Psychosocial Impairment Research Articles

An Updated Patient-CenteredSialadenitis Instrument: The Obstructive Salivary Problem Impact Test (SPIT).

The Chronic Obstructive Sialadenitis Symptoms questionnaire (COSS) was created to assess chronic sialadenitis symptoms and treatment response, but its development lacked patient input and validation. We analyzed COSS responses and feedback from sialadenitis patients and physician experts to create the novel obstructive Salivary Problem Impact Test (SPIT), a new standardized measure of sialadenitis-associated symptoms. We analyzed COSS responses via exploratory factor analysis (EFA) to identify essential symptom domains and reduce overlap in questions. Sialadenitis patients evaluated the significance of index symptoms identified from the literature review. Expert physicians rated symptom relevance in clinical assessment. An updated questionnaire (SPIT) was piloted with both patient and expert interviews to optimize structure and readability. The SPIT was assessed for internal consistency, construct validity, and test-retest stability. EFA of 310 COSS responses demonstrated 3 main symptom domains (functional impact, pain, swelling) that explained 58.4% of response variance. Results were not statistically different when collapsing from 11 to 5 question response options. Experts (n=5) ranked gland swelling, mealtime pain, and foul taste as most clinically important, while patients (n=12) ranked swelling, non-mealtime pain, and difficulty eating as most bothersome. Most patients experienced sialadenitis-related functional or psychosocial impairment. Following interviews for question refinement, a 25-question survey was finalized. SPIT responses from 50 sialadenitis patients demonstrated internal consistency (Cronbach's alpha=0.96), 14-day stability (p < 0.001), and agreement with Oral Health Impact Profile-14 scores (p < 0.0001). We developed the SPIT instrument to improve usability and content validity in chronic sialadenitis evaluation. The psychometric assessment demonstrated high construct validity and test-retest reliability. Further work will assess longitudinal changes with treatment. 4 Laryngoscope, 133:539-546, 2023.

Executive functions and psychosocial impairment in children following arterial ischemic stroke

ABSTRACT This study examined the executive function (EF) of children with a history of arterial ischemic stroke (AIS) and preserved intellectual abilities, with reference to age at stroke onset, lesion characteristics, language, and motor functioning. In addition, the associations between EF and emotional and behavioral functioning were investigated. A batteryof standardized neuropsychological tests was administered to children withprevious AIS aged 7–12 in order to assess EF, including inhibition, working memory, cognitive flexibility, and attention. Parents rated questionnaires regarding real-life emotional and behavioral functioning. Finally, clinical and neuroradiological data were also gathered. Thirty patients were enrolled. Eight children fall in the lower end of the normative range or below in more than half of the EF measures, with working memory, inhibition and cognitive flexibility equally impaired, and attention relatively better preserved. Larger lesion size and language deficits were significantly associated with higher EF impairment. Emotional and behavioral functioning was lower in children with weaker EF. Children with a history of AIS, even those with preserved intellectual functioning, have a high risk of showing poor EF, mostly regardless of clinical features or functional impairment. EF difficulties are in turn associated with emotional and behavioral problems. Therefore, a standardized evaluation of EF in this population is mandatory as part of the follow-up, in order to ensure an early intervention and prevent related difficulties.

Psychosocial profiles and their correlation with physical diagnosis in temporomandibular disorders, a preliminary report

ABSTRACT Objective To assess representative psychosocial features in a group of temporomandibular disorder (TMD) patients from Jordan using Axis II of the Diagnostic Criteria for TMD (DC/TMD) protocol. Methods Ninety-eight TMD patients were examined according to Axis I DC/TMD protocol in addition to assessment of their pain-related disability, psychological distress, and stress reactivity. Results Just under half of the patients (49%) had high intensity of characteristic pain (self-reported TMJ-related pain) and one-third (32%) had high levels of pain-related disability. Furthermore, significant proportions of patients expressed moderate-severe degrees of distress and stress reactivity (41% and 39%, respectively). Significant correlations were identified between the Graded Chronic Pain Scale (GCPS) and each of the pain-related TMD subgroups. Conclusion TMD patients are susceptible to high levels of pain-related psychosocial impairment, and clinicians should be aware of the possible correlations between the physical TMD diagnosis and specific psychosocial features during treatment planning.

