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Published in: American Journal of Clinical Dermatology 3/2016

01-06-2016 | Original Research Article

Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study

Authors: Andac Salman, Emel Kurt, Volkan Topcuoglu, Zeynep Demircay

Published in: American Journal of Clinical Dermatology | Issue 3/2016

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Abstract

Background

Vitiligo and acne vulgaris, commonly affecting the face, have significant psychological effects and impair the quality of life of the affected individuals. Because of their negative effect on physical appearance, these conditions may act as a potential barrier to social relationships and cause social anxiety.

Objective

The objective of the study was to investigate the social anxiety, quality of life, anxiety, and depression levels of acne and vitiligo patients with facial involvement and compare these levels with healthy controls.

Methods

Thirty-seven vitiligo and 37 acne patients, aged older than 18 years, with facial involvement and 74 age- and sex-matched healthy control subjects were included in the study. The patients and healthy controls were asked to complete the Liebowitz Social Anxiety Scale, the Hospital Anxiety and Depression Scale, and the Dermatology Life Quality Index. Disease severity was evaluated both objectively by the physician and subjectively by the patients using a visual analog scale.

Results

Social anxiety, depression, and anxiety levels of vitiligo and acne patients were significantly higher than healthy controls (p < 0.05). Quality of life was impaired in both patient groups (Dermatology Life Quality Index scores for vitiligo: 5.6 ± 5.1; acne: 6.4 ± 6.2). There was no correlation between psychiatric scale scores and disease severity. Quality of life was negatively correlated with social anxiety and depression levels in both patient groups in our study.

