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  • Title: Psychological factors associated with hand dermatoses: which subgroup needs additional psychological care?
    Author: Niemeier V, Nippesen M, Kupfer J, Schill WB, Gieler U.
    Journal: Br J Dermatol; 2002 Jun; 146(6):1031-7. PubMed ID: 12072072.
    Abstract:
    BACKGROUND: The aetiology of hand dermatoses (HD) is very heterogeneous. Psychological influences on severity and coping in hand eczema have been only rarely investigated. OBJECTIVES: To investigate whether psychological factors correlate with somatic factors, in order to be able to estimate the possible need for psychosocial treatment of these patients. METHODS: In a cross-sectional study 101 hand dermatosis patients (49F, 52M) with psoriasis (n = 26), vesicular hand eczema (n = 33) or contact dermatitis (n = 42) were examined with regard to dermatological [diagnosis, severity, Erlanger Atopy Score (EAS)], allergic (patch test) and psychological aspects [Coping with Chronic Skin Diseases questionnaire (CSD), Allover Depression Scale (ADS), Social Readjustment Rating Scale (SRRS), questionnaire for measuring Factors of Aggression (FAF)],and Visual Analogue Scales (VAS) concerning itching, scratching and impairment. Subgroups of high stress responders (high-SR) vs. low stress responders (low-SR) were also examined. RESULTS: Of the patients with HD, 47.52% are convinced that 'stress' influences the course of their disease. Analysis of variance shows that the subjective reaction to stress (high-SR) correlates with higher severity scores, more itching, higher depression scores and more life events. High-SRs were younger and the onset of the disease was earlier compared with patients without a subjective reaction to stress (low-SR). In the CSD those with especially high-SR but negative patch-test results stated significantly higher values for itching, helplessness and search for information. CONCLUSIONS: Psychological factors should be taken into consideration in the treatment of patients with HD. High-SR patients with a negative patch-test seem to require more adjuvant psychological care.
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