title: Tertiary individual prevention improves mental health in patients with severe occupational hand eczema.
abstract: BACKGROUND
  Occupational hand eczema (OHE) is associated with impaired health-related quality of life (QoL) and mental distress. Interdisciplinary inpatient rehabilitation measures in the framework of tertiary individual prevention (TIP) offered by the German employers' liability insurance associations include dermatological treatment, education and psychological interventions.
  
  
  OBJECTIVE
  To investigate the effects of interdisciplinary inpatient rehabilitation in the framework of TIP on mental health in patients with severe OHE and the relationships between recovery of OHE and improvement of mental health and QoL.
  
  
  METHODS
  A total of 122 patients participated in the study. A test battery consisting of the German versions of the Hospital Anxiety and Depression Scale (HADS-D), the Dermatology Life Quality Index (DLQI), the Short Form Health Survey-36 (SF-36) and the Trier Inventory for the Assessment of Chronic Stress (TICS) was applied at the time of admission (T1) and 3 weeks after dismissal (T2). Severity of hand eczema was assessed with the Osnabrueck Hand Eczema Severity Index (OHSI).
  
  
  RESULTS
  All parameters improved significantly from T1 to T2. A relationship was established between the improvement of QoL and recovery of OHE, while there was no such relationship between the improvement of mental distress and improvement of OHE. Nonresponders had significantly more cumulative days of sickness at T1.
  
  
  CONCLUSIONS
  Our data underscore the importance of psychological interventions in addition to dermatological treatment in the framework of prevention measures for OHE. These measures should be applied at an early stage of OHE prior to the occurrence of sick leave.
authors: Department of Allergology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany.
authors: K
authors: K
authors: Breuer
authors: Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Osnabrueck, Germany.|Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck, Dermatologic Centre, Trauma Hospital, Hamburg, Germany.
authors: S M
authors: SM
authors: John
authors: Department of Dermatology, Elbe-Klinikum Buxtehude, Buxtehude, Germany.
authors: F
authors: F
authors: Finkeldey
authors: Institute for Innovative Rehabilitation, Hospital Management and Distress Medicine (IREHA), Lielje Group, Löhne, Germany.
authors: D
authors: D
authors: Boehm
authors: Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Osnabrueck, Germany.|Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck, Dermatologic Centre, Trauma Hospital, Hamburg, Germany.
authors: C
authors: C
authors: Skudlik
authors: Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Osnabrueck, Germany.|Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck, Dermatologic Centre, Trauma Hospital, Hamburg, Germany.
authors: B
authors: B
authors: Wulfhorst
authors: Department of Psychology, Employers' Liability Insurance Association Hospital for Accidents, Hamburg, Germany.
authors: C
authors: C
authors: Dwinger
authors: Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
authors: T
authors: T
authors: Werfel
authors: Department of Clinical Social Medicine, Center of Health System Research, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany.
authors: T L
authors: TL
authors: Diepgen
authors: Institute for Innovative Rehabilitation, Hospital Management and Distress Medicine (IREHA), Lielje Group, Löhne, Germany.|Department of Psychosomatic Medicine, Berolina Clinic, Löhne, Germany.
authors: G
authors: G
authors: Schmid-Ott
mesh_terms: D000328:Adult; D000368:Aged; D009783:Dermatitis, Occupational / Q000517:prevention & control* / Q000523:psychology; D004485:Eczema / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006229:Hand Dermatoses / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D063128:Tertiary Health Care / Q000379:methods*; D055815:Young Adult