this study were to test the validity and reliability of a newly developed discipline-specific questionnaire, the Chronic Oral Mucosal Diseases Questionnaire (COMDQ), to measure quality of life in patients with chronic oral mucosal conditions. MATERIALS AND METHODS: Two patient samples were recruited for the purposes of this study. First, a random sample of 160 patients attending the Oral Medicine Unit of Cork University Dental School and Hospital with the following chronic oral mucosal conditions, recurrent aphthous stomatitis, oral lichen planus, the more common vesiculobullous conditions (mucous membrane pemphigoid and pemphigus vulgaris) and orofacial granulomatosis. Second, the COMDQ was randomly distributed to a sample of 100 patients without a chronic oral mucosal condition. Convergent and discriminative validity and internal consistency of the newly developed questionnaire were assessed. RESULTS: This study has demonstrated that the newly developed questionnaire has good convergent validity with Pearson correlation coefficient of 0.819 with Oral Health Impact Profile-14 and 0.883 with Visual Analogue Scale for pain scores. The discriminative validity was also good with statistically significant differences between patients with chronic oral mucosal conditions and without chronic oral mucosal conditions. The new instrument has also demonstrated excellent reliability with Cronbach's alpha of 0.929. CONCLUSIONS: In conclusion, this study has demonstrated that the COMDQ is a valid and reliable measure to assess quality of life in patients with chronic oral mucosal diseases and therefore will be a valuable instrument in the management of these conditions.
Subject(s)
Mouth Diseases/psychology , Pemphigoid, Bullous/psychology , Pemphigus/psychology , Quality of Life/psychology , Surveys and Questionnaires , Case-Control Studies , Chronic Disease , Cost of Illness , Dental Health Surveys , Humans , Mouth Diseases/pathology , Mouth Mucosa/pathology , Pemphigoid, Bullous/pathology , Pemphigus/pathology , Reference Values , Reproducibility of Results , Self-AssessmentABSTRACT
An association between bullous pemphigoid and internal malignant neoplasms has been reported by many authors, primarily in case report formats. Stone and Schroeter, however, compared cases of bullous pemphigoid with age and sex-matched control patients with contact dermatitis and psoriasis and found no evidence of an increased association between malignant neoplasms and bullous pemphigoid. A few cases of bullous pemphigoid occurring after radiation therapy for malignant neoplasms have been reported. A case of bullous pemphigoid which occurred after radiation therapy for squamous carcinoma of the cervix is presented. The interactive intervention of a hospice interdisciplinary team was crucial to the care and resolution of this patient's dermatological condition. Medical, psychological, and social aspects of the case are discussed.
