ВОЗМОЖНОСТИ ПРИМЕНЕНИЯ СТАНДАРТИЗИРОВАННЫХ ШКАЛ САМООЦЕНКИ ТРЕВОГИ И ДЕПРЕССИИ ПРИ ОБСЛЕДОВАНИИ БОЛЬНЫХ ПСОРИАЗОМ: ШКАЛЫ-ОПРОСНИКИ ДЕПРЕССИИ
Оригинальная статья
Дата публикации: июня 6, 2024
Ключевые слова
псориаз
тревожность
депрессия
тревожность
депрессия
Как цитировать
Владимирова И. С., Круглова Л. С., Свиридов О. В., Самушия М. А. ВОЗМОЖНОСТИ ПРИМЕНЕНИЯ СТАНДАРТИЗИРОВАННЫХ ШКАЛ САМООЦЕНКИ ТРЕВОГИ И ДЕПРЕССИИ ПРИ ОБСЛЕДОВАНИИ БОЛЬНЫХ ПСОРИАЗОМ: ШКАЛЫ-ОПРОСНИКИ ДЕПРЕССИИ // Кремлевская медицина. Клинический вестник. 2024. Т. № 2. С. 23-29.
Аннотация
Псориаз – это мультифакториальное системное заболевание, которое классифицируется как тип психосоматического заболевания, связанного с коморбидной тревожностью и депрессией. Создание простого в использовании инструмента скрининга тревожности и депрессии могло бы стать важным дополнением к обычной клинической практике. Цель исследования. Изучение возможности применения шкал самооценки тревоги и депрессии у пациентов со среднетяжелым и тяжелым псориазом и выбор оптимального инструмента для скрининговой диагностики коморбидных психических расстройств. Материалы и методы. Проведено ретроспективное исследование 72 пациентов с диагнозом «распространенный вульгарный псориаз». Исходные показатели оценивали по индексам PASI, BSA, sPGA, DLQI, визуально-аналоговой шкале зуда. Показатели тревожности и депрессии оценивали по шести шкалам (C-SSRS, HADS, PHQ-9, BDI, MADRS, HDRS) с целью выбора оптимальной шкалы. Результаты. Все проанализированные в исследовании шкалы-опросники оказались эффективными в диагностике депрессии у пациентов с псориазом. Колумбийская шкала не является информативным методом опросника, поэтому необходимость ее использования отпала. Шкалы PHQ-9, Бека, Монтгомери-Асберга и Гамильтона статистически связаны между собой, поэтому нет потребности в использовании этих четырех шкал, достаточно выбрать одну из них. Так как у шкалы HADS-T/D нет прямой взаимосвязи/корреляции со шкалами Бека и Гамильтона, есть основания для выбора этой шкалы с целью получения более точных и разнообразных статистических данных. Заключение. Для диагностики коморбидной депрессии достаточно использовать одну из диагностических шкал, например PHQ-9, и дополнительно HADS-T/D для получения более точных результатов.Литература
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27. Sondermann W. et al. Psycho-logical burden of psoriatic patients in a German university hospital dermatology department // J. Dermatol. – 2020. – V. 48. – P. 794–806.
28. Radtke M.A. et al. Early detection of comorbidity in psoriasis: recommendations of the National Conference on Healthcare in Psoriasis // J. Dtsch. Dermatol. Ges. – 2015. – V. 13. – P. 674–690.
29. Wu J.J. et al. Epidemiology of mental health comorbidity in psoriasis // J. Dermatolog. Treat. – 2018. – V. 29. – P. 487–495.
30. Jin W. et al. Depression symptoms predict worse clinical response to etanercept treatment in psoriasis patients // Dermatology. – 2019.– V. 235. – P. 55–64.
31. Posner K. et al. Columbia classification algorithm of suicide assessment (C-CASA): classification of suicidal events in the FDA’s pediatric suicidal risk analysis of antidepressants // Am. J. Psychiatry. – 2007. – V. 164. – No 7. – P. 1035–1043.
32. Zigmond A.S. et al. The hospital anxiety and depression scale // Acta Psychiatr. Scand. – 1983. – V. 67. – P. 361–70.
33. Stern A.F. The hospital anxiety and depression scale // Occup. Med. (Lond). – 2014. – V. 65. – No 5. – P. 393–394. DOI: 10.1093/occmed/kqu024.
34. Потекаев Н.Н. Тактика ведения пациентов с псориазом и псориатическим артритом с сопутствующими психосоматическими расстройствами: методические рекомендации № 38. – Москва, 2022.
