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BACKGROUND: Dysmorphic concern is an overconcern with an imagined or slight defect in physical appearance that can be a symptom of body dysmorphic disorder (BDD). Appearance-related concerns are frequently reported by people with dermatological conditions. However, relatively little remains known about the relationship between dysmorphic concern and other variables within persons with different skin conditions. OBJECTIVES: The aim of this multicentre, cross-sectional study was to investigate gender differences regarding dysmorphic concern and the prevalence of BDD in a large sample of patients with skin conditions, in relation to sociodemographic, clinical and psychological variables. METHODS: Participants aged ≥18 years with skin conditions were consecutively enrolled in dermatological clinics of 22 European centres. Dysmorphic concern and the possible presence of BDD were measured using the Dysmorphic Concern Questionnaire (DCQ) and compared between men and women in relation to sociodemographic, clinical and psychological variables, and separately for each skin condition. RESULTS: The DCQ questionnaire was completed by 5290 dermatological patients. In all categories, mean scores were significantly higher in women than in men. Mean DCQ scores were also higher in women for most skin conditions, with the highest effect size in vitiligo. The percentage of patients who screened positive for BDD on the DCQ was 10.5%, 7.7% of men and 12.7% of women. The prevalence of BDD positive was 6.9% in patients with mild clinical severity, 11.1% for moderate and 19.1% for severe condition. In the multivariate model in patients with mild skin condition, the presence of BDD was positively associated with stress and stigma both in men and in women. CONCLUSIONS: Dysmorphic concern and BDD were more frequent in women than in men with skin conditions. Both received and actual stigmatization might have an impact on body-related concerns, in particular in women, who may be more at risk for sociocultural reasons.
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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.
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Ansiedad , Depresión , Prurito , Estrés Psicológico , Humanos , Prurito/psicología , Depresión/psicología , Femenino , Masculino , Estrés Psicológico/psicología , Ansiedad/psicología , Europa (Continente) , Persona de Mediana Edad , Adulto , Enfermedades de la Piel/psicología , Calidad de Vida , Estereotipo , Encuestas y Cuestionarios , Anciano , Índice de Severidad de la EnfermedadRESUMEN
A mortality event involving 23 allied rock-wallabies (Petrogale assimilis) displaying neurological signs and sudden death occurred in late April to May 2021 in a suburban residential area directly adjacent to Magnetic Island National Park, on Magnetic Island (Yunbenun), North Queensland, Australia. Three allied rock-wallabies were submitted for necropsy, and in all three cases, the cause of death was disseminated toxoplasmosis. This mortality event was unusual because only a small, localised population of native wallabies inhabiting a periurban area on a tropical island in the Great Barrier Reef World Heritage Area were affected. A disease investigation determined the outbreak was likely linked to the presence of free-ranging feral and domesticated cats inhabiting the area. There were no significant deaths of other wallabies or wildlife in the same or other parts of Magnetic Island (Yunbenun) at the time of the outbreak. This is the first reported case of toxoplasmosis in allied rock-wallabies (Petrogale assimilis), and this investigation highlights the importance of protecting native wildlife species from an infectious and potentially fatal parasitic disease.
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Brotes de Enfermedades , Macropodidae , Toxoplasmosis Animal , Animales , Gatos , Animales Salvajes/parasitología , Brotes de Enfermedades/veterinaria , Epidemias/veterinaria , Islas , Macropodidae/parasitología , Queensland/epidemiología , Toxoplasma , Toxoplasmosis Animal/epidemiología , Toxoplasmosis Animal/mortalidadRESUMEN
Small molecules that bind to allosteric sites on target proteins to alter protein function are highly sought in drug discovery. High-throughput screening (HTS) assays are needed to facilitate the direct discovery of allosterically active compounds. We have developed technology for high-throughput time-resolved fluorescence lifetime detection of fluorescence resonance energy transfer (FRET), which enables the detection of allosteric modulators by monitoring changes in protein structure. We tested this approach at the industrial scale by adapting an allosteric FRET sensor of cardiac myosin to high-throughput screening (HTS), based on technology provided by Photonic Pharma and the University of Minnesota, and then used the sensor to screen 1.6 million compounds in the HTS facility at Bristol Myers Squibb. The results identified allosteric activators and inhibitors of cardiac myosin that do not compete with ATP binding, demonstrating high potential for FLT-based drug discovery.
