Report
General psychiatric symptoms, quality of sleep, and coping strategies in patients with psoriasis vulgaris Ilknur Balta1, MD, Ayse S. Karadag2, MD, Salih Selek3, MD, Sevda Onder4, MD, Asiye Kanbay5, and Hatice Burakgazi-Yilmaz6, MD
1 Department of Dermatology, Kecioren Training and Research Hospital, Ankara, 2 Departments of Dermatology, 3 Psychiatry, School of Medicine, Istanbul Medeniyet University, Istanbul, 4Department of Dermatology, School of Medicine, Yuzuncu Yıl University, Van, Turkey, 5 Istanbul Medeniyet University, School of Medicine, Department of Pulmonary Medicine, Istanbul, Turkey, and 6 Department of Psychiatry, Cooper Medical School of Rowan University, Camden, NJ, USA
Abstract
Correspondence Ilknur Balta, MD Department of Dermatology Kecioren Training and Research Hospital Ankara 69010 Turkey E-mail: [email protected]
subjects was 39.33 11.61 years. The mean score on the Psoriasis Area and Severity
Background Psoriasis is a common dermatological disorder with psychiatric comorbidity. Psoriasis is associated with a variety of psychological problems, including poor selfesteem, sexual dysfunction, sleep disturbances, anxiety, depression, and suicidal ideation. Objectives We aimed to investigate general psychiatric symptoms, quality of sleep, and coping strategies in patients with psoriasis vulgaris. Methods A total of 79 subjects (37 patients with psoriasis vulgaris and 42 control subjects) were enrolled in the study. Coping strategies were measured using the Coping Orientations to Problems Experienced (COPE) Scale. General psychopathological status was assessed using the Symptom Checklist-90-R (SCL90R), and sleep quality and disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI). Results The mean age of the patients was 39.18 16.85 years. The mean age of control Index (PASI) was 7.56 3.66. There were no significant differences in scores on the SCL90R and COPE subscales between the patient and control groups. However, significant differences between the groups emerged on the PSQI subscales for subjective sleep quality and habitual sleep efficiency (Z =
1.964, P = 0.049, and Z =
2.452,
P = 0.014, respectively).
Funding: none.
Conclusions The present study found no significant differences in general psychiatric symptoms and coping strategies between the psoriasis patients and the control group, by
Conflicts of interest: none.
contrast with findings reported elsewhere in the literature. We think that the low PASI scores of our patients, which indicate the low severity of disease in the present group, is the main reason for this finding. However, sleep quality is lower in psoriasis vulgaris patients than in healthy controls. This may be associated with the itch and pain caused by lesions. Further experimental studies are required to explain these findings.
Introduction
60
Psoriasis is a common dermatological disorder with psychiatric comorbidity.1 Psoriasis is associated with a variety of psychological problems, including poor self-esteem, sexual dysfunction, anxiety, depression, and suicidal ideation.2–5 The most commonly diagnosed conditions are depressive disorders (44%) and anxiety disorders (35%).5 Other less common general psychiatric illnesses encountered include social phobia, alcohol dependence, obsessive compulsive disorder, post-traumatic stress disorder, anorexia nervosa, and schizophrenia.5 Psoriasis is also associated with poor quality of sleep. However, the factors impairing sleep in psoriasis patients have not been well described. Pruritus, pain, psoriatic arthritis, depression, and obstructive sleep apnea may be International Journal of Dermatology 2016, 55, 60–64
likely sources of sleep impairment in patients with psoriasis.6–9 Patients’ reactions towards their disease are very diverse and depend on the clinical picture, symptoms of disease, psychological approach to perceptions of illness, and personality traits, including personal resources, temperament, ability and strategies for coping with stress, and numerous other situational factors.10,11 Therefore, we aimed to investigate general psychiatric symptoms, quality of sleep, and coping strategies in patients with psoriasis vulgaris. Materials and methods Subjects and study design A total of 37 patients with psoriasis (mean age: 39.18 16.85 years) and 42 healthy control subjects (mean age: 39.33 11.61 ª 2015 The International Society of Dermatology
Balta et al.
