title: Psychiatric comorbidities and alexithymia in patients with seborrheic dermatitis: a questionnaire study in Turkey.
abstract: OBJECTIVE
  The aim of the study was to determine the levels of anxiety, depression, and obsessive-compulsive symptoms in patients with seborrheic dermatitis (SD) compared with healthy subjects. Additionally, we aimed to investigate the presence of alexithymia among patients and its association with these psychiatric comorbidities.
  
  
  METHODS
  A total of 117 consecutive adult patients (66 male, 51 female) with SD and 95 age- and gender-matched healthy controls selected from the community (46 male, 49 female) were enrolled in the study. The demographic characteristics of the patients were recorded. The clinical severity of the disease was assessed according to the Seborrheic Dermatitis Area and Severity Index (SDASI) scoring system. Both patients and controls were evaluated by the validated Turkish versions of the Hospital Anxiety and Depression Scale (HADS), Maudsley Obsessive Compulsive Inventory (MOCI), and Toronto Alexithymia Scale (TAS-26).
  
  
  RESULTS
  There were no statistically significant differences between the patient and control groups regarding the mean scores of depressive or obsessive-compulsive symptoms or alexithymia (all p > 0.05). However, anxiety scores in patients with SD were higher than in controls (p = 0.001). No significant relationship was present between anxiety and disease severity nor disease duration (p > 0.05). Thirty-eight patients with high anxiety scores were found to be more alexithymic (p = 0.000).
  
  
  CONCLUSIONS
  SD is one of the inflammatory skin disorders that is known to be triggered or aggravated by stress. However, little scientific evidence exists to confirm this view. In addition, very limited data are available about the presence of the personality profiles leading to emotional dysregulation such as alexithymia and concurrent psychiatric disorders in patients with SD. Our study showed that anxiety levels were significantly higher in patients with SD compared with healthy controls but there was no significant association with alexithymia, depression, or obsessive-compulsive symptom levels. Dermatologists should be particularly vigilant to the possibility of concurrent psychiatric morbidity in patients with SD in order to improve patients' well-being.
authors.affiliation: Department of Dermatology, School of Medicine, Yeditepe University, Devlet Yolu Ankara Cad. No: 102/104, Kozyatağı, 34752 Istanbul, Turkey. asuderma@gmail.com
authors.forename: Asuman
authors.initials: A
authors.lastname: Cömert
authors.forename: Berfu
authors.initials: B
authors.lastname: Akbaş
authors.forename: Emine Zinnur
authors.initials: EZ
authors.lastname: Kılıç
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Akın
authors.forename: Elif
authors.initials: E
authors.lastname: Gökçe
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Göktuna
authors.forename: Oktay
authors.initials: O
authors.lastname: Taşkapan
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D017677:Age Distribution; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D012628:Dermatitis, Seborrheic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology