Itching is a very common symptom in patients suffering from skin diseases. In a new study on the psychological burden of itch in the Journal of Investigative Dermatology, researchers report that the presence of itch in dermatological patients was significantly associated with clinical depression, suicidal ideation and stress.
Part of a large European multicenter study conducted by the European Society for Dermatology and Psychiatry (ESDaP), the present study compared the psychological burden of disease and health-related quality of life between dermatological patients with itch and those without itch, as well as with healthy controls.
The study’s lead investigator, Florence Dalgard, said: “There are already studies showing evidence of a correlation between itch and mental health problems in general, and in specific skin disorders, but there is a lack of a cross-sectional study across chronic skin diseases.”
Investigators collected data from dermatological clinics in 13 European countries on 3,530 patients with skin diseases and compared the results with more than 1,000 healthy controls. Patients completed questionnaires and were also examined clinically. Outcome measures included the presence, chronicity and intensity of itch; the Hospital Anxiety and Depression Scale; sociodemographics; suicidal ideation, and stress, including negative life events; and economic difficulties.
The prevalence of depression was 14 per cent in patients with itch compared to 5.7 percent in patients without itch, six percent in controls with itch, and three percent in controls without itch. The prevalence of suicidal thoughts was 15.7 per cent in patients with itch, nine per cent in patients without itch,18.6 per cent in controls with itch and 8.6 per cent in controls without itch.
“Our research shows that itch has a high impact on quality of life,” said Dr. Dalgard. “This study illustrates the burden of the symptom of itch and its multidimensional aspect. The management of patients with itch should involve access to a multidisciplinary team when necessary, as is already the case in several European countries.”
The investigators also recommend preventive measures, such as psoriasis education programs or targeted web-based information. In many chronic inflammatory skin disorders, early aggressive treatment tailored specifically for the patient might help to reduce itch at the earliest possible opportunity and prevent the development of mental health problems. Existing anti-itch interventions should be implemented more frequently in the routine care of dermatological patients.