Supplemental Material for Sparse Models for Predicting Psychosocial Impairments in Patients With PTSD: An Empirical Bayes Approach

Supplemental Material for Sparse Models for Predicting Psychosocial Impairments in Patients With PTSD: An Empirical Bayes Approach

RARE-05. Legal degree of disability in childhood-craniopharyngioma survivors during long-term follow-up – results of the HIT-ENDO study

BACKGROUND: Cranioparyngiomas are rare low-grade embryonic malformational tumors of the sellar/parasellar region. The prognosis after diagnosis during childhood and adolescence is influenced by endocrine and hypothalamic long-term sequelae. A legal status of the degree of disability (GdB), according to the German Social Code Book V that is worthy of support, provides financial means for psychosocial rehabilitation and participation of craniopharyngioma survivors. The aim of this study was to determine the association of clinical/psychosocial characteristics and quality of life (QoL) indicators with the resulting GdB. PATIENTS AND METHODS: HIT-Endo is a German registry study on craniopharyngioma patients aged ≤ 18 years at diagnosis and included before the year 2000. In a sample of 108 patients, the degree of disability and the association with endocrine, ophthalmological, neuropsychological and psychosocial parameters was analyzed after a mean follow-up period of 16 years (95% CI: 9.8-36.4). RESULTS: 44 patients (41%) did not receive a GdB, three patients (3%) received a GdB of 30-40, 43 patients (40%) a GdB of 50-90 and 18 patients (17%) the maximum GdB of 100. Higher GdB were associated with lower education, higher body mass index standard deviation and a higher degree of visual impairment and hypothalamic involvement of the craniopharyngeoma. Patients with a GdB of 100 reported loss in physical and cognitive function, as well as fatigue, dyspnea, and pain conditions, and limitations in social and occupational contexts. They further had a lower functional capacity (German daily life ability scale (FMH)) compared to those with a smaller GdB. CONCLUSION: The GdB is associated with psychosocial and physical impairments and reflects the long-term consequences of craniopharyngioma during childhood and adolescence. A low functional capacity (assessed by FMH) may indicate the eligibility for a high GdB in later life of craniopharyngioma survivors.

An approach to identify people with mental illness that can be expected to benefit from integrated community care in Germany

IntroductionAlthough integrated community care programs specifically tailored to patients with severe mental illness (SMI) are available, recent studies show that these programs are not always provided to the population which would benefit the most from it.ObjectivesAims of this study were the selection of clinical and psychosocial characteristics and the development of a screening algorithm indicating the need for integrated community care services in people with mental disorders.MethodsData of an observational longitudinal study including N=511 participants has been used to examine the hypothesized determinants. At baseline, self-reported empowerment has been assessed via the EPAS and psychosocial impairment and perceived needs have been rated by research workers via the HoNOS and the CAN, respectively. Use of integrated community care services was defined as at least four appointments with service providers over six months and has been recorded via the CSSRI twelve to 18 months after baseline. Mixed-effects regression analyses have been performed to test the predictive value of the hypothesized determinants and marginal predictions were used to define cut-offs for the assessment tool.ResultsEPAS, HoNOS and CAN scores each proved to be significant predictors for using integrated community care services. Cut-off scores for each predictor are presented, forming practical assessment guidelines for future studies.ConclusionsA screening tool and an algorithm for the identification of mentally ill patients who can be expected to benefit from integrated community mental health care programs is available for the German health care system.DisclosureNo significant relationships.

Impact of the COVID-19 pandemic on mental health and service use of people with severe mental illness

IntroductionThe COVID-19 pandemic has a huge impact on the provision of mental health care. Particularly the limitations of face-to-face contacts and the access to treatment facilities can be expected to have significant negative effects on the practice of psychiatric treatment and outcomes. To date the extent and the severity of these effects in people with severe mental illnesses are rarely investigated in Germany.ObjectivesWe investigated the impact of the COVID-19 pandemic on mental health and service use of people with severe mental illness in Germany.MethodsAs part of a pragmatic randomized trial on the effectiveness of an integrated community mental health care program that started immediately after the first COVID-19 wave in June 2020, 1000 people with severe mental illness from different regions in Germany have been asked for the effects of the COVID-19 pandemic on their mental health care and on their general living conditions. Multivariate regression models were computed to estimate the effects of the patients’ COVID-19 experiences on the outcome parameters empowerment (EPAS), psychosocial impairment (HoNOS) and unmet needs (CAN).ResultsUsing prospective data in a large sample of people with mental illness, we will be able to examine the extent to which the pandemic has affected participants’ mental health, their social lives, but also the use of mental health care services.ConclusionsThe data will help to examine the impact of the pandemic on people with severe mental illness in a comprehensive way and will provide evidence where immediate action is needed to reduce further burdens and inequities.DisclosureNo significant relationships.