35. Kroenke K. et al. The PHQ-9: validity of a brief depression severity measure // J. Gen. Intern. Med. – 2001. – V. 16. – No 9. – P. 606–613.
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37. Beck A.T. et al. An inventory for measuring depression // Arch. Gen. Psychiatry. – 1961. – V. 4. – P. 561–571.
38. Montgomery S.A. et al. New depression scale designed to be sensitive to change // Br. J. Med. Psychol. – 1979. – V. 134. – P. 382–389.
39. Hamilton M. A rating scale for depression // J. Neurol. Neurosurg. Psychiatry. – 1960. – V. 23. – No 1. – P. 56–62.
2. Helmick C.G. Prevalence of psoriasis among adults in the U.S.: 2003–2006 and 2009–2010 National health and nutrition examination surveys // Am. J. Prev. Med. – 2014. – V. 47. – No 1. – P. 37–45.
3. Jankowiak B. et al. Relationship between self-esteem and stigmatization in psoriasis patients // Postepy Dermatol. Allergol. – 2020. – V. 37. – No 4. – P. 597–602. DOI: 10.5114/ada.2020.93242.
4. Sagaltici E. Association of the attachment styles with depression, anxiety, and quality of life in patients with psoriasis // Dermatol. Sinica. – 2020. – V. 38. – No 2. – P. 81–87. DOI: 10.4103/ds.ds_35_19.
5. Tribó M.J. et al. Patients with moderate to severe psoriasis associate with higher risk of depression and anxiety symptoms: Results of a multivariate study of 300 Spanish individuals with psoriasis // Acta Dermatol. Venereol. – 2019. – V. 99. – No 4. – P. 417–422. DOI: 10.2340/00015555-3114.
6. Hölsken S. et al. Common fundamentals of psoriasis and depression // Acta Derm. Venereol. – 2021. – V. 101. – No 11. – P. adv00609. DOI: 10.2340/actadv.v101.565.
7. Dowlatshahi E.A. et al. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis // J. Invest. Dermatol. – 2014. – V. 134. – P. 1542–1551.
8. Snast I. et al. Psychological stress and psoriasis: a systematic review and meta-analysis // Br. J. Dermatol. – 2018. – V. 178. – No 5. – P. 1044–1055. DOI: 10.1111/bjd.16116.
9. Koo J. et al. Depression and suicidality in psoriasis: review of the literature including the cytokine theory of depression // J. Eur. Acad. Dermatol. Venereol. – 2017. – V. 31. – No 12. – P. 1999–2009. DOI: 10.1111/jdv.14460.
10. Chen Y.H. et al. Major depressive disorder increased risk of psoriasis: A propensity score matched cohort study // J. Affect. Disord. – 2021. – V. 278. – P. 407–412. DOI: 10.1016/j.jad.2020.09.108.
11. Polenghi M.M. et al. Experience with psoriasis in a psychosomatic dermatology clinic // Acta Derm. Venereol. Suppl. (Stockh). –1994. – V. 186. – P. 65–66. DOI: 10.2340/000155551866566.
12. Fortune D.G. et al. A cognitive-behavioural symptom management programme as an adjunct in psoriasis therapy // Br. J. Dermatol. – 2002. – V. 146. – P. 458–465. DOI: 10.1046/j.1365-2133.2002.04622.x.
13. Mease P.J. et al. Impact of adalimumab on symptoms of psoriatic arthritis in patients with moderate to severe psoriasis: A pooled analysis of randomized clinical trials // Dermatology. – 2010. – V. 220. – P. 1–7. DOI: 10.1159/000260371.
14. Menter A. et al. The effect of adalimumab on reducing depression symptoms in patients with moderate to severe psoriasis: a randomized clinical trial // J. Am. Acad. Dermatol. – 2010. – V. 62. – P. 812–818. DOI: 10.1016/j.jaad.2009.07.022.
15. Redighieri I.P. et al. Erythrodermic psoriasis with regression after prophylaxis with isoniazid and antidepressant therapy: case report // An. Bras. Dermatol. – 2011. – V. 6. – P. 141–S143. DOI: 10.1590/s0365-05962011000700037.
16. Fordham B. et al. A pilot study examining mindfulness-based cognitive therapy in psoriasis // Psychol. Health Med. – 2015. – V. 20. – P. 121–127. DOI: 10.1080/13548506.2014.902483.
