title: A case-control study on family dysfunction in patients with alopecia areata, psoriasis and atopic dermatitis.
abstract: Family history can provide important information about a patient's psychological status, and thus their disease risk. A multicentric case-control study on family dysfunction was performed on 59 patients with psoriasis (63.7%), atopic dermatitis (11.9%) or alopecia areata (25.4%), and 47 patients with minor skin problems (controls), all attending a dermatological clinic or a psychodermatological consultation. The mean age of subjects was 47.7 years in the cases and 48.8 years in the controls. Women represented 53% of cases and 62% of controls. Patients and controls first completed the General Health Questionnaire (GHQ-12) and the Toronto Alexithymia Scale (TAS-20) questionnaire. The overall prevalence of anxiety and/or depression in cases was 43.3% (71.4% in atopic dermatitis). To collect the family history a genogram was built by the interviewer during a semi-structured interview. It can show dysfunction in the family, as it highlights alliances and ruptures, generational repetition of behaviours of dependence or vulnerability, and traumatic events. The mean (± standard deviation) genogram score was 6.7 ± 3.3 in the cases and 3.0 ± 2.4 in the controls (p<0.001). The cases had three times the risk of having moderate family dysfunction compared with controls and 16 times the risk of having a severe family dysfunction. The genogram score was correlated with the severity of the disease as evaluated by the patient. In conclusion, family dysfunction may play an important role in the onset or the exacerbation of psoriasis, alopecia, and atopic dermatitis.
authors.affiliation: Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium. fpoot@ulb.ac.be
authors.forename: Francoise
authors.initials: F
authors.lastname: Poot
authors.forename: Enora
authors.initials: E
authors.lastname: Antoine
authors.forename: Marion
authors.initials: M
authors.lastname: Gravellier
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hirtt
authors.forename: Stefania
authors.initials: S
authors.lastname: Alfani
authors.forename: Giulia
authors.initials: G
authors.lastname: Forchetti
authors.forename: Dennis
authors.initials: D
authors.lastname: Linder
authors.forename: Damiano
authors.initials: D
authors.lastname: Abeni
authors.forename: Stefano
authors.initials: S
authors.lastname: Tabolli
authors.forename: Francesca
authors.initials: F
authors.lastname: Sampogna
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000150:complications / Q000453:epidemiology; D000368:Aged; D000506:Alopecia Areata / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D000704:Analysis of Variance; D001007:Anxiety / Q000150:complications / Q000453:epidemiology; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003863:Depression / Q000150:complications / Q000453:epidemiology; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011565:Psoriasis / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires