Psychological correlates of quality of life in dermatology patients: the role of mental health and self-acceptance.

OBJECTIVES: Chronic skin diseases have been recognized as having a detrimental effect on patients' quality of life, also causing considerable mental discomfort. Reduced self-acceptance, low self-esteem, a negative body image, and a low sense of self-worth have been noted in patients with visible skin disorders. Yet in the available literature we could not find any data concerning the relationship between mental health status, self-image, and quality of life. This research, then, analyzes potential relationships between self-acceptance, mental health status, and quality of life in dermatology patients. MATERIALS AND METHODS: In total, 112 patients of the Occupational Diseases Outpatient Clinic and the Occupational and Environmental Allergy Centre of the Nofer Institute of Occupational Medicine (NIOM) were examined. The General Health Questionnaire (GHQ) was used to assess the patients' mental health; a Polish version of the Dermatology Life Quality Index (DLQI) was employed to assess life quality; and the Self-Acceptance Scale (SAS) served to obtain the patients' self-image. Results showed that there were statistically significant differences in self-assessment of mental health and quality of life depending on ones's level of self-acceptance. People with high self-acceptance are characterized by better mental health than those with low self-acceptance (t = 4.8; p = 0.00). Patients with a negative selfimage (compared to those with a positive self-image) also deem their quality of life to be poor (t = 3.1; p = 0.00). Results of regression analysis show that mental health status significantly affects the quality of life in dermatology patients; the standardized coefficient was beta = 0.42 (p < 0.0001). CONCLUSION: Relationships have been found to exist between the patient's mental health and both their subjective assessment of life quality and self-image. Taking into account the role of mental health as a potential determinant of quality of life among dermatology patients, and considering the strong correlation between self-acceptance and well-being, treatment should also focus on counseling.

[Sense of personal control and the level of occupational stress and related effects]. / Poczucie kontroli w miejscu pracy a poziom stresu zawodowego i zwiazane z nim skutki.

There is opinion that the sense of personal control at workplace is an important factor determining the occupational stress and related effects. The group of 160 policemen were studied to verify empirically the above-mentioned opinion. The subjects assessed their level of sense of personal control, occupational stress, burnout and mental health. Statistical analysis revealed following significant correlation coefficients between the sense of personal control and stress (r = -0.33); job satisfaction (r = -0.44); emotional exhaustion (r = -0.28); depersonalization (r = -0.26); and feeling of personal accomplishment (r = -0.25); total score in GHQ-28 (r = -0.16). The results of the study let us draw a practical conclusion. In order to diminish the level of job stress it is required to introduce proper organizational changes enhancing the sense of personal control among workers.

[Mental health status in workers: the results based on the Munich version of the International Composite Diagnostic Interview (M-CIDI)]. / Stan zdrowia psychicznego osób pracujacych--wyniki uzyskane na podstawie badan Monachijska wersja Zlozonego Miedzynarodowego Kwestionariusza Diagnostycznego (M-CIDI).

The present study was undertaken with two objectives. First, to assess the prevalence of mental health disorders among primary health patients. All the subjects under study (n = 170) had at least part time job. The mental health status of the patients was assessed on the basis of standardized psychiatric interview, M-CIDI (computer version). More than a half of the study population (51.8%) had at least one diagnosis of mental health disorder. The following disorders were most common in the group: neurotic, stress-related and somaform disorders (32.9%), mental and behavioral disorders due to psychoactive substance use (26.5; 11.8%--nicotine dependence) and mood (affective) disorders (16.5%). Two or more mental health disorders were diagnosed in every second person. Second, to evaluate the usefulness of M-CIDI as a tool for assessing psychiatric problems. Taking into account the research experience, M-CIDI is a valuable and easy to use diagnostic tool for detecting mental health disorders. The most important advantage of this instrument relies on its standardization that allows to carry out examinations even by persons who have no knowledge of psychiatry. The computer version of the M-CIDI is little time-consuming, simple and easy to operate as compared to the paper-pencil version It also has a quick access to the data base with the stored information about patients and their diagnoses.

