DEPRESSION AND QUALITY OF LIFE IN PATIENTS WITH PEMPHIGUS: A CROSS-SECTIONAL STUDY

MEGHA MAGHADE; ANAND SAOJI; ABHISHEK SOMANI; ABHIJEET FAYE

doi:10.22159/ajpcr.2024.v17i6.51658

Authors

MEGHA MAGHADE Department of Psychiatry, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
ANAND SAOJI Department of Psychiatry, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
ABHISHEK SOMANI Department of Psychiatry, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
ABHIJEET FAYE Department of Psychiatry, Shalini Tai Meghe Hospital and Research Center, Nagpur, Maharashtra, India.

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i6.51658

Keywords:

Pemphigus, depression, quality of life, Hospitalisation

Abstract

Objective: The objective of the study is (1) to analyze the prevalence and severity of depression in cases of pemphigus and (2) to study the association of demographic factors with the presence of depression in cases with pemphigus.

Methods: A cross-sectional single-interview study was carried out on 100 consecutively selected patients with pemphigus attending the dermatology out-patient department in a tertiary care hospital. The assessment was done with semi-structured pro forma, Beck depression inventory (BDI), and quality of life (QoL) measure – Skindex-16. The Statistical Package for the Social Sciences 24.0 was used for statistical analysis and p<0.05 was taken as statistically significant.

Results: Out of 100 cases, there were 60 (60%) males and 40 (40%) were females with M: F ratio of 1:0.66. The mean age of male and female patients was found to be comparable with no statistically significant difference (p=0.6061). The majority were married, employed, and from rural backgrounds. 22% satisfied the Diagnostic and Statistical Manual for Mental Disorders 5th edition criteria for major depressive disorder. Assessment using BDI in these patients for severity of depression showed mild depression in 12%, moderate depression in 7%, and severe depression in 3%. Patients having a longer duration of illness and a history of frequent hospitalization were found to have significantly high scores on the subscale for depressive symptoms. QoL assessment using the Skindex-16 scale among these patients showed that they experienced more severe emotional and symptomatic effects due to skin disease compared to functional effects, especially during relapse. Those who had poor QoL showed significantly high scores on the subscale for depressive symptoms.

Conclusion: More than 20% of patients of pemphigus had diagnosable depression with significant effects on QoL. Therefore, regular screening for depression is important in pemphigus patients as it will help in planning early intervention.

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References

Kridin K, Schmidt E. Epidemiology of pemphigus. JID Innov. 2021;1(1):100004. doi: 10.1016/j.xjidi.2021.100004

Melchionda V, Harman KE. Pemphigus vulgaris and pemphigus foliaceus: An overview of the clinical presentation, investigations and management. Clin Exp Dermatol. 2019;44(7):740-6. doi: 10.1111/ ced.14041

Wang J, Wu H, Cong W, Zhu H, Zheng J, Li X, et al. Psychological morbidity in patients with pemphigus and its clinicodemographic risk factor: A comparative study. J Dermatol. 2023 Oct;50(10):1237-45. doi: 10.1111/1346-8138.16875. PMID: 37381772

Matthews R, Ali Z. Comorbid mental health issues in patients with pemphigus vulgaris and pemphigus foliaceus. Clin Exp Dermatol. 2022 Jan;47(1):24-9. doi: 10.1111/ced.14916. PMID: 34459019

Mayrshofer F, Hertl M, Sinkgraven R, Sticherling M, Pfeiffer C, Zillikens D, et al. Significant decrease in quality of life in patients with pemphigus vulgaris. Results from the German Bullous Skin Disease (BSD) Study Group. J Dtsch Dermatol Ges. 2005 Jun 1;3(6):431-5.

Namazi MR. Prescribing antidepressant drugs for pemphigus patients: An important point to keep in mind. Dermatol Online J. 2004;10:22.

