Dermatologists across Europe underestimate depression and anxiety: results from 3635 dermatological consultations

F. J. Dalgard; null Svensson; U. Gieler; L. Tomas-Aragones; L. Lien; F. Poot; G. B.E. Jemec; L. Misery; C. Szabo; D. Linder; F. Sampogna; A. W.M. Evers; J. Anders Halvorsen; F. Balieva; J. Szepietowski; A. Lvov; S. E. Marron; I. K. Alturnay; A. Y. Finlay; S. S. Salek; J. Kupfer

doi:10.1111/bjd.16250

Dermatologists across Europe underestimate depression and anxiety: results from 3635 dermatological consultations

F. J. Dalgard^*, Svensson, U. Gieler, L. Tomas-Aragones, L. Lien, F. Poot, G. B.E. Jemec, L. Misery, C. Szabo, D. Linder, F. Sampogna, A. W.M. Evers, J. Anders Halvorsen, F. Balieva, J. Szepietowski, A. Lvov, S. E. Marron, I. K. Alturnay, A. Y. Finlay, S. S. SalekJ. Kupfer

^*Corresponding author for this work

Department of Clinical Medicine

18 Citations (Scopus)

Abstract

Background: It was recently demonstrated that a significant number of patients with common skin diseases across Europe are clinically depressed and anxious. Studies have shown that physicians not trained as psychiatrists underdiagnose depression. This has not been explored among dermatologists. Objectives: To estimate the concordance between clinical assessment of depression and anxiety by a dermatologist and assessment with the Hospital Anxiety and Depression Scale (HADS). Methods: The study was an observational cross-sectional multicentre study of prevalent cases of skin diseases in 13 countries in Europe. Consecutive patients were recruited in outpatient clinics and filled in questionnaires prior to clinical examination by a dermatologist who reported any diagnosis of skin disease and signs of mood disorders. Results: Analysis of the 3635 consultations showed that the agreement between dermatologist and HADS was poor to fair (lower than 0·4) for all diagnosis categories. The true-positive rate (represented by the percentage of dermatologists recognizing signs of depression or anxiety in patients with depression or anxiety as defined by a HADS value ≥ 11) was 44·0% for depression and 35·6% for anxiety. The true negative rate (represented by the percentage of dermatologists not detecting signs of depression or anxiety in non-depressed or non-anxious patients defined by HADS-value < 11) was 88.8% for depression and 85.7% for anxiety. Conclusions: Dermatologists in Europe tend to underestimate mood disorders. The results suggest that further training for dermatologists to improve their skills in diagnosing depression and anxiety might be appropriate. When present, the psychological suffering of patients with dermatological conditions needs to be addressed.

Original language	English
Journal	British Journal of Dermatology
Volume	179
Issue number	2
Pages (from-to)	464-470
Number of pages	7
ISSN	0007-0963
DOIs	https://doi.org/10.1111/bjd.16250
Publication status	Published - 2018

Access to Document

10.1111/bjd.16250

Cite this

Dalgard, F. J., Svensson, Gieler, U., Tomas-Aragones, L., Lien, L., Poot, F., Jemec, G. B. E., Misery, L., Szabo, C., Linder, D., Sampogna, F., Evers, A. W. M., Halvorsen, J. A., Balieva, F., Szepietowski, J., Lvov, A., Marron, S. E., Alturnay, I. K., Finlay, A. Y., ... Kupfer, J. (2018). Dermatologists across Europe underestimate depression and anxiety: results from 3635 dermatological consultations. British Journal of Dermatology, 179(2), 464-470. https://doi.org/10.1111/bjd.16250

Dalgard, FJ, Svensson, Gieler, U, Tomas-Aragones, L, Lien, L, Poot, F, Jemec, GBE, Misery, L, Szabo, C, Linder, D, Sampogna, F, Evers, AWM, Halvorsen, JA, Balieva, F, Szepietowski, J, Lvov, A, Marron, SE, Alturnay, IK, Finlay, AY, Salek, SS & Kupfer, J 2018, 'Dermatologists across Europe underestimate depression and anxiety: results from 3635 dermatological consultations', British Journal of Dermatology, vol. 179, no. 2, pp. 464-470. https://doi.org/10.1111/bjd.16250

@article{75bd1000c63648a1afe12fac0bd8b593,

title = "Dermatologists across Europe underestimate depression and anxiety: results from 3635 dermatological consultations",

abstract = "Background: It was recently demonstrated that a significant number of patients with common skin diseases across Europe are clinically depressed and anxious. Studies have shown that physicians not trained as psychiatrists underdiagnose depression. This has not been explored among dermatologists. Objectives: To estimate the concordance between clinical assessment of depression and anxiety by a dermatologist and assessment with the Hospital Anxiety and Depression Scale (HADS). Methods: The study was an observational cross-sectional multicentre study of prevalent cases of skin diseases in 13 countries in Europe. Consecutive patients were recruited in outpatient clinics and filled in questionnaires prior to clinical examination by a dermatologist who reported any diagnosis of skin disease and signs of mood disorders. Results: Analysis of the 3635 consultations showed that the agreement between dermatologist and HADS was poor to fair (lower than 0·4) for all diagnosis categories. The true-positive rate (represented by the percentage of dermatologists recognizing signs of depression or anxiety in patients with depression or anxiety as defined by a HADS value ≥ 11) was 44·0% for depression and 35·6% for anxiety. The true negative rate (represented by the percentage of dermatologists not detecting signs of depression or anxiety in non-depressed or non-anxious patients defined by HADS-value < 11) was 88.8% for depression and 85.7% for anxiety. Conclusions: Dermatologists in Europe tend to underestimate mood disorders. The results suggest that further training for dermatologists to improve their skills in diagnosing depression and anxiety might be appropriate. When present, the psychological suffering of patients with dermatological conditions needs to be addressed.",

