THE RELATIONSHIP BETWEEN PSYCHOLOGICAL PAIN, RUMINATION AND SUICIDE AND ACNE SEVERITY IN ACNE VULGARIS PATIENTS

Year 2024, , 187 - 193, 20.08.2024

Fatma Kartal , Bülent Nuri Kalaycı , Burak Mete , Tarık Salcan , Kerim Uğur

https://doi.org/10.24938/kutfd.1454967

Abstract

Objective: Acne vulgaris is among dermatological diseases that increase suicide risk significantly. We aimed to investigate the relationship between suicide risk and acne severity, psychological pain, and especially brooding rumination in 18-36 year old acne vulgaris patients.
Material and Methods: Our study was conducted with 103 acne vulgaris patients and 87 healthy controls. Study data were collected with a Socio-demographic Data Form, Global Acne Scoring System (GASS), Suicide Probability Scale (SPS), Psychological Pain Scale (PPS), Rumination Response Scale – Short Form (RRS-SF), and Beck Depression Inventory (BDI).
Results: It was determined that median brooding rumination, total SPS scores and Hopelesness, hostility subscale scores were statistically significantly higher in the patient group (p values; 0.035, 0.006, 0.032, 0.007). In the patient group, the analysis of the correlations between the GASS and scale scores when the BDI score is controlled demonstrated that there were weak positive correlations between SPS despair and hostility subscale scores and total SPS score and PPS and brooding rumination scores (p: 0.003; r: 0.270), (p:0.014; r: 0.218), (p:0.010; r:0.229),(p:<0.001; r:0.389), (p:0.001, r: 0.304), (p:0.010; r:0.229). It was determined that brooding rumination, PPS and GASS scores contributed significantly to the multiple linear regression model structured estimate of the total SPS score.
Conclusion: Since the suicidal risk of acne patients with acne who present to dermatology clinics could be high, it is important to follow up these patients with the psychiatry clinic, and in addition to acne treatment, therapeutic interventions that aim to reduce ruminative ideation and psychological pain could significantly contribute to the reduction of suicide risk.

Keywords

Acne vulgaris, suicide, psychological pain, rumination

Akne Vulgaris Tanılı Hastalarda Psikolojik Acı, Rıminasyon ve Suicid ile Akne Şiddeti Arasındaki İlişkisi

Abstract

Amaç: Akne vulgaris intihar riskini önemli ölçüde artıran dermatolojik hastalıklar arasında yer almaktadır. 18-36 yaş arası akne vulgaris hastalarında intihar riski ile akne şiddeti, psikolojik acı ve özellikle brooding ruminasyon arasındaki ilişkiyi araştırmayı amaçladık.
Gereç ve Yöntemler: Çalışmamız 103 akne vulgaris hastası ve 87 sağlıklı kontrol ile gerçekleştirildi. Çalışma verileri Sosyodemografik Veri Formu, Global Akne Skorlama Sistemi (GASS), İntihar Olasılığı Ölçeği (SPS), Psikolojik Ağrı Ölçeği (PPS), Ruminasyon Tepki Ölçeği-Kısa Form (RRS-SF) ve Beck Depresyon Envanteri ile toplanmıştır (BDI).
Bulgular: Hasta grubunda kara kara düşünme, toplam SPS puanları ve Umutsuzluk, düşmanlık alt ölçek puan ortalamalarının istatistiksel olarak anlamlı derecede yüksek olduğu belirlendi (p değerleri; 0.035, 0.006, 0.032, 0.007). Hasta grubunda BDÖ puanı kontrol edildiğinde GASS ile ölçek puanları arasındaki korelasyonlar incelendiğinde, SPS umutsuzluk ve düşmanlık alt ölçek puanları ile toplam SPS puanı ile PPS ve kara kara düşünme puanları arasında pozitif yönde zayıf ilişkiler olduğu görüldü (p:0.003) ; r: 0.270), (p:0.014; r: 0.218), (p:0.010; r:0.229), (p:<0.001; r:0.389),(p:0.001, r:0.304), (p:0.010; r:0.229). Brooding ruminasyon, PPS ve GASS puanlarının, çoklu doğrusal regresyon modeli yapılandırılmış toplam SPS puanı tahminine anlamlı katkı sağladığı belirlendi.
Sonuç: Dermatoloji kliniklerine başvuran akne hastalarının intihar riski yüksek olabileceğinden bu hastaların psikiyatri kliniği tarafından takip edilmesi önemlidir. Akne tedavisine ek olarak ruminatif düşünce ve psikolojik acıyı azaltmayı amaçlayan terapötik müdahaleler intihar riskinin azaltılmasına önemli ölçüde katkı sağlayabilir.