General psychiatric symptoms in patients with psoriasis
Report
years) were included in the study. There were no differences in mean age or sex ratio between the groups. We included patients
seven aspects of sleep used in this instrument were total duration of sleep, sleep disturbances during the past month,
aged >18 years and
General psychiatric symptoms, quality of sleep, and coping strategies in patients with psoriasis vulgaris Ilknur Balta1, MD, Ayse S. Karadag2, MD, Salih Selek3, MD, Sevda Onder4, MD, Asiye Kanbay5, and Hatice Burakgazi-Yilmaz6, MD
1 Department of Dermatology, Kecioren Training and Research Hospital, Ankara, 2 Departments of Dermatology, 3 Psychiatry, School of Medicine, Istanbul Medeniyet University, Istanbul, 4Department of Dermatology, School of Medicine, Yuzuncu Yıl University, Van, Turkey, 5 Istanbul Medeniyet University, School of Medicine, Department of Pulmonary Medicine, Istanbul, Turkey, and 6 Department of Psychiatry, Cooper Medical School of Rowan University, Camden, NJ, USA
Abstract
Correspondence Ilknur Balta, MD Department of Dermatology Kecioren Training and Research Hospital Ankara 69010 Turkey E-mail: [email protected]
subjects was 39.33 11.61 years. The mean score on the Psoriasis Area and Severity
Background Psoriasis is a common dermatological disorder with psychiatric comorbidity. Psoriasis is associated with a variety of psychological problems, including poor selfesteem, sexual dysfunction, sleep disturbances, anxiety, depression, and suicidal ideation. Objectives We aimed to investigate general psychiatric symptoms, quality of sleep, and coping strategies in patients with psoriasis vulgaris. Methods A total of 79 subjects (37 patients with psoriasis vulgaris and 42 control subjects) were enrolled in the study. Coping strategies were measured using the Coping Orientations to Problems Experienced (COPE) Scale. General psychopathological status was assessed using the Symptom Checklist-90-R (SCL90R), and sleep quality and disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI). Results The mean age of the patients was 39.18 16.85 years. The mean age of control Index (PASI) was 7.56 3.66. There were no significant differences in scores on the SCL90R and COPE subscales between the patient and control groups. However, significant differences between the groups emerged on the PSQI subscales for subjective sleep quality and habitual sleep efficiency (Z =
1.964, P = 0.049, and Z =
2.452,
P = 0.014, respectively).
Funding: none.
Conclusions The present study found no significant differences in general psychiatric symptoms and coping strategies between the psoriasis patients and the control group, by
Conflicts of interest: none.
contrast with findings reported elsewhere in the literature. We think that the low PASI scores of our patients, which indicate the low severity of disease in the present group, is the main reason for this finding. However, sleep quality is lower in psoriasis vulgaris patients than in healthy controls. This may be associated with the itch and pain caused by lesions. Further experimental studies are required to explain these findings.
Introduction
60
Psoriasis is a common dermatological disorder with psychiatric comorbidity.1 Psoriasis is associated with a variety of psychological problems, including poor self-esteem, sexual dysfunction, anxiety, depression, and suicidal ideation.2–5 The most commonly diagnosed conditions are depressive disorders (44%) and anxiety disorders (35%).5 Other less common general psychiatric illnesses encountered include social phobia, alcohol dependence, obsessive compulsive disorder, post-traumatic stress disorder, anorexia nervosa, and schizophrenia.5 Psoriasis is also associated with poor quality of sleep. However, the factors impairing sleep in psoriasis patients have not been well described. Pruritus, pain, psoriatic arthritis, depression, and obstructive sleep apnea may be International Journal of Dermatology 2016, 55, 60–64
likely sources of sleep impairment in patients with psoriasis.6–9 Patients’ reactions towards their disease are very diverse and depend on the clinical picture, symptoms of disease, psychological approach to perceptions of illness, and personality traits, including personal resources, temperament, ability and strategies for coping with stress, and numerous other situational factors.10,11 Therefore, we aimed to investigate general psychiatric symptoms, quality of sleep, and coping strategies in patients with psoriasis vulgaris. Materials and methods Subjects and study design A total of 37 patients with psoriasis (mean age: 39.18 16.85 years) and 42 healthy control subjects (mean age: 39.33 11.61 ª 2015 The International Society of Dermatology
Balta et al.
General psychiatric symptoms in patients with psoriasis
Report
years) were included in the study. There were no differences in mean age or sex ratio between the groups. We included patients
seven aspects of sleep used in this instrument were total duration of sleep, sleep disturbances during the past month,
aged >18 years and