author = "Dalgard, {F. J.} and Svensson and U. Gieler and L. Tomas-Aragones and L. Lien and F. Poot and Jemec, {G. B.E.} and L. Misery and C. Szabo and D. Linder and F. Sampogna and Evers, {A. W.M.} and Halvorsen, {J. Anders} and F. Balieva and J. Szepietowski and A. Lvov and Marron, {S. E.} and Alturnay, {I. K.} and Finlay, {A. Y.} and Salek, {S. S.} and J. Kupfer",

year = "2018",

doi = "10.1111/bjd.16250",

language = "English",

volume = "179",

pages = "464--470",

journal = "British Journal of Dermatology",

issn = "0007-0963",

publisher = "Wiley-Blackwell",

number = "2",

}

TY - JOUR

T1 - Dermatologists across Europe underestimate depression and anxiety

T2 - results from 3635 dermatological consultations

AU - Dalgard, F. J.

AU - Svensson, null

AU - Gieler, U.

AU - Tomas-Aragones, L.

AU - Lien, L.

AU - Poot, F.

AU - Jemec, G. B.E.

AU - Misery, L.

AU - Szabo, C.

AU - Linder, D.

AU - Sampogna, F.

AU - Evers, A. W.M.

AU - Halvorsen, J. Anders

AU - Balieva, F.

AU - Szepietowski, J.

AU - Lvov, A.

AU - Marron, S. E.

AU - Alturnay, I. K.

AU - Finlay, A. Y.

AU - Salek, S. S.

AU - Kupfer, J.

PY - 2018

Y1 - 2018

N2 - Background: It was recently demonstrated that a significant number of patients with common skin diseases across Europe are clinically depressed and anxious. Studies have shown that physicians not trained as psychiatrists underdiagnose depression. This has not been explored among dermatologists. Objectives: To estimate the concordance between clinical assessment of depression and anxiety by a dermatologist and assessment with the Hospital Anxiety and Depression Scale (HADS). Methods: The study was an observational cross-sectional multicentre study of prevalent cases of skin diseases in 13 countries in Europe. Consecutive patients were recruited in outpatient clinics and filled in questionnaires prior to clinical examination by a dermatologist who reported any diagnosis of skin disease and signs of mood disorders. Results: Analysis of the 3635 consultations showed that the agreement between dermatologist and HADS was poor to fair (lower than 0·4) for all diagnosis categories. The true-positive rate (represented by the percentage of dermatologists recognizing signs of depression or anxiety in patients with depression or anxiety as defined by a HADS value ≥ 11) was 44·0% for depression and 35·6% for anxiety. The true negative rate (represented by the percentage of dermatologists not detecting signs of depression or anxiety in non-depressed or non-anxious patients defined by HADS-value < 11) was 88.8% for depression and 85.7% for anxiety. Conclusions: Dermatologists in Europe tend to underestimate mood disorders. The results suggest that further training for dermatologists to improve their skills in diagnosing depression and anxiety might be appropriate. When present, the psychological suffering of patients with dermatological conditions needs to be addressed.

AB - Background: It was recently demonstrated that a significant number of patients with common skin diseases across Europe are clinically depressed and anxious. Studies have shown that physicians not trained as psychiatrists underdiagnose depression. This has not been explored among dermatologists. Objectives: To estimate the concordance between clinical assessment of depression and anxiety by a dermatologist and assessment with the Hospital Anxiety and Depression Scale (HADS). Methods: The study was an observational cross-sectional multicentre study of prevalent cases of skin diseases in 13 countries in Europe. Consecutive patients were recruited in outpatient clinics and filled in questionnaires prior to clinical examination by a dermatologist who reported any diagnosis of skin disease and signs of mood disorders. Results: Analysis of the 3635 consultations showed that the agreement between dermatologist and HADS was poor to fair (lower than 0·4) for all diagnosis categories. The true-positive rate (represented by the percentage of dermatologists recognizing signs of depression or anxiety in patients with depression or anxiety as defined by a HADS value ≥ 11) was 44·0% for depression and 35·6% for anxiety. The true negative rate (represented by the percentage of dermatologists not detecting signs of depression or anxiety in non-depressed or non-anxious patients defined by HADS-value < 11) was 88.8% for depression and 85.7% for anxiety. Conclusions: Dermatologists in Europe tend to underestimate mood disorders. The results suggest that further training for dermatologists to improve their skills in diagnosing depression and anxiety might be appropriate. When present, the psychological suffering of patients with dermatological conditions needs to be addressed.

U2 - 10.1111/bjd.16250

DO - 10.1111/bjd.16250

M3 - Journal article

C2 - 29247454

AN - SCOPUS:85047552929

SN - 0007-0963

VL - 179

SP - 464

EP - 470

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 2

ER -

Dermatologists across Europe underestimate depression and anxiety: results from 3635 dermatological consultations

Abstract

Access to Document

Fingerprint

Cite this