RESUMO
OBJECTIVE: To investigate whether and the extent to which psychosomatic syndromes and psychopathology are associated to psoriasis severity. METHOD: Consecutive 282 outpatients with chronic psoriasis were assessed for psychopathology (with the Mini International Neuropsychiatric Interview), psychosomatic conditions (with the Diagnostic Criteria for Psychosomatic Research, DCPR), severity of psoriatic symptoms (with the Psoriasis Area and Severity Index, PASI), and illness-related quality of life (with the Dermatology Life Quality Index, DLQI). RESULTS: Psychopathology was diagnosed in 26.6% patients while at least one DCPR syndrome in 67% of them and higher psychosomatic severity (>1 DCPR syndrome) in 29.1%. Higher symptom severity (PASI>20) was significantly more prevalent in patients with greater psychosomatic severity (29.1%) (d=1.25) - particularly, alexithymia (29.4%; d=0.83) - and poorer quality of life (DLQI>10) (d=0.86). Furthermore, after controlling for psychopathology, psychosomatic severity, and alexithymia, together with lower illness-related quality of life, independently predicted severity of symptoms, with large effect size (d=0.78 and d=1.75, respectively). CONCLUSIONS: DCPR clusters can be suggested as a useful tool for identifying psychological distress in psoriasis, significantly linked to both subjective (quality of life) and objective factors (severity of lesions and extension of affected skin areas) of the illness experience.
RESUMO
BACKGROUND: To investigate significant association between various clinical and extra-clinical factors brought out the activities of Consultation-Liaison Service. METHODS: Data from all psychiatric consultations for patients admitted to the Perugia General Hospital and carried out over a 1-year period (from July the 1st 2009 to June the 30th 2010) were collected by a structured clinical report including: socio-demographic features, features of referrals, features of back-referrals. T-test, Mann-Whitney U-test, χ(2)-test and Fischer's were statistically used. RESULTS: 1098 consultations were performed. The consultations carried out the Emergency Unit were excluded from the study. The type and the reasons for the referrals were discussed such as the ICD-10 diagnosis and the liaison interventions too. Significant associations emerged between gender and: social status and occupation (p < 0.05 and p < 0.01 respectively). Clinical sector related with reason for referral (p < 0.01), type of consultation (p < 0.01), liaison investigations (p < 0.01) and long-term treatment plan after hospital discharge (p < 0.01). The ICD-10 psychiatric diagnosis (Schizophrenia, Affective Syndrome and Neurotic-StressSomatoform Syndrome) was associated with social status (p < 0.01), social condition (p < 0.01), consultation type (p < 0.01), advice (p < 0.01) and reason for consultation (p < 0.01). CONCLUSIONS: The need for better physical and psychological investigation is confirmed in order to promote not only disease remission but overall wellbeing.