Integration of geriatric assessment in cancer care for senior adults during COVID-19 pandemic.

e24027 Background: Older patients with cancer are particularly vulnerable, and the risk of mortality and morbidity during this pandemic is high. Comprehensive geriatric assessment (CGA) helps in predicating toxicity and improve outcomes. SAOP3 is validated geriatric screening tool that can efficiently identify deficits in different GA domains. It was developed to determine when a multidisciplinary team consultation with GA-intervention is required. Methods: We performed a retrospective review of institutional cancer registry. We compared 2 groups of cancer patients ≥ 70 years old who completed SAOP3 questionnaire in the pre-COVID (9/1/2019- 3/10/2020) and during the pandemic period (3/11/2020-12/31/2020). Fisher’s exact test was used to statistical analysis. Analytical models were adjusted for age, cancer histology, stage, therapy type, and GA variables. Results: 951 patients were included (499 prepandemic,452 during pandemic). Median age was 76.6 yrs. (range = 71-86). A 50.7% male, 48.3% female and 34% (323) have metastatic disease. The capture and completion rate of SAOP3 were 82% (779) and 86% (817) respectively. There was a significant psychosocial impairment during the pandemic. More patients were feeling depressed 26% (118) during Vs. 3% (15) prior pandemic (P &lt; 0.001). The caregiver availability was different with 47% (212) during pandemic compared to 52% (259) in pre-pandemic (P = 0.0013). There was a statistically significant difference in the fall history with 4% (20) in pre-, in contrast to 10% (45) during pandemic (P = 0.003). There was a numerical difference in the cognitive impairment during the pandemic in compared to the pre-COVID [34% (171), 52% (235) respectively], but it was not statistically significant (P = 0.154). There was no difference observed in nutritional domains between the two groups. Conclusions: Data regarding patients’ domains of a CGA are crucial for optimal care. Screening with the SAOP3 questionnaire captured significant changes in CGA domains associated with the pandemic. These findings also suggest that Integration of high-yield brief geriatric screening tools such as SAOP3 is feasible in busy practice during the pandemic. It can help identify specific impairment of older cancer patients and trigger appropriate interventions to improve the quality of life and clinical outcomes.

How to Optimise the Collection of Patient-Reported Outcomes in the Context of a Specific Disease such as Eating Disorders

Background: Eating disorders (EDs) are severe psychiatric disorders which, when left untreated, can lead to psychosocial impairment, physical disability and death. In the United Kingdom, many specialist ED services collect routine outcome measures (ROMs) which serve to assess illness severity, patients’ quality of life and function. The repeated collection of ROMs over the course of treatment allows for the objective evaluation of patient progress towards recovery. Recent National Health Service (NHS) guidance on adult ED care in England suggests that all services should use ROMs, not just to track progress, but also to support the achievement of collaboratively identified, person-specific recovery goals, to empower patients and inform individualised treatment. To achieve this objective, clinicians need access to psychometrically sound ROMs which can be utilised in a collaborative and person-centred manner. Traditionally, ROMs have been collected using standardised patient-reported outcome measures (PROMs), but increasingly individualised PROMs (i-PROMs) are also being developed. Methods &amp; Findings: In this talk I will review the ‘why, what and how’ of ROMs, PROMs, I-PROMS and of associated normative and ipsative feedback on these measures in the eating disorders context. Conclusions: Use of PROMs has much to be commended both in regard to treating individual patients, at service level and also the wider health care system.DisclosureNo significant relationships.

