Itch and Mental Health in Dermatological Patients across Europe: A Cross-Sectional Study in 13 Countries

Abstract

Itch is a highly prevalent and multidimensional symptom. We aimed to analyze the association between itch and mental health in dermatological patients. This multicenter study is observational and cross-sectional and was conducted in dermatological clinics across 13 European countries. A total of 3,530 patients and 1,094 healthy controls were included. Patients were examined clinically. Outcome measures were itch (presence, chronicity, and intensity), the Hospital Anxiety and Depression Scale, EQ-5D visual analogue scale, sociodemographics, suicidal ideation, and stress (negative life events and economic difficulties). Ethical approval was obtained. Results showed significant association between the presence of itch in patients and clinical depression (odds ratio, 1.53; 95% confidence interval, 1.15e2.02), suicidal ideation (odds ratio, 1.27; 95% confidence interval, 1.01e1.60), and economic difficulties (odds ratio, 1.24; 95% confidence interval, 1.10e1.50). The mean score of reported generic health status assessed by the EQ-5D visual analogue scale was 65.9 (standard deviation ¼ 20.1) in patients with itch, compared with 74.7 (standard deviation ¼ 18.0) in patients without itch (P < 0.001) and 74.9 (standard deviation ¼ 15.7) in controls with itch compared with 82.9 (standard deviation ¼ 15.6) in controls without itch (P < 0.001). Itch contributes substantially to the psychological disease burden in dermatological patients, and the management of patients should include access to multidisciplinary care.

Chronic nodular prurigo: clinical profile and burden. A European cross‐sectional study

“…The fact that symptoms are always or often present adds to the burden in the majority of the patients (71%). The highest burden associated with the disease was the itch, which was described as disturbing (55.2%), burdensome (50.7%) or agonizing (46.6%) by a substantial number of patients and has been shown to contribute substantially to psychological disease burden 21 . Accordingly, the impairment of the quality of life correlated with itch intensity, as observed for other pruritic diseases 22 .…”

Prevalence, pathophysiology and management of itch in epidermolysis bullosa*

“…Itch in EB may start from as early as birth and is associated with a great burden in terms of quality of life (QoL) and also an economic burden on patients 7 . Its major impact on QoL is also reflected in its association with depression, anxiety, social isolation, financial difficulties and even suicidal ideation in a large number of other dermatological conditions 8 …”

Itch processing in the brain

“…Itch is a common sensation because almost one‐third of the global population has experienced it in a given week 5,6 . Itch can reduce quality of life of patients and can cause mental distress, 7,8 sometimes resulting in suicidal ideations 9 …”