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The impact of skin diseases on patients: comparing dermatologists' opinions with research data collected on their patients.
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2003 (English)In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 148, no 5, p. 989-95Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Research data suggest that the detection of psychiatric disorders by dermatologists is not completely satisfactory, and that patients and dermatologists often assess patients' quality of life differently. Given that expectations influence perception and cognitia, these discrepancies might at least in part descend from conceptual models of skin disease that are prevalent among dermatologists.

OBJECTIVES: We explored to what degree dermatologists' opinions about quality of life and prevalence of psychiatric disorders in several dermatological conditions corresponded to the actual data collected on their patients.

METHODS: All dermatologists working in a large institution were asked to express on a five-point scale their opinion about the quality of life and the prevalence of depressive and anxiety disorders in different skin conditions. Physicians' opinions were then compared with the results of a large research project on quality of life and psychological well-being in dermatological out-patients performed in their institution some months before.

RESULTS: Forty-six dermatologists (82%) agreed to participate and completed the research questionnaire. We observed a fairly good concordance between dermatologists' opinion about the impact of the various skin conditions on patients' lives and survey data on quality of life impairment. With regard to psychiatric morbidity, we found that dermatologists believe that psychiatric disorders are substantially less frequent than they actually are in many skin conditions.

CONCLUSIONS: The belief that psychiatric morbidity is rare in patients with certain skin conditions might hamper, at least in part, the recognition of psychiatric disorders in these patients. Dermatologists probably should be more alert to the question of psychiatric morbidity in their patients. Allocating more space to this issue in training programmes for dermatologists might favour a shift in their conceptual models of skin disease.

Place, publisher, year, edition, pages
John Wiley & Sons, 2003. Vol. 148, no 5, p. 989-95
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-36976DOI: 10.1046/j.1365-2133.2003.05306.xPubMedID: 12786831OAI: oai:DiVA.org:mau-36976DiVA, id: diva2:1503956
Available from: 2020-11-26 Created: 2020-11-26 Last updated: 2020-11-26Bibliographically approved
In thesis
1. Quality of life and severity assessment by provider and patient in oral and skin conditions
Open this publication in new window or tab >>Quality of life and severity assessment by provider and patient in oral and skin conditions
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A good communication between patient and provider has the aimto understand the patient’s problems, to establish and maintain acaring relation, and to inform about disease. The quality of communicationmay have an influence on different important aspects, suchas satisfaction and adherence to treatment.In this thesis, the overairching aim was to evaluate the effects ofthe communication between patient and provider, by comparing theirevaluation of either the health-related quality of life of patients, or theseverity of the disease.It was chosen to focus on oral and dermatological conditions, sinceskin and teeth are some of the most important components of the appearanceof a person, and conditions which affect them can have deeppsychosocial implications on patients’ life.Paper I concerns skin conditions. Dermatologists’ opinions on skinhealth-related quality of life and psychological problems in patientswere compared to the patients’ reports.Papers II and III concern oral conditions. The evaluation of oralhealth-related quality of life problems in patients by the caregivers wascompared to the evaluation given by patients.In Paper IV, about oral mucosal conditions, the comparison wasmade between the evaluation of the severity of the disease by patientsand providers.Paper I: as regards quality of life, physicians tended to overestimateimpairment in several conditions, particularly in alopecia. In many diagnosticcategories, an underestimation of the frequency of depressionand anxiety by dermatologists was observed. Paper II and III: the correlation between patients’ and caregivers’evaluation of oral health-related quality of life was low. In general, caregiverstended to overestimate the quality of life impairment of their patients,particularly for women, for elderly people, and for patients witha low number of teeth. The difference between patient and caregiverevaluation did not depend on the professional status of the caregiver(dentist or hygienist), nor on the clinics.Paper IV: in oral mucosal conditions, the agreement between patients’and providers’ evaluation of severity was very low. Physicians tended tounderestimate severity more in older than in younger patients, and inpatients with a higher quality of life impairment compared to the others.The underestimation by the physician was also positively associatedto psychological problems and the presence of alexithymia.This thesis showed a low agreement between patient and provider inthe evaluation of quality of life and psychological problems of patients,and of the disease severity, both in dental and dermatological conditions.The discrepancies were both in the direction of an underestimationand an overestimation by the caregiver.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology, Department of Oral Public Health, 2010
Series
Doctoral Dissertation in Odontology
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7656 (URN)10168 (Local ID)91-7104-310-1 (ISBN)10168 (Archive number)10168 (OAI)
Note

Note: The papers are not included in the fulltext online.

Paper IV in dissertation as manuscript with title "Comparison of patients’ and providers’ severity evaluation of oral mucosal diseases".

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-04Bibliographically approved

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