Conclusion

Vitiligo and acne patients had higher levels of social anxiety, anxiety, and depression compared with healthy control subjects. Considering that increased psychosocial morbidity was regardless of age, sex, and disease severity and was correlated with quality of life impairment, evaluation of the psychosocial morbidity, in particular social anxiety, may be valuable in all vitiligo and acne patients.
Literature
1.
go back to reference Timms RM. Moderate acne as a potential barrier to social relationships: myth of reality? Psyhcol Health Med. 2013;18:310–20.CrossRef Timms RM. Moderate acne as a potential barrier to social relationships: myth of reality? Psyhcol Health Med. 2013;18:310–20.CrossRef
2.
go back to reference Ongenae K, Beelaert L, van Geel N, Naeyaert JM. Psychosocial effects of vitiligo. J Eur Acad Dermatol Venereol. 2006;20:1–8.CrossRefPubMed Ongenae K, Beelaert L, van Geel N, Naeyaert JM. Psychosocial effects of vitiligo. J Eur Acad Dermatol Venereol. 2006;20:1–8.CrossRefPubMed
3.
go back to reference Kent G, al-Abadie M. Factors affecting responses on Dermatology Life Quality Index items among vitiligo sufferers. Clin Exp Dermatol. 1996;21:330–3.CrossRefPubMed Kent G, al-Abadie M. Factors affecting responses on Dermatology Life Quality Index items among vitiligo sufferers. Clin Exp Dermatol. 1996;21:330–3.CrossRefPubMed
5.
go back to reference Homan MWL, Spuls PI, de Korte J, Bos JD, Sprangers MA, van der Veen JP. The burden of vitiligo: patient characteristics associated with quality of life. J Am Acad Dermatol. 2009;61:411–20.CrossRef Homan MWL, Spuls PI, de Korte J, Bos JD, Sprangers MA, van der Veen JP. The burden of vitiligo: patient characteristics associated with quality of life. J Am Acad Dermatol. 2009;61:411–20.CrossRef
6.
go back to reference Ruscio AM, Brown TA, Chiu WT, Sareen J, Stein MB, Kessler RC. Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychol Med. 2008;38:15–28.CrossRefPubMedPubMedCentral Ruscio AM, Brown TA, Chiu WT, Sareen J, Stein MB, Kessler RC. Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychol Med. 2008;38:15–28.CrossRefPubMedPubMedCentral
7.
go back to reference Koyuncu A, Ertekin E, Deveci E, et al. Age of onset in social anxiety disorder: relation to clinical variables and major depression comorbidity. Ann Clin Psychiatry. 2015;27:84–9.PubMed Koyuncu A, Ertekin E, Deveci E, et al. Age of onset in social anxiety disorder: relation to clinical variables and major depression comorbidity. Ann Clin Psychiatry. 2015;27:84–9.PubMed
9.
go back to reference Brook CA, Schmidt LA. Social anxiety disorder: a review of environmental risk factors. Neuropsychiatr Dis Treat. 2008;4:123–43.PubMedPubMedCentral Brook CA, Schmidt LA. Social anxiety disorder: a review of environmental risk factors. Neuropsychiatr Dis Treat. 2008;4:123–43.PubMedPubMedCentral
10.
go back to reference Ongenae K, Van Geel N, De Schepper S, Naeyaert JM. Effect of vitiligo on self-reported health-related quality of life. Br J Dermatol. 2005;152:1165–72.CrossRefPubMed Ongenae K, Van Geel N, De Schepper S, Naeyaert JM. Effect of vitiligo on self-reported health-related quality of life. Br J Dermatol. 2005;152:1165–72.CrossRefPubMed
11.
go back to reference Mallon E, Newton JN, Klassen A, Stewart-Brown SL, Ryan TJ, Finlay AY. The quality of life in acne: a comparison with general medical conditions using generic questionnaires. Br J Dermatol. 1999;140:672–6.CrossRefPubMed Mallon E, Newton JN, Klassen A, Stewart-Brown SL, Ryan TJ, Finlay AY. The quality of life in acne: a comparison with general medical conditions using generic questionnaires. Br J Dermatol. 1999;140:672–6.CrossRefPubMed
12.
go back to reference Ahmed A, Leon A, Butler DC, Reichenberg J. Quality-of-life effects of common dermatological diseases. Semin Cutan Med Surg. 2013;32:101–9.CrossRefPubMed Ahmed A, Leon A, Butler DC, Reichenberg J. Quality-of-life effects of common dermatological diseases. Semin Cutan Med Surg. 2013;32:101–9.CrossRefPubMed
13.
