title: Itch in the General Internal Medicine Setting: A Cross-Sectional Study of Prevalence and Quality-of-Life Effects.
abstract: BACKGROUND
  Itch is a well-established symptom in cutaneous disease. However, little is known about the burden of itch outside the dermatology setting.
  
  
  OBJECTIVE
  To determine the prevalence and impact of itch on quality of life (QOL) in the general internal medicine setting.
  
  
  METHODS
  We performed a cross-sectional study of 2076 adults from an outpatient general internal medicine clinic, using an audio computer-assisted self-administered interview. A history of itch (acute or chronic) and other physical symptoms in the past week, Patient-Reported Outcomes Measurement Information System (PROMIS) 10-item Global Health Questionnaire scores, and Patient Health Questionnaire-2 scores were assessed.
  
  
  RESULTS
  The prevalence of itch was 39.9 % and increased with age from 33.1 % at age 19-39 years to 45.9 % at age ≥80 years. In multivariable models controlled for socio-demographics, even feeling "a little" or "some" distress from itch was significantly associated with lower PROMIS global physical and mental health T-scores and estimated health utility scores (P ≤ 0.01). Further, feeling "quite a lot" of distress or "very much" distress from itch was associated with higher adjusted odds ratios for depressed mood (4.91 [95 % confidence interval (CI) 3.36-7.18]) and anhedonia (4.46 [95 % CI 3.07-6.47]). The patient burden of itch was similar to those of pain, constipation, sexual dysfunction, cough, and weight loss.
  
  
  CONCLUSIONS
  Itch occurs commonly in the primary care setting and is associated with poor QOL. Physicians should inquire about itch and its associations during review of systems. Future studies are needed to distinguish between the effects of acute and chronic itch.
authors: Departments of Dermatology, Medical Social Sciences and Preventive Medicine, Northwestern University Feinberg School of Medicine, Suite 1600, 676 N. St. Clair Street, Chicago, IL, 60611, USA. JonathanISilverberg@gmail.com.|Northwestern Medicine Multidisciplinary Eczema Center, Chicago, IL, USA. JonathanISilverberg@gmail.com.
authors: Jonathan I
authors: JI
authors: Silverberg
authors: Collaborative Research Unit, Department of Medicine, Cook County Health and Hospitals System, Chicago, IL, USA.
authors: Keiki
authors: K
authors: Hinami
authors: Collaborative Research Unit, Department of Medicine, Cook County Health and Hospitals System, Chicago, IL, USA.
authors: William E
authors: WE
authors: Trick
authors: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: David
authors: D
authors: Cella
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011537:Pruritus / Q000453:epidemiology* / Q000209:etiology; D011788:Quality of Life; D012871:Skin Diseases / Q000150:complications*; D011795:Surveys and Questionnaires; D055815:Young Adult