Ghodsi SZ, Chams-Davatchi C, Daneshpazhooh M, Valikhani M, Esmaili N. Quality of life and psychological status of patients with pemphigus vulgaris using Dermatology Life Quality Index and General Health Questionnaires. J Dermatol. 2012;39(2):141-4. doi: 10.1111/j.1346-8138.2011.01382.x

Rao R, Srinivas CR. Counseling in pemphigus. Indian J Dermatol. 2017;62(3):279-81. doi: 10.4103/ijd.IJD_198_17

Jackson-Koku G. Beck depression inventory. Occup Med (Lond). 2016;66(2):174-5. doi: 10.1093/occmed/kqv087

Chren MM. The skindex instruments to measure the effects of skin disease on quality of life. Dermatol Clin. 2012;30(2):231-6, xiii. doi: 10.1016/j.det.2011.11.003

Tolentino JC, Schmidt SL. DSM-5 criteria and depression severity: Implications for clinical practice. Front Psychiatry. 2018;9:450. 2018 Oct 2. doi: 10.3389/fpsyt.2018.00450

Layegh P, Mokhber N, Javidi Z, Mashhadi MP, Moghiman T. Depression in patients with pemphigus: Is it a major concern? J Dermatol. 2013 Jun;40(6):434-7. doi: 10.1111/1346-8138.12067. PMID: 23621570

Clarke EN, Thompson AR, Norman P. Depression in people with skin conditions: The effects of disgust and self-compassion. Br J Health Psychol. 2020;25(3):540-57. doi: 10.1111/bjhp.12421

Christensen RE, Jafferany M. Psychiatric and psychologic aspects of chronic skin diseases. Clin Dermatol. 2023;41(1):75-81. doi: 10.1016/j. clindermatol.2023.03.006

Porro AM, Seque CA, Ferreira MC, Enokihara MM. Pemphigus vulgaris. An Bras Dermatol. 2019;94(3):264-78. 2019 Jul 29. doi: 10.1590/abd1806-4841.20199011

Hsu YM, Fang HY, Lin CL, Shieh SH. The risk of depression in patients with pemphigus: A nationwide cohort study in Taiwan. Int J Environ Res Public Health. 2020 Mar 17;17(6):1983. doi: 10.3390/ijerph17061983. PMID: 32192212; PMCID: PMC7142767

Wohl Y, Mashiah J, Kutz A, Hadj-Rabia S, Cohen AD. Pemphigus and depression comorbidity: A case control study. Eur J Dermatol. 2015 Nov;25:602-5.

Picardi A, Abeni D, Melchi CF, Puddu P, Pasquini P. Psychiatric morbidity in dermatological outpatients: An issue to be recognized. Br J Dermatol. 2000;143(5):983-91. doi: 10.1046/j.1365-2133.2000.03831.x

Caccavale S, Lo Schiavo A. Psychiatric morbidity and pemphigus: A review of theories and literature on pathogenesis. G Ital Dermatol Venereol. 2016;151(2):198-202.

Ghodsi SZ, Asadi A, Ghandi N, Balighi K, Mahmoudi H, Abedini R, et al. Family impact of pemphigus disease in an Iranian population using the Family Dermatology Life Quality Index. Int J Womens Dermatol. 2020;6(5):409-13. doi: 10.1016/j.ijwd.2020.09.004

Tee CT, Lee CS, Gunabalasingam P. Characteristics and quality of life in pemphigus patients. Med J Malaysia. 2022;77(3):324-30.

Terrab Z, Benchikhi H, Maaroufi A, Hassoune S, Amine M, Lakhdar H. Qualité de vie et pemphigus. Ann Dermatol Venereol. 2005 Apr 1;132(4):321-8.

Arbabi M, Ghodsi Z, Mahdanian A, Noormohammadi N, Shalileh K, Darvish F, et al. Mental health in patients with pemphigus: An issue to worth consideration. Indian J Dermatol. 2011 Sep 1;56(5):541-5.