title: Psychological distress in patients with morphea and eosinophilic fasciitis.
abstract: OBJECTIVE
  To examine the level of psychological distress and factors contributing to distress in patients with morphea or eosinophilic fasciitis.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Dermatology outpatient clinic of a university hospital.
  
  
  METHODS
  Of 120 patients with morphea or eosinophilic fasciitis diagnosed between December 1, 1994, and July 15, 2007, who were enrolled in the study, only 74 completed questionnaires were suitable for data analysis.
  
  
  METHODS
  Self-reported responses on the Impact of Chronic Skin Diseases on Daily Life scale measure psychological distress, specifically anxiety and depressed mood.
  
  
  RESULTS
  Psychological functioning was generally impaired in patients with skin disease, particularly among patients with generalized morphea and eosinophilic fasciitis. Twenty-eight patients (38%) were at risk of depression or anxiety. Higher levels of psychological distress were significantly related to greater severity of skin disease; more pain and fatigue; impact of disease on daily life; more perceived stigmatization; illness cognitions of greater helplessness; and less acceptance and less perceived social support.
  
  
  CONCLUSIONS
  Physical and psychosocial aspects play a substantial role in the quality of life for patients with morphea. Physicians should be encouraged to assess the physical and psychosocial factors when treating patients with sclerotic skin diseases. This approach could improve quality of life and ultimately lead to improved dermatological treatment outcomes.
authors.affiliation: Radboud University Nijmegen Medical Centre, PO Box 9101, NL-6500 HB Nijmegen, the Netherlands. i.kroft@zgt.nl
authors.forename: Elisabeth B M
authors.initials: EB
authors.lastname: Kroft
authors.forename: Elke M G J
authors.initials: EM
authors.lastname: de Jong
authors.forename: Andrea W M
authors.initials: AW
authors.lastname: Evers
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003430:Cross-Sectional Studies; D004802:Eosinophilia / Q000150:complications* / Q000473:pathology / Q000523:psychology; D005208:Fasciitis / Q000150:complications* / Q000473:pathology / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D012594:Scleroderma, Localized / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult