Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional Study

Background: Hand eczema (HE) is a chronic inflammatory disease with a high prevalence, negatively influencing patients’ quality of life (QoL). It may also affect patients’ psychological status. The aim of this study was to assess and characterize the psychological burden of HE, its influence on pati...

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Main Authors: Adam Zalewski, Piotr K. Krajewski, Jacek C. Szepietowski
Format: Article
Language:English
Published: MDPI AG 2023-09-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/12/17/5741
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author Adam Zalewski
Piotr K. Krajewski
Jacek C. Szepietowski
author_facet Adam Zalewski
Piotr K. Krajewski
Jacek C. Szepietowski
author_sort Adam Zalewski
collection DOAJ
description Background: Hand eczema (HE) is a chronic inflammatory disease with a high prevalence, negatively influencing patients’ quality of life (QoL). It may also affect patients’ psychological status. The aim of this study was to assess and characterize the psychological burden of HE, its influence on patients’ QoL, and the presence and severity of anxiety and depressive disorders in HE patients. Methods: The study group consisted of 100 adult HE individuals. To assess the severity of the disease, two instruments were used: the Investigator Global Assessment for Chronic Hand Eczema (IGA-CHE) scale and the Hand Eczema Severity Index (HECSI). Assessment of patients’ quality of life (QoL) was obtained with the use of the DLQI tool. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) questionnaires were employed to assess depression and anxiety, respectively, as well as a modified version of the Hospital Anxiety and Depression Scale (HADS-M). Results: The mean DLQI value for the whole group reached 11.62 ± 6.35 points (13.27 ± 6.67 points in females and 9.15 ± 4.95 points in males; <i>p</i> = 0.023). A decrease in QoL correlated positively with the severity of the disease and the severity of itch and pain. In 17 patients (17%), a possible diagnosis of depressive disorder was found. Patients scoring higher results on the PHQ-9 and HADS-M depression (D) questionnaires reported greater intensity of the itch (r = 0.363, <i>p</i> < 0.001, and r = 0.237, <i>p</i> = 0.017, respectively) and the pain (r = 0.445, <i>p</i> < 0.001, and r = 0.287, <i>p</i> = 0.004, respectively). The anxiety disorder might possibly be diagnosed in 25% of patients (n = 25). This study revealed a positive correlation between the severity of the anxiety symptoms, measured with the use of both GAD-7 and HADS-M anxiety (A) tools, and the intensity of the pain (r = 0.248, <i>p</i> = 0.013, and r = 0.342, <i>p</i> = 0.001, respectively). The severity of depressive and anxiety symptoms correlated positively with the severity of the disease. Conclusions: The psychosocial burden of HE is an undeniable phenomenon. The disorder influences patients’ QoL and may cause mental disturbances such as depression and anxiety disorders.
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spelling doaj.art-030ba7b1935843aca829732560e22ce92023-11-19T08:24:44ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011217574110.3390/jcm12175741Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional StudyAdam Zalewski0Piotr K. Krajewski1Jacek C. Szepietowski2Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, PolandDepartment of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, PolandDepartment of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, PolandBackground: Hand eczema (HE) is a chronic inflammatory disease with a high prevalence, negatively influencing patients’ quality of life (QoL). It may also affect patients’ psychological status. The aim of this study was to assess and characterize the psychological burden of HE, its influence on patients’ QoL, and the presence and severity of anxiety and depressive disorders in HE patients. Methods: The study group consisted of 100 adult HE individuals. To assess the severity of the disease, two instruments were used: the Investigator Global Assessment for Chronic Hand Eczema (IGA-CHE) scale and the Hand Eczema Severity Index (HECSI). Assessment of patients’ quality of life (QoL) was obtained with the use of the DLQI tool. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) questionnaires were employed to assess depression and anxiety, respectively, as well as a modified version of the Hospital Anxiety and Depression Scale (HADS-M). Results: The mean DLQI value for the whole group reached 11.62 ± 6.35 points (13.27 ± 6.67 points in females and 9.15 ± 4.95 points in males; <i>p</i> = 0.023). A decrease in QoL correlated positively with the severity of the disease and the severity of itch and pain. In 17 patients (17%), a possible diagnosis of depressive disorder was found. Patients scoring higher results on the PHQ-9 and HADS-M depression (D) questionnaires reported greater intensity of the itch (r = 0.363, <i>p</i> < 0.001, and r = 0.237, <i>p</i> = 0.017, respectively) and the pain (r = 0.445, <i>p</i> < 0.001, and r = 0.287, <i>p</i> = 0.004, respectively). The anxiety disorder might possibly be diagnosed in 25% of patients (n = 25). This study revealed a positive correlation between the severity of the anxiety symptoms, measured with the use of both GAD-7 and HADS-M anxiety (A) tools, and the intensity of the pain (r = 0.248, <i>p</i> = 0.013, and r = 0.342, <i>p</i> = 0.001, respectively). The severity of depressive and anxiety symptoms correlated positively with the severity of the disease. Conclusions: The psychosocial burden of HE is an undeniable phenomenon. The disorder influences patients’ QoL and may cause mental disturbances such as depression and anxiety disorders.https://www.mdpi.com/2077-0383/12/17/5741hand eczemaitchpainchronic inflammationinflammatory diseasequality of life
spellingShingle Adam Zalewski
Piotr K. Krajewski
Jacek C. Szepietowski
Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional Study
Journal of Clinical Medicine
hand eczema
itch
pain
chronic inflammation
inflammatory disease
quality of life
title Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional Study
title_full Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional Study
title_fullStr Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional Study
title_full_unstemmed Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional Study
title_short Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional Study
title_sort psychosocial consequences of hand eczema a prospective cross sectional study
topic hand eczema
itch
pain
chronic inflammation
inflammatory disease
quality of life
url https://www.mdpi.com/2077-0383/12/17/5741
work_keys_str_mv AT adamzalewski psychosocialconsequencesofhandeczemaaprospectivecrosssectionalstudy
AT piotrkkrajewski psychosocialconsequencesofhandeczemaaprospectivecrosssectionalstudy
AT jacekcszepietowski psychosocialconsequencesofhandeczemaaprospectivecrosssectionalstudy