Keywords

Akne vulgaris, intihar, psikolojik acı, ruminasyon

References

• WHO. Preventing suicide: a global imperative. Geneva: World Health Organization, 2014.
• Akan M, Ayaz N, Taşkapan MÇ, Bulut N, Erbay LG. The relationship between suicide attempt and gonadotropins, gonadal hormones, and cortisol in females. Alpha Psychiatry. 2021;22(5):230-236.
• Picardi A, Lega I, Tarolla E. Suicide risk in skin disorders. Clin Dermatol. 2008;31:47-56.
• Naghavi, M. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ. 2019:364:194.
• Xu S, Zhu Y, Hu H, et al. The analysis of acne increasing suicide risk. Medicine. 2021;100(24):e26035.
• Özlü E, Ertaş R, Özyurt K, Karaatlı İ, Karadağ AS. Effects of Isotretinoin treatment on sleep and quality of life in patients with acne vulgaris. Konuralp Med J. 2018;10(1):65-73.
• Cotterill JA, Cunliffe WJ. Suicide in dermatological patients. Br J Dermatol. 1997;137(2): 246-250.
• Verrocchio MC, Carrozzino D, Marchetti D, Andreasson K, Fulcheri M, Bech P. Mental pain and suicide: a systematic review of the literature. Front Psychiatry. 2016;7:108.
• Ducasse D, Holden RR, Boyer L, et al. Psychological pain in suicidality: A meta-analysis. J Clin Psychiatry. 2018;79(3):16r10732.
• Mee S, Bunney BG, Reist C, Potkin SG, Bunney WE. Psychological pain: a review of evidence.J Psychiatr Res. 2006;40:680-690.
• Treynor W, Gonzalez R, Nolenhoeksema S. Rumination reconsidered: A psychometric analysis. Cognit Ther Res. 2003;27:247–259.
• Tang H, Xiong T, Shi J, et al. Global and reflective rumination are related to suicide attempts among patients experiencing major depressive episodes. BMC Psychiatry. 2021;21(1):117.
• Teismann T, Forkmann T. Rumination, entrapment and suicide ideation: a mediational model: rumination, entrapment and suicide ideation: a mediational model. Clin Psychol&Psychotherapy. 2017;24:226–234.
• Yazici K, Baz K, Yazici AE, et al. Disease-specific quality of life is associated with anxiety and depression in patients with acne. J Eur Acad Dermatol Venereol. 2004;18(4):435-459.
• Faul F, Erdfelder E, Lang A. Buchner, A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-191.
• Tan JK, Tang J, Fung K, et al. Development and validation of a comprehensive acne severity scale. J Cutan Med Surg.2007;11:211-216.
• Mee S, Bunney BG, Bunney WE, Hetrick W, Potkin SG, Reis C. Assessment of psychological pain in major depressive episodes. J Psychiatr Res. 2011;45(11):1504–1510.
• Demirkol ME, Güleç H, Çakmak S, et al. Reliability and validity study of the Turkish Version of the Psychache Scale. Anadolu Psikiyatri Derg. 2018; 19(Suppl1):14-20.
• Cull JG, Gill WS. Suicide Probability Scale Manual. Los Angeles, CA: Western Psychological Services,1988.
• Treynor W, Gonzalez R, Nolen-Hoeksema S. Rumination reconsidered: A psychometric analysis. Cognit Ther Res. 2003;27:247–259.
• Erdur-Baker O. Bugay A. The Turkish version of the Ruminative Response Scale: An examination of its reliability and validity. Int J Educ Psychol Assess. 2012;10(2):1-16.
• Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561–571.
• Hisli N. Beck Depresyon Envanterinin gecerliligi uzerine bir calisma (a study on the validity of Beck depression inventory). Psikoloji Dergisi. 1989;6:118–122.
• Halvorsen JA, Stern RS, Dalgard F, Thoresen M, Bjertness E, Lien L. Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: a population-based study. J Invest Dermatol. 2011;131(2):363–370.
• Rehn LM, Meririnne E, Höök-Nikanne J, et al. Depressive symptoms, suicidal ideation and acne: a study of male Finnish conscripts. J Eur Acad Derm Venereol. 2008; 22:561-567.
• Lear MK, Stacy SE, Pepper CM. Interpersonal needs and psychological pain: The role of brooding and rejection sensitivity. Death Stud. 2018;42(8):521-528.
• Uğur K, Polat H. The relationship of suicidal ideation with psychological pain and anger rumination in patients with major depressive disorder. Arch Psychiatr Nurs. 2021;35(5):479-485.
• Nolen-Hoeksema S, Wisco B E, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3(5):400–424.
• Morrison R, O’Connor RC. A systematic review of the relationship between rumination and suicidality. Suicide Life Threat Behav. 2008;38:523–538.
• Kerkhof A, Van Spijker B. Worrying and rumination as proximal risk factors for suicidal behaviour. In: O’Connor RC, Platt S, Gordon J, editors. International handbook of suicide prevention research, policy and practice, 1st ed. Malden, MA: John Wiley & Sons, 2011:199–210.
• Rogers ML, Joiner TE. Rumination, suicidal ideation, and suicide attempts: A meta-analytic review. Rev Gen Psychol. 2017;21:132–142.
• Cohen NJ, Stange JP, Hamilton JL, et al. The interaction of affective states and cognitive vulnerabilities in the prediction of non-suicidal self-injury. Cogn Emot. 2015;29:539–547.
• Horwitz AG, Czyz EK, Berona J, King CA. Rumination, brooding, and reflection: prospective associations with suicide ideation and suicide attempts. Suicide Life Threat Behav. 2019;49(4):1085-1093.