Kvaliteta života i psihijatrijski komorbiditet u dermatoveneroloških bolesnika

Dediol, Iva (2017) Kvaliteta života i psihijatrijski komorbiditet u dermatoveneroloških bolesnika. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Skin diseases are mostly chronic and lifelong with recurrences. The special thing about skin diseases is their psychosocial burden. Pruritus and in fewer instances pain are common physical symptoms of skin diseases. All of these facts influence patient's life, social network and psychological status. Objectives: This study assessed different dimensions of quality of life and psychiatric comorbidities: depression and anxiety were evaluated among patients with dermtovenereological diseases. Methods: This study was approved by the Ethics Committee of the University Center Hospital „Sestre milosrdnice“, in Zagreb, where the study was conducted. Two hundred and ninety female and male patients suffering from different dermatoses and venereological diseases participated in the study. All participants were treated in an inpatient and outpatient treatment at the Department of Dermatovenereology. Participants were divided into three groups. The first group of patients were those with symptomatic dermatoses like psoriasis, atopic dermatitis and venous ulcer. The second group were asymptomatic dermatoses like vitiligo, alopecia and acne. The third group involved venereological patients with diagnoses of anogenital warts, genital Herpes simplex infection and Balanopostitis. Consenting participants completed the following standardized psychological questionnaires: Dermatology Specific Quality of Life Index, Beck's Index of Depression and State and Trait Anxiety Inventory. Results: Participants with symptomatic skin diseases had the highest influence of the disease on their quality of life. There was a statistically significant difference between different dimensions of quality of life, except for the psychological dimension. Depression and anxiety symptoms were mild but 4,1 % of the participants had high depression scores and 13-15 % had very high anxiety scores. Different dimensions of quality of life were in correlation with the intensity of the disease, with the exception of the psychological dimension. Patients with high intensity of the skin lesions were more depressed, but patients with always exposed lesions were more anxious as a state and trait. Conclusion: Patients with pruritic and painful dermatoses have the highest influence of skin disease on their quality of life. The Psycholgical aspect of quality of life is probably mostly affected by the patient's personality traits, and not by a skin or venereological disease in itself. Localisation and intensity of the dermatovenereological disease influence symptoms of depression and anxiety.

Abstract in Croatian

Većina bolesti kože je kronično recidivirajućeg karaktera. Bolesnici s bolestima kože nose teret psihosocijalnog opterećanja njihovih bolesti. Nadalje, svrbež i rjeđe bol su simptomi koji ometaju bolesnikovu kvalitetu života, njegov psihološki status i socijalno funkcioniranje. Cilj: istražiti kvalitetu života i učestalost anksioznog i depresivnog poremećaja kod bolesnika s različtim dermatovenerološkim bolestima. Metode: Istraživanje je provođeno u Klinici za kožne i spolne bolesti KBC-a Sestre milosrdnice, čije Etičko povjerenstvo je odobrilo provođenje studije. U istraživanju je sudjelovalo 270 ispitanika s različitim dermatozama i venerološkim bolestima koji su liječeni u Poliklinici i Odjelu Klinike za kožne i spolne bolesti KBC-a Sestre milosrdnice. Ispitanici su bili podijeljeni u tri ispitivane skupine. Prva skupina su bolensici sa simptomatskim bolestima kože poput psorijaze, atopijskog dermatitisa i venskog ulkusa. Druga skupina su bolesnici s asimptomatskim bolestima kože poput vitiliga, akne i alopecije. Treća skupina su venerološki bolesnici s anogenitalnim kondilomima, genitalnom Herpes simplex infekcijom i balanopostitisom. Ispitanici su ispunili Upitnik kvalitete života specifičan za dermatološku praksu, Beckovu skalu depresivnosti i Upitnik anksioznosti kao stanja i kao osobine. Rezultati: Ispitanici sa simptomatskim bolestima kože su imali najnižu kvalitetu života. Psihološka dimenzija kvalitete života je bila jednaka u sve tri ispitivane skupine. Ispitanici su imali blage simptome depresivnosti i anksioznosti, ali je 4,1 % bolesnika imalo teške simptome depresivnosti, a 13-15 % teške simptome anskioznosti kao stanja i ličnosti. Težina kliničke slike je u korelaciji s različitim dimenzijama kvalitete života osim psihološkom dimenzijom kvalitete života. Ispitanici s težom kliničkom slikom imaju više simptome depresivnosti, a ispitanici sa stalno izloženim promjenama imaju više simptome anksioznosti kao stanja i ličnosti. Zaključak: Ispitanici sa simptomatskim bolestima kože imaju najveći utjecaj na kvalitetu života. Psihološki aspekt kvalitete života ispitanika ovisi o osobinama ličnosti ispitanika, a ne o samim dermatovenerološkim bolestima. Područja promjena na koži i težina kliničke slike utječu na razvoj simptoma depresivnosti i anksioznosti.

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