Addiction and chronic skin diseases: A Pan-European study on prevalence, associations and patient impact.
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Ziehfreund Stefanie, Saak Magdalena, Schaal Alisa, Mazilu Roxana, Mahé Emmanuel, Hajj Carla, Johansson Emma K, Lysell Josefin, Sigurdardottir Gunnthorunn, Legat Franz J, Koch Catherina, Schmieder Astrid, Glatzel Caroline, Kirby Brian, Pender Emily, Zalewska-Janowska Anna, Tomaszewska Katarzyna, Ciccarese Giulia, Lauriola Pia, Boffa Michael J, Farrugia Stephanie, Pilz Anna Caroline, Schauer Franziska, Trzeciak Magdalena, Zysk Weronika, Gáspár Krisztián, Szegedi Andrea, Damiani Giovanni, Carugno Andrea, Hartmane Ilona, Mikazans Ingmars, Valiukeviciene Skaidra, Petrokaite Livija, Szepietowski Jacek C, Jastrząb Beata, Staubach Petra, Hadžavdić Suzana Ljubojević, Buzina Daška Štulhofer, Posch Christian, Jochmann Jakob, Wiala Antonia, Scheffenbichler Ludwig, Trovato Emanuele, Calabrese Laura, Fekete Gyula Laszlo, Chernyshov Pavel, Kolodzinska Lidiia, Welzel Julia, Thölken Karisa, Maul Julia-Tatjana, Maul Lara Valeska, Meyersburg Damian, Bowe Stephanie, Connor Cathal O, Darlenski Razvigor, Traidl Stephan, Vestergaard Christian, Pinto-Pulido Elena Lucía, Konstantinou Maria Polina, Szlávicz Eszter, Heidemeyer Kristine, Yawalkar Nikhil, Lantzsch Hanka Agnes Caroline, Soplinska Aleksandra, Seitz Anna-Theresa, Torres Tiago, Brzoza Zenon, Vučemilović Ana Sanader, Manolache Liana, Magnolo Nina, Scala Emanuele, Eyerich Kilian, Biedermann Tilo, Zink Alexander
Аннотация
OBJECTIVES: To estimate the prevalence and patterns of addictive behaviours among patients with chronic skin diseases in European tertiary dermatology centres and explore associated sociodemographic and clinical factors.
METHODS: This multicentre cross-sectional study recruited adult patients with PSO, AD, HS, alopecia areata (AA), urticaria, or vitiligo from dermatology departments in 20 European countries. Participants completed a standardized questionnaire assessing sociodemographics, disease characteristics, and addictive behaviours (smoking, alcohol use, drug use, gambling, internet addiction, and eating disorders). Descriptive analyses and multivariate logistic regression were performed.
RESULTS: Among 3585 participants (median age 43 years; 51.1% female), the prevalence of addictive behaviours was notable: smoking (25.7%), pathological gambling (4.5%), hazardous drinking (8.8%), alcohol dependence (2.5%), drug use disorders (5.3%), eating disorders (1.8%), and internet addiction (29.7%). Smoking was most common among PSO and HS patients (48.6%), and gambling among AA and vitiligo patients (8.2%). Significant associations included male sex, younger age, single status, higher Dermatology Life Quality Index (DLQI) scores, and regional variation.
DISCUSSION: Addictive behaviours are prevalent in dermatology patients and are associated with both sociodemographic and disease-related factors. The DLQI was positively correlated with multiple addictions, suggesting that reduced quality of life may contribute to maladaptive coping. However, due to the absence of a control group, the tertiary care setting, limited center distribution, and unknown response rate, generalizability is restricted.
CONCLUSIONS: Addiction screening and supportive mental health strategies should be integrated into dermatologic care, particularly for high-risk patients. Population-based studies with control groups are needed to confirm these findings.