University of Hertfordshire

From the same journal

By the same authors


  • Florence Dalgard
  • Uwe Gieler
  • Lucia Tomas-Aragones
  • Lars Lien
  • Francoise Poot
  • Gregor B.E. Jemec
  • Laurent Misery
  • Csanád Szabó
  • D Linder
  • Francesca Sampogna
  • A W M Evers
  • Jon Anders Halvorsen
  • Flora Balieva
  • Jacek C. Szepietowski
  • Dmitry Romanov
  • SE Marron
  • Ilknur K. Altunay
  • Andrew Y. Finlay
  • Mir-Saeed Shayegan Salek
  • Joerg Kupfer
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Original languageEnglish
Pages (from-to)984-991
Number of pages8
JournalJournal of Investigative Dermatology
Early online date5 Feb 2015
Publication statusPublished - 1 Apr 2015


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.

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