title: Photodermatoses: environmentally induced conditions with high psychological impact.
abstract: Photodermatoses are a group of skin disorders caused or exacerbated by ultraviolet and/or visible radiation, which collectively affect a high proportion of the population and substantially affect quality of life (QoL). Our objective was to assess the psychological impact of these conditions. Patients with a range of photodermatoses diagnosed at a specialist investigation centre in the UK completed questionnaires evaluating (i) anxiety and (ii) depression, using the Hospital Anxiety and Depression Scale (HADS), (iii) social anxiety, using the Fear of Negative Evaluation measure (FNE), (iv) coping strategies (brief COPE) and (v) QoL, using the Dermatology Life Quality Index (DLQI). Questionnaires were returned by 185 of 260 patients (71.1% response rate). Mean age was 50.2 years (SD 14.5, range 20-85), 80.3% female. Polymorphic light eruption was the most common diagnosis, followed by photoaggravated eczema, other photoaggravated dermatological conditions and solar urticaria. Across the sample, high percentages, i.e. 23% and 7.9% of individuals, showed scores indicating clinical levels of anxiety and depression, respectively. Facial involvement was a strong indicator for depression (t = 2.7, p < 0.01). In regression analyses psychological factors (particularly depression and adaptive coping) were the principle predictors of QoL, accounting for 17.7% of the variance (F = 7.61, p < 0.01), while clinical variables accounted for an additional 10.1% (F = 8.96, p < 0.01), with number of months/year affected exerting a significant effect (p < 0.01). This study demonstrates the high psychological comorbidity of these conditions; more awareness of this is required, with adoption of a biopsychosocial approach to their management.
authors.affiliation: Photobiology Unit, Dermatological Sciences, University of Manchester, Manchester Academic Health Science Centre, Salford Royal Foundation Hospital, Manchester M6 8HD, UK.
authors.forename: Muneeza
authors.initials: M
authors.lastname: Rizwan
authors.forename: Charlotte Louise
authors.initials: CL
authors.lastname: Reddick
authors.forename: Christine
authors.initials: C
authors.lastname: Bundy
authors.forename: Rebecca
authors.initials: R
authors.lastname: Unsworth
authors.forename: Helen Louise
authors.initials: HL
authors.lastname: Richards
authors.forename: Lesley Elizabeth
authors.initials: LE
authors.lastname: Rhodes
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D003710:Demography; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010787:Photosensitivity Disorders / Q000523:psychology*; D011788:Quality of Life; D012044:Regression Analysis; D012737:Sex Factors; D011795:Surveys and Questionnaires