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Transferencia Resonante de Energía de Fluorescencia , Ensayos Analíticos de Alto Rendimiento , Ensayos Analíticos de Alto Rendimiento/métodos , Transferencia Resonante de Energía de Fluorescencia/métodos , Miosinas Cardíacas , Descubrimiento de Drogas/métodosAsunto(s)
Dermatología , Hipopigmentación , Vitíligo , Dermatólogos , Humanos , Vitíligo/diagnóstico , Vitíligo/terapiaRESUMEN
BACKGROUND: Skin conditions have a large emotional, psychological and psychiatric impact on the individual. The All-Party Parliamentary Group on Skin (APPGS) commissioned a qualitative survey to further explore this relationship alongside the experiences of those accessing services in relation to these difficulties in the UK. AIM: To examine the experiences of UK individuals living with a skin condition, and their views of seeking and receiving psychological treatment. This survey formed part of the evidence collected in the preparation of the APPGS Mental Health and Skin Disease report. METHODS: A free-text electronic survey was widely distributed by professional bodies and skin-related charities. Responses were analysed using descriptive thematic analysis and descriptive statistics. Data for each question were classified and labelled, leading to the development of a coding frame. Inter-rater reliability was assessed using Cohen kappa statistic. RESULTS: In total, 544 participants (84% female) completed the survey. The majority of respondents had inflammatory skin diseases such as eczema (43%) or psoriasis (33%). The thematic analysis revealed five key themes associated with impact on mood; impact of intimacy; impact on activities of daily living; lack of recognition from others of the impact; and lack of accessible services. CONCLUSION: The survey demonstrates that there is an urgent need to improve both awareness of the impact that skin conditions can have, and for the provision of psychological services to address this impact.
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Accesibilidad a los Servicios de Salud , Sistemas de Apoyo Psicosocial , Enfermedades de la Piel/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Autoinforme , Enfermedades de la Piel/terapia , Reino UnidoAsunto(s)
Dermatología/métodos , Práctica Asociada/normas , Psicología/métodos , Investigación/normas , Enfermedades de la Piel/psicología , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/psicología , COVID-19/virología , Depresión/etiología , Depresión/psicología , Dermatología/normas , Desconcierto , Humanos , Servicios de Salud Mental/economía , Fobia Social/etiología , Fobia Social/psicología , Distrés Psicológico , Psicología/normas , Calidad de Vida , SARS-CoV-2/genética , SARS-CoV-2/aislamiento & purificación , Enfermedades de la Piel/patología , Enfermedades de la Piel/terapiaAsunto(s)
Melanoma , Recurrencia Local de Neoplasia , Ansiedad , Miedo , Estudios de Seguimiento , Humanos , MasculinoRESUMEN
BACKGROUND: Those affected by alopecia are at risk of experiencing a range of psychosocial consequences. Alopecia UK provides online peer support via facilitated Facebook pages. Online peer support has been found to provide a variety of benefits in other long-term conditions, such as providing information and emotional support. OBJECTIVES: This study sought to gain an experiential account as to how online support provides benefit to people living with alopecia. METHODS: A purposive sample of 12 participants was recruited directly from Alopecia UK's Facebook group. A total of 11 were diagnosed with alopecia and one participant was a family member of someone with alopecia. The qualitative approach of Interpretative Phenomenological Analysis was used to guide data collection and analysis. Participants took part in online synchronous interviews, which drew on review of participant-selected screenshots of online activity. RESULTS: Four themes were identified, including 'gradual healing', 'image concern', 'belonging' and 'new identity and self-acceptance'. The participants made use of the group through expressing emotion, finding practical advice, and also as a place to connect and share experiences. Participants also reported that the online support facilitated the return of social confidence. CONCLUSIONS: This study provides a detailed understanding as to how online peer support groups can be beneficial. Online groups have the potential to create a feeling of belonging, which can develop a sense of being accepted and understood and as such can be important in maintaining psychological well-being. The findings indicate that online groups have the potential to be used as a platform for assisting people in developing both effective coping styles and feeling understood, and such platforms warrant further investment by healthcare professionals. What's already known about this topic? Alopecia may be associated with psychosocial distress due to both the individual impact and the reactions of others. Online peer support is known to be a beneficial method of providing psychosocial support for people living with a range of health conditions. What does this study add? An in-depth view of the benefits experienced through belonging to an online peer support group for those diagnosed with alopecia, in addressing the psychosocial effects experienced with the condition. This research highlights the need for further investigation of the utility of supporting the development of online peer support for people living with skin conditions. Online peer support groups could be highly effective to use in combination with existing psychological therapies to connect others with shared experience. What are the clinical implications of this work? People living with alopecia can benefit from peer support, and healthcare professionals should ensure that patients know where they can gain access to both psychological support and peer support.