심리사회적 손상을 동반한 측두하악장애에 대한 물리치료 효과

The purpose of this study was to investigate the effects of physical therapy intervention on psychosocial aspects and temporomandibular function in patients with temporomandibular disorder (TMD) presenting psychosocial impairment. The subjects of this study were twenty-one patients with TMD diagnosed by Pain-Related TMD and Headache through Diagnostic Criteria for TMD (DC/TMD) and with psychosocial impairment characteristics in the Symptom Check-list 90-Revision (SCL-90-R). DC/TMD AxisII assessment tool was used to characterize psychosocial disability, and maximum comfortable opening (MCO) and neck disability index (NDI) were assessed for improvement in temporomandibular and neck function. This study was pre- and post-test single group trial to evaluate he symptoms. Physical therapy interventions were performed for an hour a day, 3 times a week for 4 weeks. As a result of SCL-90-R, there were significant effects in somatization, interpersonal sensitivity, depression, anxiety, paranoid ideation, and global severity index (p<.05). And the number of subjects with T score of 60 or higher was decreased. DC/TMD AxisII evaluation showed a significant effect on psychosocial aspects (p<.05). Furthermore, MCO and NDI had a significant effect on temporomandibular and neck pains and functional improvement (p<.05). Based on these results, it is suggested that physical therapy will be effective in improving not only the function of the temporomandibular mandible but also the psychosocial characteristics for patients with TMDs with psychosocial impairment.

Psychosocial impact and treatment trends of hidradenitis suppurativa in Singapore

Dear Editor, Hidradenitis suppurativa (HS) is a common disease with a prevalence of about 1%.1 Patients commonly suffer from pain, disfigurement and psychosocial embarrassment, and have a worse quality of life compared to other dermatologic conditions.2,3 It is frequently misdiagnosed as other skin infections and delays in diagnosis are associated with more psychosocial impairment.4 We

Vestibular dysfunction amongst adolescents: what do we know? A review.

Vestibular dysfunction in children is a debilitating condition that results in countless pernicious effects, such as motor development delay, poor academic performance and psychosocial impairment. Yet, research pertaining to vestibular and balance disorders amongst adolescents is still lacking and remains an enigma. This paper outlines novel emerging aetiological factors contributing to vestibular dysfunction amongst adolescents by appraising published articles through a narrative review. Underlying aetiological factors of vestibular dysfunction can be identified among adolescents with thorough evaluation. Proper diagnostic evaluation of vestibular dysfunction is imperative in providing optimal care and guiding appropriate treatment strategies. The available literature demonstrated multifactorial aetiological factors that contribute to vestibular dysfunction in adolescents. Outlining the underlying aetiological factors of vestibular dysfunction is vital to ensure that patients receive appropriate care and treatment.

Habitual Physical Activity and Sleep in Adults with End-Stage Renal Disease

ABSTRACT Background Treatment of end-stage renal disease (ESRD) is necessary to maintain life. However, it can cause physiological, psychosocial, and cognitive impairments, which may impact physical activity (PA) and sleep, although there is insufficient device-based data to elucidate such impacts. Methods PA, sedentary time (SED), and sleep were measured over 7 consecutive days in 12 adults with ESRD (9 dialyzing at home, 3 dialyzing in center) using wrist-worn accelerometers. Validated raw acceleration thresholds were used to quantify time spent in each PA intensity domain and SED, and sleep duration and efficiency. Results Adults with ESRD engaged in little moderate-to-vigorous PA (MVPA; 6.9 ± 9.7 min·d−1) and spent 770.0 ± 68.6 min·d−1 SED. People dialyzing at home engaged in more light-intensity PA than those attending in center (131.2 ± 28.1 versus 106.9 ± 5.4 min·d−1, respectively; P = 0.05); however, neither group met the recommended guidelines for daily MVPA. Individuals with ESRD slept for an average of 286.8 ± 79.3 min·night−1 with an efficiency of 68.4 ± 18.5%, although people dialyzing at home slept for longer and more efficiently (74.5% versus 50.0%, P = 0.07) than those attending in center. Conclusion In this study, we suggest that adults with ESRD engage in less total PA than recommended guidelines and are characterized by poor sleep duration and efficiency. Moreover, results indicate that dialysis mode may influence PA, SED, and sleep, with those dialyzing at home engaging in greater leisure time PA and achieving a greater sleep duration and efficiency.

