Self-reported skin morbidity and mental health. A population survey among adults in a Norwegian city

Abstract

Several studies among dermatological patients have shown a link between various chronic dermatological diseases and mental morbidity. To explore the association between self-reported skin morbidity and psychosocial factors in the general population. This population-based cross-sectional study is part of the Oslo Health Study conducted during 2000-2001. All individuals in Oslo County, Norway, born in 1924/25, 1940/41, 1955, 1960 and 1970 received a postal questionnaire, which 18,770 men and women answered. The questionnaire provided information on sociodemographic factors and self-reported health and psychosocial factors. Dichotomous variables for 10 self-reported skin complaints were used. These were previously validated and refer to the most common chronic skin diseases. Mental distress was measured with a validated 10-item instrument, the Hopkins Symptom Check List-10; social support with the number of confidants; and negative life events with a 12-item validated instrument. The odds ratio (OR) for mental distress was 1.70 [95% confidence interval (CI) 1.21-2.38] for having itch, 1.64 (95% CI 1.15-2.34) for pimples and 1.72 (95% CI 1.06-2.80) for face rash in an adjusted model. In an adjusted model the OR for skin disease was 1.60 (95% CI 1.39-1.84) when the individual had experienced more than two negative life events; and 2.52 (95% CI 2.12-3.00) for mental distress. Skin morbidity increased for both genders, with poor social support network. There was a significant interaction between social support network and negative life events in the logistic regression model for skin disease when adjusted for sociodemographic factors. The study quantifies the association between dermatological problems and psychosocial factors at a population level. It underlines the need to focus on these issues in research and needs assessment in dermatology.