go back to reference Yarpuz AY, Saadet ED, Sanli HE, Ozguven HD. Social anxiety level in acne vulgaris patients and its relationship to clinical variables. Turk Psikiyatri Derg. 2008;19:29–37. Yarpuz AY, Saadet ED, Sanli HE, Ozguven HD. Social anxiety level in acne vulgaris patients and its relationship to clinical variables. Turk Psikiyatri Derg. 2008;19:29–37.
14.
go back to reference Bez Y, Yesilova Y, Kaya MC, Sir A. High social phobia frequency and related disability in patients with acne vulgaris. Eur J Dermatol. 2011;21:756–60.PubMed Bez Y, Yesilova Y, Kaya MC, Sir A. High social phobia frequency and related disability in patients with acne vulgaris. Eur J Dermatol. 2011;21:756–60.PubMed
15.
go back to reference Loney T, Standage M, Lewis S. Not just ‘skin deep’: psychosocial effects of dermatological-related social anxiety in a sample of acne patients. J Heatlh Psychol. 2008;13:47–54.CrossRef Loney T, Standage M, Lewis S. Not just ‘skin deep’: psychosocial effects of dermatological-related social anxiety in a sample of acne patients. J Heatlh Psychol. 2008;13:47–54.CrossRef
16.
go back to reference Balaban OD, Atagun MI, Ozguven HD, Ozsan HH. Psychiatric morbidity in patients with vitiligo. Dusunen Adam. 2011;24:306–13.CrossRef Balaban OD, Atagun MI, Ozguven HD, Ozsan HH. Psychiatric morbidity in patients with vitiligo. Dusunen Adam. 2011;24:306–13.CrossRef
17.
go back to reference Krüger C, Schallreuter KU. Stigmatisation, avoidance behaviour and difficulties in coping are common among adult patients with vitiligo. Acta Derm Venereol. 2015;95:553–8.CrossRefPubMed Krüger C, Schallreuter KU. Stigmatisation, avoidance behaviour and difficulties in coping are common among adult patients with vitiligo. Acta Derm Venereol. 2015;95:553–8.CrossRefPubMed
18.
go back to reference Hughes JE, Barraclough BM, Hamblin LG, White JE. Psychiatric symptoms in dermatology patients. Br J Psychiatry. 1983;143:51–4.CrossRefPubMed Hughes JE, Barraclough BM, Hamblin LG, White JE. Psychiatric symptoms in dermatology patients. Br J Psychiatry. 1983;143:51–4.CrossRefPubMed
19.
go back to reference Picardi A, Abeni D, Renzi C, Braga M, Puddu P, Pasquini P. Increased psychiatric morbidity in female outpatients with skin lesions on visible parts of the body. Acta Derm Venereol. 2001;81:410–4.CrossRefPubMed Picardi A, Abeni D, Renzi C, Braga M, Puddu P, Pasquini P. Increased psychiatric morbidity in female outpatients with skin lesions on visible parts of the body. Acta Derm Venereol. 2001;81:410–4.CrossRefPubMed
20.
go back to reference Nast A, Dreno B, Bettoli V, et al. European evidence-based (S3) guidelines for the treatment of acne. J Eur Acad Dermatol Venereol. 2012;26(S1):1–29.CrossRefPubMed Nast A, Dreno B, Bettoli V, et al. European evidence-based (S3) guidelines for the treatment of acne. J Eur Acad Dermatol Venereol. 2012;26(S1):1–29.CrossRefPubMed
22.
go back to reference Soykan C, Ozguven HD, Gencoz T. Liebowitz Social Anxiety Scale: the Turkish version. Psychol Rep. 2003;93:1059–69.CrossRefPubMed Soykan C, Ozguven HD, Gencoz T. Liebowitz Social Anxiety Scale: the Turkish version. Psychol Rep. 2003;93:1059–69.CrossRefPubMed
23.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRefPubMed Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRefPubMed
24.
go back to reference Aydemir O, Guvenir T, Kuey L, Kultur S. Hastane anksiyete ve depresyon olçegi Turkce formunun gecerlilik ve guvenilirligi. Turk Psikiyatri Derg. 1997;8:280–7. Aydemir O, Guvenir T, Kuey L, Kultur S. Hastane anksiyete ve depresyon olçegi Turkce formunun gecerlilik ve guvenilirligi. Turk Psikiyatri Derg. 1997;8:280–7.
25.
go back to reference Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI): a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19:210–6.CrossRefPubMed Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI): a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19:210–6.CrossRefPubMed
26.
go back to reference Oztürkcan S, Ermertcan AT, Eser E, Sahin MT. Cross validation of the Turkish version of Dermatology Life Quality Index. Int J Dermatol. 2006;45:1300–7.CrossRefPubMed Oztürkcan S, Ermertcan AT, Eser E, Sahin MT. Cross validation of the Turkish version of Dermatology Life Quality Index. Int J Dermatol. 2006;45:1300–7.CrossRefPubMed