[The usefulness of the Health Status Questionnaire: D. Goldberg's GHQ-12 and GHQ-28 for diagnosis of mental disorders in workers]. / Przydatnosc Kwestionariuszy Ogólnego Stanu Zdrowia: GHQ-12 i GHQ-28 D. Goldberga w diagnozowaniu zdrowia psychicznego osób pracujacych.

The General Health Questionnaires, developed by D. Goldberg (GHQ-12 and GHQ-28), are self-administered screening instruments designed to detect current diagnosable changes in the mental health status and to identify cases of potential mental disorders leaving a detailed diagnosis to a psychiatric interview. The General Health Questionnaires were designed for the use in primary health care settings, in the general population surveys or in general medical practice. The validation studies of the Polish version of GHQ-12 and GHQ-28 are described. The internal consistency coefficients (Cronbach alpha) reached the value of 0.859 for GHQ-12 in the study of 2540 employees, and 0.934 for GHQ-28 in the group of 1108 employees. The coefficients obtained in our studies are comparable to those reported by other authors who carried out investigations in populations of various countries. Test-retest reliability (ru approximately 0.7) seems to be good enough, taking account of the fact that the methods presented are aimed at diagnosing the state of mental health and not its stable traits. Having obtained significant differences in scores assigned to patients examined in settings at different levels of health care (a significant increase in GHQ scores of patients examined in psychiatric clinic as compared to patients of primary health care settings) it may be concluded that the criteria validity of both questionnaires is satisfactory.

The assessment of Big Five Personality Factors and Temperament Domains as modifiers of cardiovascular response to occupational stress.

The aim of the study was to explore the role of Big Five Personality Factors and Temperament Domains as the factors influencing cardiovascular response to work, and their moderating effect on the relationship between occupational stress and cardiovascular reactivity. The self-reported data on occupational stress and filled in NEO-Five Factor Inventory by Costa, and McCrae and Pavlovian Temperament Survey by Strelau et al. were collected from 97 bank clerks employed in large bank branches. The subjects also responded to the questionnaire on personal and professional background factors. A 24 hour monitoring of cardiovascular reactivity (heart rate and blood pressure) was also provided. Conscientiousness was found to be the only modifier of cardiovascular response to occupational stress reflected by systolic blood pressure. Several main, independent of stress effects of personality and temperament domains were also found. The ratio of heart rate at work to heart rate during sleep was associated with the strength of excitatory process, the percentage of maximum heart rate index with Conscientiousness, and systolic blood pressure at work was influenced by the strength of inhibitory process. However, generally speaking, physiological indicators of the cardiovascular system functioning were not very sensitive to changes in values of personality and temperament variables at the level of occupational stress reported by the bank clerks who participated in the study.

Impairment of psychological functions in children environmentally exposed to lead.

The major objective of the study was to determine whether environmental exposure to lead exerts a negative impact upon psychological functions in children. The examined group consisted fo school age children (6-15 years old, x = 9.5, SD = 1.4) living close to copper works. Out of 4548 children with measured blood lead concentrations, two groups were selected one with the highest exposure levels (12.0-27.2 micrograms/dl) and the other drawn from the remaining children, with low blood lead levels. The mean exposure level for the whole examined group equalled 10.18 mu/dl PbB (SD-4.73 micrograms/dl). To assess effects of the exposure, the following variables were measured in the examined children: intelligence, hand-eye coordination, perception, memory, reaction time and accuracy, and behaviour disorders. The moderator variables of sociodemographic character, i.e. parents' education, income, etc., were also controlled. A significant impact of lead upon psychological functions and behaviour was revealed for two variables only: intelligence and attention concentration. An increase in the exposure level by 10 micrograms/dl PbB was associated with deterioration of general IQ by 5.3 points and growth of the number of mistakes in the Simple Reaction Time test by 3.3. It was also revealed that the short-term memory deteriorates with growing level of exposure, the strength of this relationship was close to the level of statistical significance (p < 0.07).