17. Wang X. et al. Abnormal functional connectivity in psoriasis patients with depression is associated with their clinical symptoms // Front. Neurosci. – 2022. – V. 16. – P. 1026610. DOI: 10.3389/fnins.2022.1026610.
18. Jing D. et al. Association of psoriasis with anxiety and depression: a case–control study in Chinese patients // Front. Med. – 2021. – V. 8. – P. 771645.
19. Tong N. et al. The potency of common proinflammatory cytokines measurement for revealing the risk and severity of anxiety and depression in psoriasis patients // J. Clin. Lab. Anal. – 2022. – V. 36. – P. e24643.
20. Владимирова И.С. и др. Эффективность терапии больных псориазом с тревожностью и депрессией ингибитором интерлейкина-23 гуселькумабом // Медицинский алфавит. – 2023. – Т. 24. – С. 28–35. DOI: 10.33667/2078-5631-2023-24-28-35.
21. Lamb R.C. et al. Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting // Br. J. Dermatol. – 2017. – V. 176. – P. 1028–1034.
22. Patel N. et al. Psoriasis, depression, and inflammatory overlap: a review // Am. J. Clin. Dermatol. – 2017. – V. 18. – P. 613–620.
23. Gonz ́alez-Parra S. et al. Psoriasis and depression: the role of inflammation // Actas Dermosifiliogr. – 2019. – V. 110. – No 1. – P. 12–19. DOI: 10.1016/j. ad.2018.05.009.
24. Ferreira B.I.R.C. et al. Psoriasis and associated psychiatric disorders: a systematic review on etiopathogenesis and clinical correlation // J. Clin. Aesthet. Dermatol. – 2016. – V. 9. – No 6. – P. 36–43.
25. Burden A.D. et al. Diagnosis and management of psoriasis and psoriatic arthritis in adults: summary of SIGN guidance // BMJ. – 2010. – V. 341. – P. 5623
26. Sondermann W. et al. Psychosocial burden and body mass index are associated with dermatology-related quality of life in psoriasis patients // Eur. J. Dermatol. – 2020. – V. 30. – P. 140–147.
27. Sondermann W. et al. Psycho-logical burden of psoriatic patients in a German university hospital dermatology department // J. Dermatol. – 2020. – V. 48. – P. 794–806.
28. Radtke M.A. et al. Early detection of comorbidity in psoriasis: recommendations of the National Conference on Healthcare in Psoriasis // J. Dtsch. Dermatol. Ges. – 2015. – V. 13. – P. 674–690.
29. Wu J.J. et al. Epidemiology of mental health comorbidity in psoriasis // J. Dermatolog. Treat. – 2018. – V. 29. – P. 487–495.
30. Jin W. et al. Depression symptoms predict worse clinical response to etanercept treatment in psoriasis patients // Dermatology. – 2019.– V. 235. – P. 55–64.
31. Posner K. et al. Columbia classification algorithm of suicide assessment (C-CASA): classification of suicidal events in the FDA’s pediatric suicidal risk analysis of antidepressants // Am. J. Psychiatry. – 2007. – V. 164. – No 7. – P. 1035–1043.
32. Zigmond A.S. et al. The hospital anxiety and depression scale // Acta Psychiatr. Scand. – 1983. – V. 67. – P. 361–70.
33. Stern A.F. The hospital anxiety and depression scale // Occup. Med. (Lond). – 2014. – V. 65. – No 5. – P. 393–394. DOI: 10.1093/occmed/kqu024.
34. Потекаев Н.Н. Тактика ведения пациентов с псориазом и псориатическим артритом с сопутствующими психосоматическими расстройствами: методические рекомендации № 38. – Москва, 2022.
35. Kroenke K. et al. The PHQ-9: validity of a brief depression severity measure // J. Gen. Intern. Med. – 2001. – V. 16. – No 9. – P. 606–613.
36. Новицкий М.А. и др. Применение параметрических и опросниковых методов исследования депрессивных и тревожных расстройств при шизофрении // Доктор.Ру. 2021. – Т. 20. – № 5. – С. 55–61.
37. Beck A.T. et al. An inventory for measuring depression // Arch. Gen. Psychiatry. – 1961. – V. 4. – P. 561–571.
38. Montgomery S.A. et al. New depression scale designed to be sensitive to change // Br. J. Med. Psychol. – 1979. – V. 134. – P. 382–389.
39. Hamilton M. A rating scale for depression // J. Neurol. Neurosurg. Psychiatry. – 1960. – V. 23. – No 1. – P. 56–62.