Prevalence of Anxiety Disorders in Chinese Children with Autism Spectrum Disorder in Hong Kong

Background: Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder. Children with ASD are faced with various challenges considering their lifelong neurodevelopmental disabilities. Comorbid psychiatric disorders are found to be prevalent among children with ASD. Anxiety disorders are one of the most prevalent psychiatric comorbidities in this population and have been associated with debilitating psychosocial impairment. Objective: This study aimed to examine the prevalence of comorbid anxiety disorders among Chinese school-age children diagnosed with ASD in a child and adolescent psychiatry outpatient clinic in Hong Kong. Methods: This cross-sectional study was conducted at the Yaumatei Child and Adolescent Mental Health Service specialist outpatient clinic from August 2019 to April 2020. The sample consisted of one hundred thirty-two subjects aged 6 to &lt;12 years who were diagnosed with ASD. The Developmental, Dimensional and Diagnostic Interview were administered to confirm the diagnosis of ASD. The National Institute of Mental Health Diagnostic Interview Schedule for Children-Version 5, parent version was administered for the assessment of comorbid anxiety disorders. Results: The one-year prevalence rate of any anxiety disorder was 28.8%. The most common anxiety disorder was specific phobia (22.7%), followed by social anxiety disorder (13.6%), separation anxiety disorder (3.8%), generalized anxiety disorder (3.8%) and selective mutism (1.5%). No subjects were diagnosed with panic disorder or agoraphobia. Conclusion: Anxiety disorders are prevalent among Chinese school-age children with ASD in Hong Kong. Early recognition and identification of comorbid anxiety disorders are necessary in the diagnostic process of ASD.

Feasibility, Acceptability, and Preliminary Outcome of a Cognitive-Behavioral Group Intervention for Problematic Internet Use via Smartphones in Chinese University Students.

Problematic Internet use is increasingly prevalent among college students and is associated with psychosocial impairments. Cognitive-behavioral intervention has been widely used in addressing addictive behaviors, and is shown to be a promising approach for problematic Internet use. This study presented a brief cognitive-behavioral group intervention developed to reduce problematic Internet use through modifying maladaptive cognitions and coping and enhancing self-regulation. This pilot study assessed the feasibility, acceptability, and preliminary effect of this adapted intervention with six Chinese college students who had problems with Internet use via smartphones. Important issues including conceptualization of the treatment model, feasibility and acceptability of the intervention protocol, and promising therapeutic benefits were reported and discussed. Findings on the feasibility, acceptability, and preliminary outcome of this intervention may be informative to investigators planning similar studies. This study provides useful guidance to clinicians concerning cognitive-behavioral group intervention to address problematic Internet use among university students in China.

The Long-Term Outcomes of Prepubertal Depression and Internalizing Problems: A Scoping Review.

After participating in this activity, learners should be better able to:• Discuss whether prepubertal depression shows longitudinal continuity with depression in adulthood.• Summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems. Adolescent- and young adult-onset depression are common, recurrent, and can cause significant distress and psychosocial impairment across the life span, but recognition of prepubertal internalizing problems and depression, along with their prevalence, clinical course, and long-term outcomes, remains elusive. To examine whether prepubertal depression, which can manifest differently from adult depression, shows longitudinal continuity with depression in adulthood, and to summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems. A scoping review was conducted for peer-reviewed cohort articles published between 2000 and 2020 using PubMed and PsycINFO. From 4309 identified references, 17 articles were included. Prepubertal depression confers increased risk of recurrence of depression in adulthood, with similar findings for prepubertal internalizing problems. No studies found prepubertal depression or internalizing problems predicting adult substance abuse, and no studies asked about adult bipolar diagnoses. More research is needed to draw clear conclusions regarding their implications for other psychiatric, medical, or psychosocial outcomes. The reviewed studies provide limited evidence that prepubertal depression onset predicts adult depression. The small evidence base and heterogeneous methodological assessments may limit, however, the ability to draw meaningful conclusions about the long-term course of prepubertal-onset depression. Well-designed studies with longer follow-up and multiple assessments in adulthood are needed to clarify and assess the potential effects of prepubertal depression on adult health and functioning. This information will eventually become available as the samples in recently initiated longitudinal cohort studies of children mature further.