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Adaptación Psicológica , Alopecia/psicología , Grupo Paritario , Grupos de Autoayuda/organización & administración , Medios de Comunicación Sociales/organización & administración , Adulto , Consejo , Femenino , Humanos , Persona de Mediana Edad , Investigación Cualitativa , Calidad de Vida , Encuestas y CuestionariosAsunto(s)
Cosméticos/administración & dosificación , Estética , Enfermedades de la Piel/rehabilitación , Estrés Psicológico/prevención & control , Administración Cutánea , Anciano , Femenino , Humanos , Persona de Mediana Edad , Investigación Cualitativa , Calidad de Vida , Piel , Enfermedades de la Piel/complicaciones , Enfermedades de la Piel/patología , Enfermedades de la Piel/psicología , Estereotipo , Estrés Psicológico/etiología , Estrés Psicológico/psicologíaAsunto(s)
Calidad de Vida , Enfermedades de la Piel , Ansiedad , Trastornos de Ansiedad , Humanos , AutoimagenAsunto(s)
Empatía , Imágenes en Psicoterapia/métodos , Atención Plena/métodos , Enfermedades de la Piel/terapia , Adulto , Anciano , Ansiedad/terapia , Retroalimentación Psicológica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Autocuidado , Autoimagen , Autoevaluación (Psicología) , Vergüenza , Enfermedades de la Piel/psicología , Resultado del TratamientoRESUMEN
BACKGROUND: While rosacea is a chronic skin condition, it can often have a large psychosocial impact on the individual. There is therefore a need to understand the experience of living with rosacea from the patient perspective. OBJECTIVES: To examine the experience of living with rosacea and the experience of seeking and receiving treatment. METHODS: Nine participants took part in semistructured interviews, which were analysed using interpretative phenomenological analysis. RESULTS: Three superordinate themes were identified within the data: 'self-consciousness', which focused on the fear of others assigning blame to participants for having caused symptoms; 'avoidance, concealment and hiding emotions', referring to the coping strategies participants employed in response to rosacea; and 'inconsistencies in general practitioner treatment and guidance', which focused on the need for medical professionals to assess the psychosocial well-being of patients with rosacea. CONCLUSIONS: Rosacea can have a negative impact on the daily life of people with the condition, contributing to lowered self-esteem, embarrassment and feelings of shame. Engaging in emotion-focused and behavioural/avoidant-focused coping strategies increased participants' confidence and reduced their avoidance of social situations. However, such strategies might still serve to maintain underlying unhelpful cognitive processes. Consequently, it is important for medical professionals to assess for the presence of cognitive factors that might contribute to maintaining distress in patients with rosacea, and where unhelpful thoughts or beliefs are reported, patients may need to be referred for psychological support.
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Rosácea/psicología , Adaptación Psicológica , Adulto , Emociones , Miedo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Satisfacción del Paciente , Relaciones Médico-Paciente , Calidad de Vida , Estudios Retrospectivos , Rosácea/terapia , Autoimagen , Vergüenza , Adulto JovenRESUMEN
BACKGROUND: Vitiligo is a chronic disorder causing skin depigmentation with global prevalence varying from 0·2% to 1·8%. U.K. guidelines recommend assessment of psychological state during clinical evaluation of vitiligo. However, the prevalence of psychological comorbidity in people with vitiligo has not been described. OBJECTIVES: To establish the prevalence of psychological symptoms or disorders in people with vitiligo and describe the outcome measures used. METHODS: We performed a comprehensive search of MEDLINE, Embase, CINAHL and PsycINFO to identify observational studies assessing the prevalence of psychological symptoms or disorders (December 2016). DerSimonian and Lard random-effects models were used to estimate the overall pooled prevalence. RESULTS: We identified 29 studies with 2530 people with vitiligo. Most studies included a measure of either depression (n = 25) or anxiety (n = 13). The commonest tools were the Hospital Anxiety and Depression Scale and the Centre for Epidemiology Studies Depression Scale. Ten studies provided information on 13 other psychological outcomes. Pooled prevalence using depression-specific and anxiety-specific questionnaires was 0·29 [95% confidence interval (CI) 0·21-0·38] and 0·33 (95% CI 0·18-0·49), respectively. Prevalence was lower for clinically diagnosed depression (0·21, 95% CI 0·15-0·28) and anxiety (0·15, 95% CI 0·06-0·24). When nonspecific tools were used the prevalence remained similar for depression (0·27, 95% CI 0·08-0·46) but increased for anxiety (0·46, 95% CI 0·39-0·52). High heterogeneity was observed. CONCLUSIONS: A range of psychological outcomes are common in people with vitiligo. The prevalence of anxiety was influenced by type of screening tool, suggesting the need for validation of psychological outcome screening tools in the field of dermatology.
