The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants––3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67–3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68–2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33–2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications.

Itch is the most frequent symptom in dermatology and has been researched more extensively in recent years. Nevertheless, there are few true epidemiological studies on itch. The aim of this paper is to review the current state of research on the epidemiology of chronic itch in Western and non-Western populations. The electronic databases PubMed, Medline and the Cochrane Library were searched. Conference proceedings and national and international studies were included. It is difficult to compare existing studies due to differing methodology and lack of standardized measures. The symptom of itch is a challenge, not only to clinicians, but also within the structure of regional health systems, and with regards to accessibility to specialized medical doctors in non-Western countries. Published studies show that the symptom of itch is highly prevalent; it should therefore receive adequate attention from physicians and other healthcare providers, including healthcare planners.

This study shows that skin complaints referring to the most common chronic skin diseases varied with age, gender and marital status, and worsened with middle-income household. It provides evidence that household income is associated with skin morbidity, bringing dermatological aspects to studies on health inequalities.

Background: Many reports indicate that skin diseases are affected by lifestyle factors. Objective: To examine the relationship between reported skin diagnoses, smoking and alcohol consumption in an urban population. Methods: Cross-sectional questionnaire-based health study among 18,747 adults in Oslo. Results: For current smokers, odds ratio for reporting psoriasis was 1.49 (95% CI 1.11–2.00) for males, and 1.48 (95% CI 1.15–1.91) for females, as compared to never smokers. There was no association between reported atopic dermatitis or hand eczema and smoking. High consumption of cigarettes was associated with an increased reporting of psoriasis in men, but not women. Reporting drinking alcohol 4–7 times per week was crudely associated with reporting psoriasis in men, but not in the adjusted model. Conclusion: Cigarette smoking was associated with reported psoriasis, but not with atopic dermatitis or hand eczema.

There is a strong association between itch and psychosocial factors in the general population.

This questionnaire is a simple tool to evaluate skin morbidity in an adult population. The use of self-reported complaints to predict clinical morbidity may be of value in quantifying and exploring skin diseases at the population level. Further studies are needed to improve the instrument. It is our intention to demonstrate the potential usefulness of this questionnaire in a forthcoming population survey in Norway.

The association between itch and suicidal ideation has not been explored previously in the general population. The aim of the present study is to analyse the association between itch and suicidal ideation in adolescents, and to compare the findings with an expected association between pain and suicidal ideation in the same sample. A total of 4,744 adolescents were invited to join the questionnaire-based study. The participation rate was 80%. The prevalence of suicidal ideation among those who reported no itch was 8.4% vs 21.1% among those who reported severe itch. Significant association between itch and suicidal ideation was found in a multivariate model (odds ratio 3.0, 95% confidence interval (CI) 2.1-4.2) and between pain and suicidal ideation (odds ratio 3.8, 95% CI 2.6-5.7). The findings were similar and statistically significant in girls and boys separately. Itch and pain are approximately equally strongly associated with suicidal ideation in a large general population of adolescents.

Itch is known to be associated with psychological factors in adults, but has not been explored among adolescents. A cross-sectional, questionnaire-based population study involving adolescents born mostly in 1986 was carried out in 2004. A total of 4744 individuals were invited and the participation rate was 80%. The Hopkins Symptom Checklist-10 was used to measure mental distress. The prevalence of itch was 8.8%. Itch was associated with mental distress, gender, socio-demographic factors, asthma, rhinoconjunctivitis and eczema. In a logistic regression model adjusting for possible confounders (including eczema), an association between itch and mental distress was found (odds ratio=3.1). In a subgroup analysis of those without eczema, the association was stronger. When the severity of itch increased, in both genders mental distress also increased. Mental distress and eczema are the variables in the study that contributes most to the distribution of itch at population level among adolescents in Oslo, Norway.