Relationship between disease severity, perceived stress, and depression in patients with seborrheic dermatitis

Yıl 2022, , 362 - 366, 31.10.2022

Esra Sarac Emek Kocatürk

https://doi.org/10.5472/marumj.1195298

Cited By: 3

Öz

Objective: A significant proportion of patients with seborrheic dermatitis state that disease attacks are triggered by psychological
stress and disease severity increases during stressful times. This study aimed to determine the relationship between disease severity
and perceived stress and depression levels in patients with seborrheic dermatitis.
Patients and Methods: The patients’ demographic characteristics, medical history, and Seborrheic Dermatitis Area Severity Index
(SDASI), Perceived Stress Scale (PSS), and Beck Depression Inventory (BDI) scores were recorded, and the relationship between
disease severity and the scale scores were statistically analyzed by comparing disease severity groups and using correlation analyses.
Results: The study included 120 patients with seborrheic dermatitis. The mean age of the patients was 29.5±8.2 years, and the female/
male ratio was 49/71. According to disease severity, 66 (55%) patients were classified as mild, 30(25%) moderate, and 24 (20%) as
severe seborrheic dermatitis. When the scale scores were evaluated, a significant positive correlation was found between SDASI and
PSS (r=0.767, p<0.001), between SDASI and BDI (r=0.663, p<0.001), and between PSS and BDI (r=0.687, p<0.001).
Conclusion: A significant relationship was observed between disease severity, stress, and depression in patients with seborrheic
dermatitis. There is a need for a multidisciplinary approach involving a dermatologist and psychiatrist in the follow-up and treatment
of these patients.