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Trastornos de Ansiedad/etiología , Trastorno Depresivo/etiología , Vitíligo/psicología , Trastornos de Ansiedad/epidemiología , Trastorno Depresivo/epidemiología , Femenino , Humanos , Masculino , Estudios Observacionales como Asunto , Prevalencia , Escalas de Valoración Psiquiátrica , Proyectos de Investigación , Vitíligo/epidemiologíaRESUMEN
BACKGROUND: Skin conditions can be associated with significant psychological distress. Investigation of attachment orientation and associated use of coping strategies is a promising perspective from which to investigate psychological adjustment to skin conditions. OBJECTIVES: To examine the role of adult attachment orientation, conceptualized as two dimensions - attachment avoidance and attachment anxiety - in psychological adjustment [appearance-related distress and skin-related quality of life (QoL)], and the mediating role of two coping strategies - defeatism and activity. METHODS: Attachment avoidance and attachment anxiety, use of coping strategies, appearance-related distress and skin-related QoL were assessed via a cross-sectional online survey in 207 adults with skin conditions. Multiple mediation analyses were performed using PROCESS pathway analysis. RESULTS: Overall, higher attachment avoidance and higher attachment anxiety were associated with higher appearance-related distress and greater impact on emotions and functioning aspects of QoL. For attachment anxiety, the relationship was fully explained by more frequent use of defeatism coping. For attachment avoidance, the relationship was partially explained by more frequent use of defeatism coping (and in the case of appearance-related distress also more frequent use of activity coping), and higher attachment avoidance was also associated with poorer psychological adjustment in a way that could not be explained by use of assessed coping strategies. CONCLUSIONS: Insecure attachment orientation (high attachment avoidance or high attachment anxiety) is linked to poorer adjustment. People with insecure attachment might benefit from psychological interventions that target underlying attachment orientation.
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Adaptación Psicológica , Apego a Objetos , Enfermedades de la Piel/psicología , Adolescente , Adulto , Anciano , Estudios Transversales , Ajuste Emocional , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Estrés Psicológico/etiología , Adulto JovenRESUMEN
BACKGROUND: Individuals with visible skin conditions often experience stigmatization and discrimination. This may trigger maladaptive responses such as feelings of anger and hostility, with negative consequences to social interactions and relationships. OBJECTIVE: To identify psychosocial factors contributing to aggression levels in dermatology patients. METHODS: Data were obtained from 91 participants recruited from outpatient clinics in the north of England, U.K. This study used dermatology-specific data extracted from a large U.K. database of medical conditions collected by The Appearance Research Collaboration. This study looked at the impact of optimism, perceptions of social support and social acceptance, fear of negative evaluation, appearance concern, appearance discrepancy, social comparison and well-being on aggression levels in a sample of dermatology patients. RESULTS: In order to assess the relationship between variables, a hierarchical regression analysis was performed. Dispositional style (optimism) was shown to have a strong negative relationship with aggression (ß = -0·37, t = -2·97, P = 0·004). Higher levels of perceived social support were significantly associated with lower levels of aggression (ß = -0·26, t = -2·26, P = 0·02). Anxiety was also found to have a significant positive relationship with aggression (ß = 0·36, t = 2·56, P = 0·01). CONCLUSIONS: This study provides evidence for the importance of perceived social support and optimism in psychological adjustment to skin conditions. Psychosocial interventions provided to dermatology patients might need to address aggression levels and seek to enhance social support and the ability to be optimistic.
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Agresión/psicología , Trastornos de Ansiedad/psicología , Optimismo , Enfermedades de la Piel/psicología , Apoyo Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Prejuicio , Calidad de Vida , Estigma Social , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Mindfulness, defined as purposively and nonjudgementally paying attention in the present moment, could be used within psychosocial interventions to reduce the distress associated with social anxiety and avoidance found in many skin conditions. However, little is known about the relationship between naturally occurring levels of mindfulness and distress in dermatology patients. OBJECTIVES: To examine the relationship between mindfulness and psychosocial distress in a dermatological population. It was hypothesized that higher levels of mindfulness would be associated with lower levels of social anxiety, anxiety, depression and skin shame, and with better quality of life. METHODS: Adult dermatology outpatients (n = 120) from one hospital completed items assessing subjective severity, skin shame, fear of negative evaluation, anxiety and depression, quality of life, and levels of mindfulness. RESULTS: Considering depression, 14% reported mild, 5% moderate and 2·5% severe symptoms. For anxiety, 22% reported mild, 23% moderate and 6% severe symptoms. In addition, 33·4% reported clinically significant social anxiety. After controlling for subjective severity, mindfulness explained an additional 19% of the variance in depression, 39% in anxiety, 41% in social anxiety, 13% in skin shame and 6% in dermatological quality of life. One specific facet of mindfulness (acting with awareness) was found to be the most consistent predictor of distress. CONCLUSIONS: The findings indicate that higher levels of mindfulness are associated with lower distress. This suggests that facilitating mindfulness may be helpful in reducing distress in dermatology patients, and the use of mindfulness techniques warrants further investigation.