Psychological morbidity in pemphigus patients in clinical remission and its relation with clinico-demographic parameters.

Abstract

Significant psychological morbidity exists in patients with active pemphigus. Pemphigus being a chronic disease, psychological morbidity may exist in pemphigus patients in remission as well. The objectives of the study were to assess the psychological morbidity in pemphigus patients in clinical remission and to correlate it with clinico-demographic parameters. Pemphigus patients in clinical remission were consecutively included and were asked to respond to the Hindi/English version of Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) and panic disorder module of PHQ. Of 107 patients recruited, 41 (38.3%, 95% CI: 29.1-48.2%) patients were found to have either depression (33 [30.8%, 95% CI: 22.2-40.5%]) or anxiety (38 [35.5%, 95% CI: 26.5-45.4%] syndrome based on cut-offs of PHQ-9 score and GAD-7 score, respectively. Number of patients with mild, moderate and moderately severe/severe depression syndrome were 26 (24.3%, 95% CI: 17.2-33.2%), 7 (6.5%, 95% CI: 0.3-12.9%) and 0 respectively and patients with mild, moderate, severe anxiety syndrome were 29 (27.1%, 95% CI: 19.6-36.2%), 9 (8.4%, 95% CI: 4.5-15.2%) and 0 respectively. Patients with anxiety or depression syndrome had significantly higher clinical disease activity in the past, number of days spent in dermatology inpatient and significantly shorter clinical remission at the time of assessment as compared to those without these symptoms. Significant burden of mild/moderate depression or anxiety syndrome associated with past severity of disease and shorter duration of clinical remission was found.