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      Stigmatisation and body image impairment in dermatological patients: protocol for an observational multicentre study in 16 European countries

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          Abstract

          Introduction

          Patients with common skin diseases may have substantial psychosocial comorbidity and reduced quality of life. This study aims at exploring further the psychosocial burden of skin diseases by assessing stigmatisation and body image problems in a large sample of patients with skin disease across Europe.

          Methods and analysis

          The study is an observational cross-sectional multicentre study across 16 European countries comparing stigmatisation and body image in patients with skin disease compared with controls. Consecutive patients will be recruited in outpatient clinics and will complete validated questionnaires prior to clinical examination by a dermatologist at each recruitment site. In addition to sociodemographic background information, the outcomes will be: mood disorders assessed by short versions of the Patient Health Questionnaire and the General Anxiety Disorder Assessment; general health assessed by the EuroQol-Visual Analogue Scale; stigmatisation experience assessed by the Perceived Stigmatisation Questionnaire; stress assessed by the Perceived Stress Scale and body image assessed by the Dysmorphic Concern Questionnaire. The main criteria for eligibility are to be 18 years old or more. The analysis will include comparison between patients and controls for the main outcomes using t-tests, analyses of covariance and multivariate logistic regression models adjusting for potential confounding factors.

          Ethics and dissemination

          The study protocol is approved by the University of Giessen and by the local Ethical Committee in each recruitment centre. Informed consent will be given by each participant. The results of the study will be disseminated by publications in international peer-reviewed journals and presented at international conferences and general public conferences. Results will influence support intervention and management of patients with skin disease across Europe.

          Trial registration number

          DRKS00012745; Pre-results.

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          Most cited references 32

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          A Global Measure of Perceived Stress

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            The Global Burden of Cancer 2013.

            Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies.
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              The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review.

              Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable. Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales. The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is > or = 10 on the parent scales (PHQ-9 and GAD-7) and > or = 3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15. The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization. Copyright 2010. Published by Elsevier Inc.
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                Author and article information

                Affiliations
                [1 ] departmentDepartment of Dermatology and Venereology , Skåne University Hospital , Malmo, Sweden
                [2 ] National Centre for Dual Diagnosis, Innlandet Hospital Trust , Brumunddal, Norway
                [3 ] departmentDepartment of Dermatology , Barts Health NHS Trust , London, UK
                [4 ] departmentDepartment of Health, Medical and Neuropsychology , Faculty of Social and Behavioral Science , Leiden, The Netherlands
                [5 ] departmentDepartment of Dermatology , Justus Liebig University , Giessen, Germany
                [6 ] departmentClinical Epidemiology Unit , Istituto Dermopatico dell’Immacolata , Rome, Italy
                [7 ] departmentCenter for Chronic Pruritus and Department of Dermatology , University Hospital Münster , Münster, Germany
                [8 ] departmentDepartment of Psychology , University of Zaragoza , Zaragoza, Spain
                [9 ] departmentDepartment of Psychiatry , Academic Medical Hospital , Amsterdam, The Netherlands
                [10 ] Institute of Medical Psychology, Justus Liebig University , Giessen, Germany
                Author notes
                [Correspondence to ] Dr Florence J Dalgard; florikje@ 123456gmail.com
                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2018
                22 December 2018
                : 8
                : 12
                30580274 6307615 bmjopen-2018-024877 10.1136/bmjopen-2018-024877
                © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                Product
                Categories
                Dermatology
                Protocol
                1506
                1687
                Custom metadata
                unlocked

                Medicine

                burden of disease, dermatological epidemiology, stigmatisation, body image

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