Sensory Versus Affective Pain Descriptors Predicting Functional Versus Psychosocial Disability

In the lexical assessment of pain, an offshoot of the McGill Pain Questionnaire is the Pain Descriptor System (PDS) which assesses sensory, affective, and overall intensity of pain. To determine if sensory versus affective pain components might be selectively related to different aspects of disability, PDS scores were examined in relation to functional status and psychosocial impairment on the Pain Disability Questionnaire (PDQ). A sample of 629 chronic pain patients rated the degree to which each of 36 PDS words described their pain and also rated 15 items of the PDQ. Three regression models (including Group Lasso) were applied to the data. Results showed that as hypothesized, PDS sensory scores significantly predicted PDQ functional status, accounting for about 13% of the variance; PDS affective scores significantly predicted PDQ psychosocial impairment, accounting for 17% of the variance; PDS total scores significantly predicted PDQ total scores, accounting for approximately 24% of the variance. This supports the overall predictive validity of pain descriptors, while confirming more specific links between components of pain and facets of disability. Clinically, the patient's description of pain sensation may hold valuable clues to physical impairment, whereas the communication of affect/suffering is more likely to connote psychosocial difficulties in functioning. PerspectiveRegression models (including Group Lasso) were applied to data on pain and disability from 629 patients. Findings support the Pain Descriptor System in assessing pain but further suggest that sensory descriptors are predictive of physical impairment from chronic pain, whereas affective descriptors are more predictive of psychologically-related disability.

Posttraumatic stress disorder-related anhedonia as a predictor of psychosocial functional impairment among United States veterans.

Prior research suggests that anhedonia symptoms related to posttraumatic stress disorder (PTSD; i.e., diminished interest, detachment from others, and difficulty experiencing positive emotions) are consistently associated with a higher degree of impairment in psychosocial functioning beyond that associated with other PTSD symptoms. Unfortunately, much of this research has used cross-sectional study designs; relied upon outdated DSM diagnostic criteria; and failed to control for potentially confounding variables, such as the presence of co-occurring depression. This study used data from Waves 2 and 4 (n = 1,649) of the Veterans' After-Discharge Longitudinal Registry (Project VALOR), a longitudinal dataset of U.S. Army and Marine veterans. As measured using the Inventory of Psychosocial Functioning, Wave 4 psychosocial functioning was regressed on seven PTSD symptom factors at Wave 2 (i.e., intrusions, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal) and potential Wave 2 confounds. The Anhedonia factor, β = .123, most strongly predicted later psychosocial functional impairment beyond the impact of other PTSD symptom factors, βs = -.076-.046. Clinical implications of these findings are also discussed.

Case report: surgical management of massive scrotal lymphedema in a bariatric patient

A morbidly obese male patient was referred to our department for joint-venture excision surgery of a massive genital lymphedema that had increased 10-fold in volume over a 3-year period. The patient underwent two-stage excision and reconstruction surgery including orchiectomy and was discharged with no major complications and reported improved outcome and urogenital function after surgery at 6-month follow-up. Genital lymphedema is a rare and surgically challenging disease that is related to obesity and causes functional and psychosocial impairment. The planning, performance and postoperative care of surgery on bariatric patients requires tailored surgical treatment and the involvement of several different medical professions and specialties. Surgical debulking can bring about satisfactory outcomes and profound improvements in quality of life.

First use of the Adolescent Depression Rating Scale (ADRS) in the management of young people with severe acne treated with isotretinoin: a pilot study of an active monitoring of depressive disorders by dermatologists.

During isotretinoin treatment, special attention is required to detect any symptom or change in the mental health of patients. The monitoring is complex for adolescents because of confounding factors such as mood changes associated with adolescence and puberty and the higher psychosocial impairment due to the acne itself. To determine the utility of the Adolescent Depression Rating Scale (ADRS) for monitoring symptoms in adolescents before and during isotretinoin treatment in dermatology real-life practice. This was a national, multicentre prospective study that enrolled a random sample of dermatologists treating adolescents. An algorithm including ADRS score and its changes between consecutive visits was used. At each visit, dermatologists rated their satisfaction with ADRS and its ease of use, while patients rated the acceptability of the ADRS. In total, 70 dermatologists used the algorithm for 1227 visits of 283 adolescents receiving isotretinoin. Of these 70 dermatologists, 80.8% were satisfied/very satisfied with the ADRS, 82.7% considered the use of the ADRS in clinical practice to be easy/very easy and 75% considered that the ADRS enabled them to discuss more easily the risk of depression with their patients. For the patients, acceptability of the ADRS was considered good by 93.8%. The implementation of the ADRS could be valuable in dermatology practice, optimizing the monitoring of patients and the good use of isotretinoin.