Anahtar Kelimeler

Depression, Disease severity, Seborrheic dermatitis, Stress

Kaynakça

• Gupta AK, Madzia SE, Batra R. Etiology and management of seborrheic dermatitis. Dermatology 2004;208:89-93. doi: 10.1159/000076478.
• Sampaio AL, Mameri AC, Vargas TJ, Ramos-e-Silva M, Nunes AP, Carneiro SC. Seborrheic dermatitis. An Bras Dermatol 2011;86:1061-71; quiz 1072-4. doi: 10.1590/ s0365.059.6201100.060.0002.
• Sanders MGH, Pardo LM, Franco OH, Ginger RS, Nijsten T. Prevalence and determinants of seborrhoeic dermatitis in a middle-aged and elderly population: the Rotterdam Study. Br J Dermatol 2018;178:148-53. doi: 10.1111/bjd.15908.
• Borda LJ, Wikramanayake TC. Seborrheic dermatitis and dandruff: a comprehensive review. J Clin Investig Dermatol 2015;3:10.13188/2373-1044.100.0019. doi: 10.13188/2373- 1044.100.0019.
• Paulino LC. New perspectives on dandruff and seborrheic dermatitis: lessons we learned from bacterial and fungal skin microbiota. Eur J Dermatol 2017;27(S1):4-7. doi: 10.1684/ ejd.2017.3038.
• Adalsteinsson JA, Kaushik S, Muzumdar S, Guttman-Yassky E, Ungar J. An update on the microbiology, immunology and genetics of seborrheic dermatitis. Exp Dermatol 2020;29:481- 9. doi: 10.1111/exd.14091.
• Fink G. Stress: Concepts, Definition, and History George. In: Neuroscience and Biobehavioral Psychology. Amsterdam, The Netherlands: Elsevier, 2017.
• Jafferany M, Franca K. Psychodermatology: Basics Concepts. Acta Derm Venereol 2016;96:35-7. doi: 10.2340/00015.555.2378.
• Colavincenzo ML, Granstein RD. Stress and the skin: a meeting report of the Weill Cornell Symposium on the Science of Dermatology. J Invest Dermatol 2006;126:2560-1. doi: 10.1038/sj.jid.5700565.
• Baker N, Billick SB. Psychiatric consequences of skin conditions: Multiple case study analysis with literature review. Psychiatr Q 2022;93:841-7. doi: 10.1007/s11126.022.09991-6.
• Magin PJ, Pond CD, Smith WT, Watson AB, Goode SM. A cross-sectional study of psychological morbidity in patients with acne, psoriasis and atopic dermatitis in specialist dermatology and general practices. J Eur Acad Dermatol Venereol 2008;22:1435-44. doi: 10.1111/j.1468- 3083.2008.02890.x.
• Misery L, Touboul S, Vinçot C, et al. Stress et dermatite séborrhéique. Ann Dermatol Venereol 2007;134:833-7. doi: 10.1016/s0151-9638(07)92826-4.
• Cömert A, Bekiroglu N, Gürbüz O, Ergun T. Efficacy of oral fluconazole in the treatment of seborrheic dermatitis: a placebo-controlled study. Am J Clin Dermatol 2007;8:235-8. doi: 10.2165/00128.071.200708040-00005.
• Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385-96.
• Eskin M, Harlak H, Demirkıran F, Dereboy C. Algılanan stres ölçeğinin Türkçe’ye uyarlanması: güvenirlik ve geçerlik analizi. Yeni Symposium Journal 2013;51:132-40.
• Hisli N. Beck Depresyon Envanteri’nin geçerliği üzerine bir çalışma. Türk Psikoloji Dergisi 1988;7:3-13.
• Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy of Depression. New York: Guilford Press, 1979.
• Alexopoulos A, Chrousos GP. Stress-related skin disorders. Rev Endocr Metab Disord 2016;17:295-304. doi: 10.1007/ s11154.016.9367-y.
• Pondeljak N, Lugović-Mihić L. Stress-induced interaction of skin immune cells, hormones, and neurotransmitters. Clin Ther 2020;42:757-70. doi: 10.1016/j.clinthera.2020.03.008.
• Lugović-Mihić L, Ljubesić L, Mihić J, Vuković-Cvetković V, Troskot N, Situm M. Psychoneuroimmunologic aspects of skin diseases. Acta Clin Croat 2013;52:337-45.
• Stewart TJ, Schut C, Whitfeld M, Yosipovitch G. Crosssectional study of psychological stress and skin symptoms in Australian university students. Australas J Dermatol 2018;59:e82ee84.
• Bin Saif GA, Alotaibi HM, Alzolibani AA, et al. Association of psychological stress with skin symptoms among medical students. Saudi Med J 2018;39:59e66.
• Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflamm Allergy Drug Targets 2014;13:177- 90. doi:10.2174/187.152.8113666.140.522104422.
• Slominski AT, Zmijewski MA, Skobowiat C, Zbytek B, Slominski RM, Steketee JD. Sensing the environment: regulation of local and global homeostasis by the skin’s neuroendocrine system. Adv Anat Embryol Cell Biol 2012;212:v,vii,1-115. doi: 10.1007/978-3-642-19683-6_1.
• Koo JYM, Lee CS. General approach to evaluating psychodermatological disorders. In: Koo JYM, Lee CS, eds. Psychocutaneous medicine. New York: Marcel Dekker, 2003: 17-28.
• Sanders MGH, Pardo LM, Ginger RS, Kiefte-de Jong JC, Nijsten T. Association between diet and seborrheic dermatitis: a cross-sectional study. J Invest Dermatol 2019;139:108-14. doi:10.1016/j.jid.2018.07.027.
• Bae JM, Ha B, Lee H, Park CK, Kim HJ, Park YM. Prevalence of common skin diseases and their associated factors among military personal in Korea. A cross-sectional study. J Korean Med Assoc 2012;27:1248-54.
• Lancar R, Missy P, Dupuy A, et al. Risk factors for seborrhoeic dermatitis flares: case-control and casecrossover study. Acta Derm Venereol 2020;100:adv00292. doi: 10.2340/00015.555.3661.
• Park SY, Kwon HH, Min S, Yoon JY, Suh DH. Clinical manifestation and associated factors of seborrheic dermatitis in Korea. Eur J Dermatol 2016;26:173-6. doi: 10.1684/ ejd.2015.2706.
• Aksoy M, Ozkorumak E, Bahadır S, Yayli S, Aksu Arica D. Quality of life, anxiety and depression levels in patients with seborrheic dermatitis. Turkderm 2012;46:39–43.
• Oztas P, Calıkoglu E, Cetin I. Psychiatric tests in seborrhoeic dermatitis. Acta Derm Venereol 2004;85:68–9.
• Doğramacı AÇ, Havlucu DY, Savaş N. Seboreik dermatitli hastalarda yaşam kalite değerlendirmesi. Türk Dermatoloji Dergisi 2008;2:99-102.
• Peyrí J, Lleonart M; Grupo español del Estudio SEBDERM: Clinical and therapeutic profile and quality of life patients with seborrheic dermatitis. Actas Dermosifiliogr 2007;98:476- 82.
• Maietta G, Fornaro P, Rongioletti F, Rebora A. Patients with mood depression have a high prevalence of seborrhoeic dermatitis. Acta Derm Venereol 1990;70:432-4.
• Cömert A, Akbaş B, Kılıç EZ, et al. Psychiatric comorbidities and alexithymia in patients with seborrheic dermatitis: a questionnaire study in Turkey. Am J Clin Dermatol 2013;14:335-42. doi:10.1007/s40257.013.0019-7.