Investigation of factors associated with health-related quality of life and psychological distress in vitiligo [Eine Untersuchung von Faktoren, die mit der gesundheitsbezogenen Lebensqualität und der psychologischen Belastung bei Vitiligo verbunden sind]

Background and objectives Skin diseases distort the body image with possible negative effects on the quality of life and psychosocial health of patients. While vitiligo does not affect the physical well-being, it may be psychologically distressing. The present study was based on the hypothesis that particular factors might be critical regarding the adjustment to the disease. Patients and Methods We investigated the vitiligo-related quality of life and psychological distress of 216 patients diagnosed with the disease in relation to demographic factors, disease components, and personality traits. For this purpose, we administered the self-completed questionnaires Dermatological Quality of Life Index, General Health Questionnaire, Eysenck Personality Inventory, and Rosenberg Self-Esteem Scale. Results Statistical analysis revealed a significant positive correlation between patients' distress and health-related quality of life. Moreover, the impact of vitiligo on the quality of life was significantly associated with disease variables as well as personality traits and gender. On the other hand, psychological distress was significantly associated with personality traits and gender, but not with disease components. Conclusions Our results indicate that the psychosocial adjustment to the disease is mainly influenced by subjective factors. This observation could imply the need for targeted support interventions in the treatment of vitiligo. © 2015 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd

Lack of association of acute phase response proteins with hormone levels and antidepressant medication in perimenopausal depression

Background: Major depression is associated with higher plasma levels of positive acute-phase proteins, as well as with lower plasma levels of negative acute-phase proteins. The aim of this study is to examine the levels of acute-phase response proteins and whether these levels are influenced by reproductive hormones and antidepressant medication in the perimenopausal depression. Methods: Sixty-five women (age range: 40-58 years old) participated in this study. All women were in the perimenopausal phase. The diagnosis of depression was made through a psychiatric interview and with the aid of Hamilton Depression Rating Scale 17 (HAM-D 17). The acute-phase response proteins, such as haptoglobin (HP), transferrine (TRf), alpha 1-antitrypsin, complement protein 3 (C3), complement protein 4 (C4) and C-reactive protein (CRP) and the reproductive hormones, for example follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), were analyzed using standard laboratory methods. Pearson's correlations were applied to evaluate the relationship between acute-phase proteins and hormones. Results: Perimenopausal women were divided into three groups. The first group consisted of normal controls, the second one involved depressed perimenopausal women, who were taking selective serotonin reuptake inhibitors (SSRIs), and the third one included depressed women that were not treated with SSRIs. Depressed women in perimenopause, when being compared to non-depressed women, did not differ as to serum levels of acute-phase proteins. There was a positive correlation between HP and E2 in depressed perimenopausal women, who were not taking SSRIs. Conclusions: The lack of association between acute-phase proteins and depressive mood mentioned in this study does not support previous findings in patients with major depression. This negative finding in perimenopausal depression indicates either the absence or a more complex nature of the interactions between acute-phase proteins, low-grade inflammation and depression. The hormonal profile of women is a part of this complexity, because it seems that in perimenopause the hormonal changes are accompanied by changes of acute-phase response proteins. Particularly, in perimenopausal depression, there is an interaction between HP and E2. Therefore, it seems that perimenopause is a period of a woman's life during which hormonal, immune and metabolic changes occur and interact with each other making women vulnerable to depression