Prevalence and Risk Factors of Anxiety and Depression in Rosacea Patients: A Cross-Sectional Study in China

Abstract

Rosacea is a chronic inflammatory skin disease characterized by facial redness and bothersome symptoms. It can exert significant psychological effects and impair the quality of life of patients. To investigate the prevalence and risk predictors of anxiety and depression in rosacea patients, we conducted a cross-sectional study in an outpatient setting. Consecutive patients completed a questionnaire, which included questions on sociodemographic information and severity of signs and symptoms; they also completed the Patient Health Questionnaire and the Generalized Anxiety Disorder scale. Disease burden was assessed using Dermatology Life Quality Index (DLQI), Willing-to-Pay, and Time trade-off. Multivariate analysis was conducted to determine the risk factors for anxiety and depression. A total of 774 patients completed the survey. The prevalence of anxiety was 53.9% (95% CI: 50.4–57.4%) and that of depression was 58.1% (95% CI: 54.7–61.6%). The factors associated with anxiety were age, gender, the need to make appearances at work, severity of self-reported symptoms, the number of rosacea signs and adaptive behaviors, and disease burden. Depression was associated with younger age, more severe self-reported symptoms, more adaptive behaviors, and higher disease burden. After adjusting for demographics, the risk of anxiety or depression increased in young patients who had severe self-reported symptoms, high DLQI scores, and many adaptive behaviors. Taken together, there is a high prevalence of anxiety and depression among Chinese rosacea patients. Younger rosacea patients who have more severe self-reported symptoms and higher disease burden are prone to anxiety and depression.

A Cross-Sectional Study on the Relationship Between Rosacea Severity and Quality of Life or Psychological State

“…Both anxiety and depression were predominantly mild to moderate in our results, which is consistent with previous studies. 48 , 49 In a sense, HADS is only a screening tool and does not accurately diagnose anxiety and depression, but in general, our study clearly indicates the presence of psychological problems of anxiety and depression in patients with rosacea.…”

Serum Level of Brain-Derived Neurotrophic Factor (BDNF) Associated with Depression in Patients with Rosacea: A Candidate Predictive Biomarker

“… 15 In China, the high prevalence of comorbidities with anxiety and depression was showed from a 754 rosacea patients’ study, even higher to 53.9% (95% CI: 50.4–57.4%) and 58.1% (95% CI: 54.7–61.6%) respectively. 35 The mechanism of comorbidity between rosacea and neuropsychiatric diseases is not completely clear, but it may be considered to be associated with the Gut-Brain-Skin axis at present. 36 Up to date, although some biomarkers are used to diagnose depression and detect its treatment response, the reliable biomarker for rosacea with depression was absent, which is almost based on subjective evaluation.…”

The link between cutaneous inflammation and cognitive impairment

“…51 Psychological disorders in rosacea patients include depression, anxiety and cognitive impairment. [52][53][54][55] HRs of dementia and Alzheimer's disease were 1.07 and 1.25, respectively, in patients with rosacea, with a higher HR in females than in males (1.28 vs. 1.16). 52 Moreover, a study on a small group of subjects showed that patients with prurigo nodularis displayed various degrees of cognitive impairment, ranging from MCI to Alzheimer's disease.…”

“…For instance, rosacea is common in subjects aged 45–60 years, with a rosacea prevalence of ≈5.5% 51 . Psychological disorders in rosacea patients include depression, anxiety and cognitive impairment 52–55 . HRs of dementia and Alzheimer's disease were 1.07 and 1.25, respectively, in patients with rosacea, with a higher HR in females than in males (1.28 vs. 1.16) 52 .…”