Relationship between itch and psychological status of patients with atopic dermatitis

Abstract

Background: Itching is a cardinal symptom of atopic dermatitis (AD).

Objective: The study aim was to evaluate the relationships between pruritus and stress, health-related quality of life (HRQoL) and depression in adult patients with AD.

Methods: Eight-nine patients (30 men and 59 women) with AD were included. Demographic and clinical data were collected. The intensity of pruritus was assessed according to the 10-point Visual Analogue Scale (VAS) and the 4-Item Itch Questionnaire, HRQoL according to Dermatology Life Quality Index, and depression symptoms with Beck's Depression Inventory (BDI). Stress experienced by patients was evaluated with Social Readjustment Rating Scale and Stress Self-assessment Scale.

Results: The mean intensity of pruritus according to VAS was 7.9 ± 2.2 points, and according to 4-Item Itch Questionnaire 14.0 ± 4.4 points. The intensity of pruritus was related to the stress experienced by the patients prior to disease exacerbation (ρ = 0.37, P < 0.001). A significant correlation between pruritus and HRQoL was also found (VAS: ρ = 0.5, P < 0.001, 4-Item Itch Questionnaire: ρ = 0.5, P < 0.001) as well as between pruritus and BDI (VAS: ρ = 0.44, P < 0.001, 4-Item Itch Questionnaire: ρ = 0.51, P < 0.001). Patients with symptoms suggesting depression had more intense pruritus compared with the rest of patients (VAS: 9.1 ± 1.6 vs. 7.6 ± 2.2 points, P = 0.004; 4-Item Itch Questionnaire: 17.3 ± 2.5 vs. 13.1 ± 4.4 points, P < 0.001).

Conclusions: Itching intensity in AD plays an important role in determining patients' psychosocial well-being. Patients with atopic dermatitis require an effective, long-term antipruritic therapy to improve their QoL and reduce the potential risk of depression.