title: Development and validation of the psychosomatic scale for atopic dermatitis in adults.
abstract: Psychosocial factors play an important role in the course of adult atopic dermatitis (AD). Nevertheless, AD patients are rarely treated for their psychosomatic concerns. The purpose of the present study was to develop and validate a brief self-rating scale for adult AD in order to aid dermatologists in evaluating psychosocial factors during the course of AD. A preliminary scale assessing stress-induced exacerbation, the secondary psychosocial burden, and attitude toward treatment was developed and administered to 187 AD patients (82 male, 105 female, aged 28.4 +/- 7.8, 13-61). Severity of skin lesions and improvement with standard dermatological treatment were assessed by both the dermatologist and the participant. Measures of anxiety and depression were also determined. In addition, psychosomatic evaluations were made according to the Psychosomatic Diagnostic Criteria for AD. Factor analysis resulted in the development of a 12-item scale (The Psychosomatic Scale for Atopic Dermatitis; PSS-AD) consisting of three factors: (i) exacerbation triggered by stress; (ii) disturbances due to AD; and (iii) ineffective control. Internal consistency indicated by Cronbach's alpha coefficient was 0.86 for the entire measure, 0.82 for (i), 0.81 for (ii), and 0.77 for (iii), verifying the acceptable reliability of PSS-AD. Patients with psychosomatic problems had higher PSS-AD scores than those without. PSS-AD scores were positively associated with the severity of the skin lesions, anxiety and depression. The scores were negatively associated with improvement during dermatological treatments. In conclusion, PSS-AD is a simple and reliable measure of the psychosomatic pathology of adult AD patients. It may be useful in dermatological practice for screening patients who would benefit from psychological or psychiatric interventions.
authors.affiliation: Department of Psychosomatic Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. ando@ncnp-k.go.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ando
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashiro
authors.forename: Keishi
authors.initials: K
authors.lastname: Noda
authors.forename: Jun
authors.initials: J
authors.lastname: Adachi
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Hosoya
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Kamide
authors.forename: Toshio
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Gen
authors.initials: G
authors.lastname: Komaki
mesh_terms: D000293:Adolescent; D000328:Adult; D003876:Dermatitis, Atopic / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires