title: Stressful life events and pemphigus.
abstract: BACKGROUND
  Stress might be a triggering factor causing pemphigus. We studied 11 consecutive cases of pemphigus over 5 years.
  
  
  OBJECTIVE
  Studying and looking for a link between severe life events and the history of the disease.
  
  
  METHODS
  An epidemiological retrospective and prospective study was carried out, including an interview and a collection of the clinical history; then the life events were integrated into the clinical history with the patient blind. Two scales were used: Paykel's inventory (assessing the negative impact of life events) and the Mini International Neuropsychiatric Interview DSM-IV (MINI).
  
  
  RESULTS
  10 patients out of 11 were included. With the MINI, 2 patients presented anxiety. Paykel's inventory showed type 3 life events for numerous patients, life event type 4 for 7 patients and type 5 for 3 patients, happening from 1 to 6 months before the first signs or worsening of pemphigus. We found stressful life events before the start or worsening of pemphigus for all patients with no other risk factors.
  
  
  CONCLUSIONS
  Stressful life events can worsen or trigger off a pemphigus. Psychological care, associated with the immunosuppressive treatment, should entail a better management of these patients.
authors.affiliation: Internal Medicine Department, CHRU Lille and Lille II University, Lille, France. s-morell@chru-lille.fr
authors.forename: S
authors.initials: S
authors.lastname: Morell-Dubois
authors.forename: O
authors.initials: O
authors.lastname: Carpentier
authors.forename: O
authors.initials: O
authors.lastname: Cottencin
authors.forename: V
authors.initials: V
authors.lastname: Queyrel
authors.forename: E
authors.initials: E
authors.lastname: Hachulla
authors.forename: P-Y
authors.initials: PY
authors.lastname: Hatron
authors.forename: E
authors.initials: E
authors.lastname: Delaporte
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires