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Date
2023-06-05
Authors
Publisher
Philipps-Universität Marburg
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Abstract
Background: Pemphigus vulgaris and pemphigus foliaceus are rare but fatal autoimmune diseases, which are characterized by circulating autoantibodies against epidermal adhesion molecules. The clinical symptoms are painful, chronic blisters as well as erosions of the skin and mucous membranes. Besides the physical symptoms, the chronicity of the disease is a primary factor which may affect the quality of life and may lead to mental comorbidities. For this reason, not only drug treatment but also the improvement of the quality of life and mental health of the affected patients gain more importance.
Whereas pathogenesis and therapy of pemphigus vulgaris have been intensively investigated in recent studies, there are only few studies concerning the occurrence of depressions and impact on of health-related quality of life.
Objective and methodology: The aim of the present prospective multicentric study was to examine the occurrence and severity of depressions as well as the health-related quality of life among pemphigus patients. Moreover, the study aimed at determining to which extent the level of the disease and socioeconomic factors affect the severity of depressions and the quality of life. For that purpose, the patients have been dermatologically tested in the respective outpatient clinics for their physical status as well as any depression symptoms. Thereby, the Autoimmune Bullous Skin Disorder Intensity Score and the Montgomery-Asberg Depression-Rating Scale served as validated questionnaires. In addition, the patients have been asked to assess their mental health by use of the Beck- Depressions-Inventar II and their health-related quality of life through the European Quality of Life 5 Dimensions questionnaire and Skindex questionnaire, as well as to provide general sociodemographic information.
Results: In sum, 68 patients have been included in the study. Most of the study patients presented a mild to moderate disease activity, whereas four of the patients suffered from severe pemphigus. Apart from that, an investigator attested that the mental symptoms of every tenth patient indicated a moderate depression. The degree of the depression, determined by Montgomery-Asberg Depression-Rating Scale, thereby correlates with the severity of the disease. Besides, it has been found that single men even show higher results. According to the self-evaluation using the Beck-Depressions-Inventar II, a quarter of the study patients assessed themselves as slightly depressive, whereas 15 percent reported a moderate depression. Neither the self-assessment nor the assessment by a physician identified a high grade of depression among the study population.
The evaluation of the questionnaires showed a reduced perceived quality of life. Furthermore, symptoms of a depression among female pemphigus patients are statistically significant associated with a decreased sense of well-being. These findings highlight once more the impact of depressions on health-related quality of life. Likewise, the co-existing symptom ‘pain’ led to a decreased quality of life. Regarding socioeconomic findings, it became clear that a low gross income was associated with a reduced health-related quality of life.
Conclusion: The findings of this clinical study demonstrate that pemphigus negatively affects the mental health of pemphigus patients, and it reveals the impact of the disease on patients` quality of life. An optimization of the individual disease management may be achieved through the standardized evaluation of pain and depressive conditions as well as the involvement of an objective measurement of the quality of life during the course of pemphigus.
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Dates
Created: 2023Issued: 2023-06-05Updated: 2023-06-05
Faculty
Medizin
Language
ger
Data types
DoctoralThesis
Keywords
DepressionPemphigus vulgarisHealth-related quality of Life
DFG-subjects
DepressionPemphigus vulgarisGesundheitsbezogene Lebensqualität
DDC-Numbers
610
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Nolte, Stephanie: Depression und Lebensqualität bei Pemphigus-PatientInnen. : Philipps-Universität Marburg 2023-06-05. DOI: https://doi.org/10.17192/z2023.0360.