Depression and suicidal ideation demonstrate a strong association with the presence of itch in dermatology patients compared with patients without itch according to study results published in the Journal of Investigative Dermatology.
Itch is highly prevalent and the burden of itch has been demonstrated in various diseases; however, limited cross-sectional studies across chronic skin diseases have shown the correlations between itch and mental health issues in dermatologic patients.
The investigation was an observational cross-sectional multicenter analysis conducted in dermatologic outpatient clinics in 13 European countries and included a total of 3530 patients (mean age, 47.2±17.5 years; 56.3% women) and 1094 healthy control participants (mean age, 40.5±13.3 years; 64.6% women Outcome measures included itch, the Hospital Anxiety and Depression Scale, EQ-5D visual analogue scale, sociodemographic factors, suicidal ideation, and stress. The study was questionnaire-based, and data collection took place from 2011 to 2013.
The major findings included a higher prevalence of depression, anxiety, and suicidal ideation in patients with compared with patients without itch, control patients with itch, and control patients without itch. Patients with itch reported increased experiences with negative events vs patients without itch (38.2%; 95% CI, 36.1%-40.5% vs 32.4%; 95% CI, 29.9%-34.7%; P <.001). Furthermore, the presence of itch was significantly associated with clinical depression (odds ratio [OR] 1.53; 95% CI, 1.15-2.02), suicidal ideation (OR 1.27; 95% CI, 1.01-1.6), and economic difficulties (OR 1.24; 95% CI, 1.05-1.45). The mean score of reported generic health status assessed by the EQ-5D visual analogue scale was 65.9±20.1 in patients with itch compared with 74.7±18 in patients without itch (P =.001) and 74.9±15.7 in control patients with compared with 82.9±15.6 control patients without itch (P <.001).
Limitations of the study include the fact that because it was cross-sectional, inferences on causation cannot be made and patient selection may have been biased as control patients were typically hospital employees.
The study results demonstrate that mental health issues and skin diseases are strongly linked in patients and the association becomes stronger if the patient experiences itch. Consequently, a multidisciplinary team should be involved in the management of patients with itch.
Dalgard FJ, Svensson A, Halvorsen JA, et al. Itch and mental health in dermatological patients across Europe: A cross-sectional study in 13 countries. J Invest Dermatol. 2020;140(3):568-573.