title: Psychological comorbidities and compliance to interventional treatment of patients with cutaneous vascular malformations.
abstract: OBJECTIVE
  The aim of this study was to assess qualitatively the psychological stressors affecting patients with cutaneous vascular malformations and hemangiomas (CVM-H) and their impact on compliance to interventional treatment.
  
  
  METHODS
  A retrospective chart review was conducted of all patients with CVM-H treated by interventional neuroradiology at a single academic institution during a five-year period (2009-2014). Psychological complaints were documented during each clinic visit by a neuroradiologist. Compliance to interventional treatment was defined by adherence to the scheduled treatment sessions. Fisher's exact test was used to assess for associations between psychological complaints and compliance.
  
  
  RESULTS
  Seventy-five patients were assessed, of whom 49 (65.3%) were female, with an age range of 2-78 years (mean age 30.2 years). All except one patient older than seven years of age (n = 71; 94.6%) had a psychological complaint, including fear of negative appearance (n = 53; 70.6%), dissatisfaction with appearance (n = 46; 61.3%), low self-esteem (n = 35; 46.6%), anxiety (n = 16; 21.3%), stress (n = 13; 17.3%), bullying (n = 5; 6.6%), and low mood (n = 4; 5.3%). Twenty-three (31%) patients were non-compliant. Low self-esteem was significantly associated with non-compliance (p = 0.0381).
  
  
  CONCLUSIONS
  There is a high prevalence of psychological comorbidities among patients treated for CVM-H. This has potential implications for interventional treatment, as it was found that low self-esteem is significantly associated with non-compliance. These results suggest the need for early psychological support in these patients in order to maximize compliance to interventional treatment.
authors.affiliation: Department of Medical Imaging, University of Ottawa, Canada.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Kenny
authors.affiliation: Department of Medical Imaging, University of Ottawa, Canada.
authors.forename: Nevin
authors.initials: N
authors.lastname: Majeed
authors.affiliation: Department of Psychiatry, University of Ottawa, Canada.
authors.forename: Naista
authors.initials: N
authors.lastname: Zhand
authors.affiliation: Department of Medical Imaging, University of Ottawa, Canada Department of Medical Imaging, The Ottawa Hospital, Canada Ottawa Hospital Research Institute, and Brain and Mind Research Institute, Canada.
authors.forename: Rafael
authors.initials: R
authors.lastname: Glikstein
authors.affiliation: Department of Medical Imaging, UHN - Toronto Western Hospital, University of Toronto, Canada.
authors.forename: Ronit
authors.initials: R
authors.lastname: Agid
authors.affiliation: Department of Medical Imaging, University of Ottawa, Canada Department of Medical Imaging, The Ottawa Hospital, Canada Ottawa Hospital Research Institute, and Brain and Mind Research Institute, Canada msantos@toh.ca.
authors.forename: Marlise P
authors.initials: MP
authors.lastname: Dos Santos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006391:Hemangioma / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D012867:Skin / Q000098:blood supply*; D054079:Vascular Malformations / Q000523:psychology* / Q000628:therapy*
keywords: Cutaneous vascular malformation; compliance; congenital vascular malformation; disfigurement; hemangioma; interdisciplinary healthcare team; interventional radiology; proliferating vascular tumor; psychological comorbidity; psychological support services