Anxiety and Depression in Patients with Atopic Dermatitis in a Southeast Asian Tertiary Dermatological Centre.
BACKGROUND
This study aimed to assess the frequency of anxiety and depression in a cohort of adult patients with atopic dermatitis (AD) in a tertiary dermatological centre, using the Hospital Anxiety and Depression Scale (HADS). We looked for any correlation between anxiety and depression with skin disease severity.


METHODS
Patients with AD were recruited from the National Skin Centre, Singapore, from 2008 to 2009 for a prospective cross-sectional study. The scoring atopic dermatitis (SCORAD) grade was determined and the HADS was administered via interviews.


RESULTS
A total of 100 patients (78 males, 22 females) were enrolled (92% Chinese, 4% Malays and 4% Indians). Their average age was 25.7 years. Sixty-five percent used topical steroids, 14% had previously taken oral prednisolone for the control of disease flares, and 20% were on concurrent systemic therapy. The mean SCORAD was 55.0, with 99% of patients having moderate or severe AD. The mean HADS anxiety score was 7.2 and the mean depression score was 5.0. The level of anxiety correlated well with that of depression (Spearman's rank correlation coefficient, ρ = 0.59,P<0.05); 18% were considered as cases of anxiety and 5% as cases of depression. These patients also had higher SCORAD values compared to other patients with lower scores for anxiety or depression (P<0.05). Linear regression demonstrated a statistically significant positive relationship between anxiety and depression scores, and SCORAD scores.


CONCLUSIONS
Our study identified, by means of the HADS, the frequency of anxiety and depression amongst a cohort of Singaporean patients with AD. More severe skin disease correlated to greater psychological burden. The HADS is a useful screening tool that can constitute part of the overall holistic management of patients with AD so as to improve patient care.
National Skin Centre, Singapore.
Vanessa Zy
VZ
Lim
Roger Cm
RC
Ho
Shang Ian
SI
Tee
Madeline Sl
MS
Ho
Jiun Yit
JY
Pan
Yen Loo
YL
Lim
Mark By
MB
Tang
Keen Loong
KL
Chan
Yoke Chin
YC
Giam
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D003876:Dermatitis, Atopic / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology; D062606:Tertiary Care Centers
D000305:Adrenal Cortex Hormones