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Yıl:2014; Cilt: 4; Sayı: 4>> Özet
TAM METİN
Journal of Mood Disorders; 2014;4(4):157-162
Psoriasis hastalarında depresyon, anksiyete ve yaşam kalitesinin hastalığın şiddeti ile ilişkisi
F Köşger, ME Bilgili, M Genek, B Yıldız, N Saraçoğlu, A Eşsizoğlu
Eskişehir Osmangazi Üniversitesi, Eskişehir
Amaç: Depresyon ve anksiyete bozuklukları psoriasis tanılı hastalarda en sık karşılaşılan psikiyatrik bozukluklardır. Psoriasiste ruhsal etkenlerin önemi bilinmekle birlikte hastalığın şiddetiyle depresyon ve anksiyetenin şiddeti arasındaki bağlantı ile ilgili yapılan çalışmalarda çelişkili sonuçlar ortaya çıkmıştır. Psikiyatrik bozuklukların birlikteliği psoriasis hastalarının yaşam kalitesini de olumsuz yönde etkilemektedir. Bu çalışmada psoriasis vulgaris hastalarındaki anksiyete, depresyon ve yaşam kalitesi düzeylerinin yaş, cinsiyet ve eğitim düzeyi açısından benzer özelliklerde olan sağlıklı kontrollerle karşılaştırılması ve psoriasis vulgaris şiddetiyle, depresyon, anksiyete ve yaşam kalitesi düzeyi arasındaki ilişkinin belirlenmesi amaçlanmıştır. Yöntem: Çalışmamıza psoriasis vulgaris tanısıyla izlenen daha önce psikiyatrik tanı ve tedavi almamış 69 hasta alındı. Hastalarla yaş, cinsiyet ve eğitim düzeyi açısından benzer özelliklere sahip 37 sağlıklı gönüllü kontrol grubu olarak çalışmaya dahil edildi. Hasta grubuna dermatoloji polikliniğinde psoriasis klinik şiddetini belirlemek için Psoriasis Alan Şiddet İndeksi (PAŞİ) uygulandı. Daha sonra farklı bir araştırmacı tarafından hastalara ve kontrol grubuna psikiyatri polikliniğinde Hamilton Depresyon Ölçeği (HAM-D), Hamilton Anksiyete Ölçeği (HAM-A), yaşam kalitesini değerlendirmek için Kısa Form-36 (KF-36) ölçeği uygulandı. Bulgular: Hasta grubunun kontrol grubuna göre HAM-D, HAM-A ruhsal ve HAM-A toplam ortalama puanları istatistiksel olarak anlamlı derecede yüksekti. Hasta grubunun kontrol grubuna göre KF-36 fiziksel fonksiyon, sosyal fonksiyon, fiziksel rol güçlüğü, emosyonel rol güçlüğü, mental sağlık, enerji, ağrı ve genel sağlık düzeyi ortalama puanları istatistiksel olarak anlamlı derecede düşüktü. Hasta grubunda PAŞİ puanlarıyla HAM-A bedensel ve HAM-A toplam puanları arasında pozitif korelasyon saptandı. Sonuç: Psoriasis hastalarında depresyon ve anksiyete düzeylerinin yüksek olması, hastaların ruhsal olarak değerlendirilmesinin gerekli olabileceğini düşündürebilir. Psoriasis şiddetiyle anksiyete arasında bağlantı olması, psoriasis hastalarının özellikle anksiyete yönüyle değerlendirilmesinin gerekliliğini gösterebilir.
The relationship between disease severity and depression, anxiety and quality of life in psoriasis patients
Objective: Depression and anxiety disorders are the most common psychiatric disorders in patients with psoriasis. Although the importance of psychological factors is known in psoriasis, the relationship between severity of disease and depression and anxiety is still undetermined. Psychiatric comorbidity negatively affects the quality of life in patients with psoriasis. In this study, we aimed to compare the depression, anxiety and quality of life levels of psoriasis vulgaris patients with those of healthy controls who are similar to them in terms of age, sex and education level and to determine the relationship between depression, anxiety and quality of life and the disease severity among psoriasis vulgaris patients. Method: This study involved 69 patients with psoriasis who had never been diagnosed and treated with a psychiatric disorder before. Thirty-seven healthy subjects who were similar to the study group in terms of age, gender and education level have also been included in the study. To determine the clinical severity of psoriasis Psoriasis Area Severity Index (PASI) was applied to the patient group in dermatology outpatient clinic. All participants were administered Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Short Form-36 (SF-36) by a different researcher in psychiatry outpatient clinic. Results: The mean HAM-D, HAM-A total and HAM-A mental scores of the patient group were significantly higher when compared to the scores of control group. The mean SF-36 physical functioning, social functioning, physical role difficulty, emotional role difficulty, mental health, energy, pain, and general health scores were significantly lower in the patient group than the control group. HAM-A total and HAM-A somatic scores were positively correlated with PASI scores in the patients.Conclusion: High levels of depression and anxiety in psoriasis patients may be showing a need for psychiatric assessment in these patients. The relationship between the psoriasis severity and anxiety level may suggest an assessment especially focusing on anxiety in psoriasis patients.

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