27.
go back to reference Shah R, Hunt J, Webb TL, Thompson AR. Starting to develop self-help for social anxiety associated with vitiligo: using clinical significance to measure the potential effectiveness of enhanced psychological self-help. Br J Dermatol. 2014;171:332–7.CrossRefPubMed Shah R, Hunt J, Webb TL, Thompson AR. Starting to develop self-help for social anxiety associated with vitiligo: using clinical significance to measure the potential effectiveness of enhanced psychological self-help. Br J Dermatol. 2014;171:332–7.CrossRefPubMed
28.
go back to reference Khattri S, Bist JS, Arun A, Mehta AK. Clinical correlates of vitiligo with depression and anxiety: a comparative study in patients and their caregivers. Int J Adv Res. 2015;3:200–5. Khattri S, Bist JS, Arun A, Mehta AK. Clinical correlates of vitiligo with depression and anxiety: a comparative study in patients and their caregivers. Int J Adv Res. 2015;3:200–5.
29.
go back to reference Ozturk A, Deveci E, Bagcioglu E, Atalay F, Serdar Z. Anxiety, depression, social phobia, and quality of life in Turkish patients with acne and their relationships with the severity of acne. Turk J Med Sci. 2013;43:660–6.CrossRef Ozturk A, Deveci E, Bagcioglu E, Atalay F, Serdar Z. Anxiety, depression, social phobia, and quality of life in Turkish patients with acne and their relationships with the severity of acne. Turk J Med Sci. 2013;43:660–6.CrossRef
30.
go back to reference Clark DM, Wells A. A cognitive model of social phobia. In: Heimberg RG, Liebowitz MR, Hope DA, Schenier FR, editors. Social phobia: diagnosis, assessment, and treatment. New York: Guilford Press; 1995. p. 69–74. Clark DM, Wells A. A cognitive model of social phobia. In: Heimberg RG, Liebowitz MR, Hope DA, Schenier FR, editors. Social phobia: diagnosis, assessment, and treatment. New York: Guilford Press; 1995. p. 69–74.
31.
go back to reference 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;18:435–9.CrossRefPubMed 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;18:435–9.CrossRefPubMed
32.
go back to reference Kostopoulou P, Jouary T, Quintard B, et al. Objective vs. subjective factors in the psychological impact of vitiligo: the experience from a French referral centre. Br J Dermatol. 2009;161:128–33.CrossRefPubMed Kostopoulou P, Jouary T, Quintard B, et al. Objective vs. subjective factors in the psychological impact of vitiligo: the experience from a French referral centre. Br J Dermatol. 2009;161:128–33.CrossRefPubMed
33.
go back to reference Parsad D, Pandhi R, Dogra S, Kanwar AJ, Kumar B. Dermatology Life Quality Index score in vitiligo and its impact on the treatment outcome. Br J Dermatol. 2003;148:373–4.CrossRefPubMed Parsad D, Pandhi R, Dogra S, Kanwar AJ, Kumar B. Dermatology Life Quality Index score in vitiligo and its impact on the treatment outcome. Br J Dermatol. 2003;148:373–4.CrossRefPubMed
34.
go back to reference Lasek RJ, Chren MM. Acne vulgaris and the quality of life of adult dermatology patients. Arch Dermatol. 1998;134:454–8.CrossRefPubMed Lasek RJ, Chren MM. Acne vulgaris and the quality of life of adult dermatology patients. Arch Dermatol. 1998;134:454–8.CrossRefPubMed
35.
go back to reference Wittkowski A, Richards HL, Griffiths CE, Main CJ. The impact of psychological and clinical factors on quality of life in individuals with atopic dermatitis. J Psychosom Res. 2004;57:195–200.CrossRefPubMed Wittkowski A, Richards HL, Griffiths CE, Main CJ. The impact of psychological and clinical factors on quality of life in individuals with atopic dermatitis. J Psychosom Res. 2004;57:195–200.CrossRefPubMed
36.
go back to reference Sampogna F, Picardi A, Chren MM, et al. Association between poorer quality of life and psychiatric morbidity in patients with different dermatological conditions. Psychosom Med. 2004;66:620–4.CrossRefPubMed Sampogna F, Picardi A, Chren MM, et al. Association between poorer quality of life and psychiatric morbidity in patients with different dermatological conditions. Psychosom Med. 2004;66:620–4.CrossRefPubMed
