While most of the skin disorders, in their symptoms or lesion aren’t rendered immediately fatal without causing any serious problems compared to systemic diseases, they can still affect seriously our emotional well-being, interpersonal relationships...
While most of the skin disorders, in their symptoms or lesion aren’t rendered immediately fatal without causing any serious problems compared to systemic diseases, they can still affect seriously our emotional well-being, interpersonal relationships, and social life particularly, skin disorders appearing in exposed body parts involve cosmetic aspects and can impact on mental health and quality of life. Globally prevailing atopic dermatitis is a typical example of chronic and recurrent skin diseases and the quality of life with this skin disease is taking on more and more importance.
In this study, Korean version of Skindex-29, amore objective and officially-adopted tool for evaluation of quality of life was used and psychological aspects as well as quality of life with atopic dermatitis patients were evaluated, using such evaluation tools as Beck Depression Inventory (BDI) for evaluation of depression, Beck Anxiety Inventory (BAI) for evaluation of anxiety. In order to do this, a survey was conducted with an outpatient group of 102 atopic dermatitis patients about the same age and sex from dermatologist's offices in Seoul and its vicinity and a normal group of 91 people in the form of face-to-face interview and self-administered questionnaire method.
Survey data was collected from June '07 to Aug.30'07 and the analysis was made using cross tabulation analysis method, Independent T-Test, analysis of variance (ANOVA), Pearson correlation coefficient, to obtain the following results.
First, there was no significant difference in the clinical characteristics in accordance with sex and age. In terms of severity of skin symptoms with erythema and edema, "mild" had the most responses, and "no symptoms" had the most responses with exudation or scab and abrasion. Also, "mild" had the most responses with skin dryness and lichenification.
For difference in the affected area by dermatitis, there was no significant difference according to sex and age, except in reproductive parts. Concerning severity in atopic dermatitis in scalp and face, front and rear body, "mild" had the most responses. "No symptoms" had the most responses with arms, legs and hands. There was a significant difference in reproductive parts based on sex (p<0.01); 51.6% of men surveyed said "no symptoms’, and 41.9% said "mild", while over 80% of surveyed women said ‘no symptoms' in this part of the body. Regarding the difference in subjective symptoms, there was no significant difference based on sex and age and mild itch and sleeping disorder were most prevailing. There was no significant difference in clinical severity based on age and sex. There was no significant difference in reoccurrence frequency within one year period based on age but there was a significant difference based on sex (p<0.01). For men, 1-2 times had the highest rate (61.3%), followed by more than 5 times (35.5%), while 1-2 times had the highest rate (40.8%), followed by 3-4 times (35.2%) for women.
In case of reoccurrence, there was no significant difference in the duration based on sex and age. In most cases, it lasted for 1-3 days There was no significant difference based on sex and age in prevalence period which was mostly 1-2 years.
Second, in comparison of depression, anxiety, quality of life between the patient group and the normal group, there was no significant difference in the level of anxiety, however, there was a significant difference in the level of depression and quality of life. The patient group was more depressed and had lower quality of life compared with normal group in other factors except for the level of anxiety.
Third, in comparison of depression and anxiety and quality of life based on sex, age and the clinical characteristics within atopic dermatitis patient group, there was a significant difference in depression only, based on age (p<0.01).Depression was most prevail under age 25 and least prevail between age over 25-30, followed by age over 30(p<0.05). For comparison based on sex, there was a significant difference only in anxiety (p<0.05) and women were higher (0.649) than men.
Analyzing depression, anxiety level according to prevalence period, there was a significant difference in anxiety only (p<0.01). Depression level was highest when prevalence period lasted about 6-10 years and anxiety level was highest when prevalence period lasted more than 10 years. In addition, there was a significant difference in overal quality of life and over 10 years marked the lowest figures (p<0.001). In the analysis of anxiety, depression based on the frequency of reoccurrence within one year period, there was no significant difference but there was a significant difference in quality of life (p<0.001), which was shown lowest at more than 5 times of frequency (p<0.001).
In the analysis of anxiety, depression level according to reoccurrence duration, there was a significant difference (p<0.001) and the level was shown highest when the duration lasted more than one week. There was also a significant difference in overall quality of life (p<0.001) and it was shown lowest when the duration lasted more than one week. In the analysis of anxiety, depression level with atopic dermatitis severity, there was a significant difference (p<0.001) and in both cases, the level was highest in "severe" stage. There was also a significant difference in overall quality of life (p<0.001) according to severity and it was shown lowest in "severe" stage.
Fourth, the analysis of correlation between anxiety, depression and quality of life (in patent group) showed a statistically significant difference (p<0.001) and correlation between quality of life and depression or anxiety showed negative in every case, therefore, you can say that the severer(less severe) depression or anxiety is, the lower (higher) the quality of life is (overall and in sub-categories). For depression, the correlation coefficient was shown high particularly in functionality (-0.598) among sub-categories of quality of life. For anxiety, the correlation coefficient was shown high particularly in emotional well-being (-0.598) among sub-categories of quality of life.
In conclusion, this study polled adult patients with atopic dermatitis and found that their psychological side and quality of life were far inferior to those of normal people. In comparison between men and women with atopic dermatitis in terms of psychological side and quality of life, depression was more dominant with women, younger patients with keen interest in their looking and those in their 30s―40s having lots of social relationships. Besides, the longer the prevalence period of atopic dermatitis is, the higher the anxiety level gets significantly. In case of reoccurrence, the longer the duration is and the severity atopic dermatitis is, the worse anxiety and depress get as well as quality of life. By showing the seriously affected quality of life of atopic dermatitis patients through the study of their psychological side and quality of life, it is believed that the understanding of this aspect will help improve the quality of treatment for patients.
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