Screening for depression in psoriasis patients during a dermatological consultation: A first step towards treatment
Screening for depression in psoriasis patients during a dermatological consultation: A first step towards treatment
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DOI：
10.1111/ddg.14532
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发表时间：
2021-09-01
影响因子：
3.6
通讯作者：
Wilsmann-Theis, Dagmar
中科院分区：
文献类型：
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作者：
Kromer, Christian;Mohr, Johannes;Wilsmann-Theis, Dagmar
背景和目的：抑郁症是银屑病患者中非常普遍的一种共病。这项前瞻性研究的目的是跟踪有抑郁风险的银屑病患者，并在现实生活中评估个体获得心理健康护理的途径和抑郁筛查的有效性。患者和方法：在这项前瞻性多中心研究中，355名银屑病患者使用修订的贝克抑郁问卷(BDI-II)进行抑郁症状筛查。有抑郁风险的患者的全科医生被要求进行进一步的评估。结果：130例患者抑郁症状筛查阳性，71例患者获得随访，随访率为54.6%。28.2%的患者建议接受精神治疗，23.9%的患者接受精神治疗。银屑病的疾病活动性(PASI3.1，Delta：-1.7，P=0.018)、生活质量(皮肤科生活质量指数：6.5，Delta：-2.8，P=0.005)和抑郁症状(BDI-II：13.2，Delta：-8.3，P<；0.001)显著改善。PASI下降程度越高，BDI-II评分下降越明显。结论：抑郁症状筛查提高了精神卫生服务的利用率，改善了银屑病、抑郁症状和生活质量。因此，这种筛查应该在常规护理中实施，以优化患者管理。
Background and Objectives: Depression is a highly prevalent comorbidity in psoriatic patients. The aim of this prospective study was to follow up psoriasis patients at risk for depression and to evaluate individual pathways to mental health care and the efficacy of depression screening in a real-life setting.Patients and Methods: In this prospective multicenter study, 355 patients with psoriasis were screened for depressive symptoms with the revised Beck Depression Inventory (BDI-II). General practitioners of patients at risk for depression were asked for further evaluation. One year later, information on mental health care provision was gathered.Results: 130 patients were screened positive for depressive symptoms, and 71 patients were followed-up (follow-up rate: 54.6 %). Psychiatric treatment was recommended for 28.2 % and accepted by 23.9 % of patients. Parameters of disease activity of psoriasis (PASI: 3.1, Delta: -1.7, P = 0.018), quality of life (Dermatology Life Quality Index [DLQI]: 6.5, Delta: -2.8, P = 0.005), and depressive symptoms ( BDI-II: 13.2, Delta: -8.3, P < 0.001) improved significantly. Decrease of the BDI-II score was more pronounced in patients with higher PASI decrease.Conclusions: Screening for depressive symptoms led to increased utilization of mental health care and improvement of psoriasis, depressive symptoms, and quality of life. Thus, such screening should be implemented in routine care to optimize patient management.