Sintomatologia ansiosa, depressiva e qualidade de vida em pessoas com dermatoses

Abstract

Abstract Introduction: The study of interactions between the psychological and somatic mechanisms has been a pressing need in numerous clinical contexts. The skin is constantly exposed to various stress-inducing stimuli, including emotional stressors. In the presence of depressive and/or anxious condi-tions, the hypothalamus stimulates cortisol production. This alteration contributes to the release of inflammatory factors that trigger immune disturbances, promoting or modifying the course of derma-toses. Conversely, the immune system altered by dermatoses also influences the Central Nervous Sys-tem and its neurotransmitters. Despite evidence suggesting this relationship, the tipical patient care in clinical practice often undervalues the comprehension of the individual as a whole and fails to estab-lish coordinated care between Psychiatry and Dermatology. This study aimed to understand how de-pressive and anxious symptoms are related to dermatoses. Methods: The instruments GAD-7 (Gen-eralized Anxiety Disorder 7), PHQ-9 (Patient Health Questionnaire 9), and DLQI (Dermatology Life Quality Index) were applied consecutively to patients over 18 years old treated at the dermatology outpatient clinic of the Intermunicipal Health Consortium of the Microrregion of Viçosa (Minas Ge-rais, Brazil) during the months between October 2021 and January 2022. The study intended to de-termine if patients with anxiety and depression experienced a major impact of their dermatoses on their quality of life. It also aimed to assess whether patients wich scores indicates anxiety or depression had been previously diagnosed with such conditions. Results: Data from 330 participants were analyzed, with 104 (31.5%) of males and 226 (68.5%) of females. The mean age was 46.5 years, with a stand-ard deviation of 17.1 years. The presence of depressive symptoms suggestive of major depression was found in 25.8% of participants, and 32.1% of participants exhibited anxious symptoms sugges-tive of anxiety disorder. It was noted that in the group of patients with an indication of depression, there was a higher prevalence of a moderate impact of dermatosis on quality of life (42.4% versus 11% for patients without an indication of depression; p-value < 0.001). Regarding individuals with an indication of anxiety, there was also a higher prevalence of a moderate impact of skin disease on quali-ty of life (42.5% versus 8% for those without an indication of anxiety disorder, p-value: <0.001). Fur-thermore, 51.9% (55) of individuals with a positive indicator for anxiety and 54.1% (46) with an indi-cation for depression had no previously known diagnoses of either conditions. Conclusion: The sig-nificant association between dermatoses and anxious and/or depressive symptoms, the greater impact of these dermatoses on the quality of life of anxious and/or depressed individuals, and the likely exist-ence of underdiagnosis of depression and anxiety once again highlight the intimate relationship be-tween skin and psyche. These findings underscore the importance of addressing psychiatric symp-toms in dermatological patients. Keywords: Psychodermatology; Dermatology; Psychiatry; Anxiety; Depression.