37.
go back to reference Sampogna F, Raskovic D, Guerra L, et al. Identification of categories at risk for high quality of life impairment in patients with vitiligo. Br J Dermatol. 2008;159:351–9.CrossRefPubMed Sampogna F, Raskovic D, Guerra L, et al. Identification of categories at risk for high quality of life impairment in patients with vitiligo. Br J Dermatol. 2008;159:351–9.CrossRefPubMed
39.
go back to reference Demircay Z, Seckin D, Senol A, Demir F. Patient’s perspective: an important issue not to be overlooked in assessing acne severity. Eur J Dermatol. 2008;18:181–4.PubMed Demircay Z, Seckin D, Senol A, Demir F. Patient’s perspective: an important issue not to be overlooked in assessing acne severity. Eur J Dermatol. 2008;18:181–4.PubMed
40.
go back to reference Magin PJ, Pond CD, Smith WT, Watson AB, Goode SM. Correlation and agreement of self-assessed and objective skin disease severity in a cross-sectional study of patients with acne, psoriasis, and atopic eczema. Int J Dermatol. 2011;50:1486–90.CrossRefPubMed Magin PJ, Pond CD, Smith WT, Watson AB, Goode SM. Correlation and agreement of self-assessed and objective skin disease severity in a cross-sectional study of patients with acne, psoriasis, and atopic eczema. Int J Dermatol. 2011;50:1486–90.CrossRefPubMed
41.
go back to reference Gupta MA, Gupta AK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol. 2003;4:833–42.CrossRefPubMed Gupta MA, Gupta AK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol. 2003;4:833–42.CrossRefPubMed
42.
go back to reference Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol. 1998;139:846–50.CrossRefPubMed Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol. 1998;139:846–50.CrossRefPubMed
43.
go back to reference Woodruff PW, Higgins EM, du Vivier AW, Wessely S. Psychiatric illness in patients referred to a dermatology-psychiatry clinic. Gen Hosp Psychiatry. 1997;19:29–35.CrossRefPubMed Woodruff PW, Higgins EM, du Vivier AW, Wessely S. Psychiatric illness in patients referred to a dermatology-psychiatry clinic. Gen Hosp Psychiatry. 1997;19:29–35.CrossRefPubMed
44.
go back to reference Kent G, Al’Abadie M. Psyshologic effects of vitiligo: a critical incident analysis. J Am Acad Dermatol. 1996;35:895–8.CrossRefPubMed Kent G, Al’Abadie M. Psyshologic effects of vitiligo: a critical incident analysis. J Am Acad Dermatol. 1996;35:895–8.CrossRefPubMed
45.
go back to reference Niemeier V, Kupfer J, Gieler U. Acne vulgaris-psychosomatic aspects. J Dtsch Dermatol Ges. 2006;4:1027–36.CrossRefPubMed Niemeier V, Kupfer J, Gieler U. Acne vulgaris-psychosomatic aspects. J Dtsch Dermatol Ges. 2006;4:1027–36.CrossRefPubMed
46.
go back to reference Moretti S, Arunachalam M, Colucci R, et al. Autoimmune markers in vitiligo patients appear correlated with obsession and phobia. J Eur Acad Dermatol Venereol. 2012;26:861–7.CrossRefPubMed Moretti S, Arunachalam M, Colucci R, et al. Autoimmune markers in vitiligo patients appear correlated with obsession and phobia. J Eur Acad Dermatol Venereol. 2012;26:861–7.CrossRefPubMed
47.
go back to reference Mattoo SK, Handa S, Kaur I, Gupta N, Malhotra R. Psyhiatric morbidity in vitiligo: prevalence and correlates in India. J Eur Acad Dermatol Venereol. 2002;16:573–8.CrossRefPubMed Mattoo SK, Handa S, Kaur I, Gupta N, Malhotra R. Psyhiatric morbidity in vitiligo: prevalence and correlates in India. J Eur Acad Dermatol Venereol. 2002;16:573–8.CrossRefPubMed
48.
go back to reference Stein MB, Kean YM. Disability and quality of life in social phobia: epidemiologic findings. Am J Psychiatry. 2000;157:1606–13.CrossRefPubMed Stein MB, Kean YM. Disability and quality of life in social phobia: epidemiologic findings. Am J Psychiatry. 2000;157:1606–13.CrossRefPubMed
Metadata
Title
Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study
Authors
Andac Salman
Emel Kurt
Volkan Topcuoglu
Zeynep Demircay
Publication date
01-06-2016
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 3/2016
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.1007/s40257-016-0172-x

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