Background:An association of mental stress with atopic dermatitis is widely accepted. However, no long-term evaluation of psychophysiological reactivity over the course of disease has yet been performed. Objective:We ...Background:An association of mental stress with atopic dermatitis is widely accepted. However, no long-term evaluation of psychophysiological reactivity over the course of disease has yet been performed. Objective:We examined whether atopic dermatitis patients have an increased psychophysiological reactivity compared to healthy controls and in between acute and disease-free phases, and whether they differ in psychological state and trait variables. Methods:Fifteen patients with atopic dermatitis underwent a stress test during acute exacerbation and after symptom improvement and were compared to matched controls. Results:Psychophysiological responses to stress were not stronger in the patient group than in the controls. Nevertheless, the patients had a higher heart rate and lower vagal activity throughout the resting and stress phases at both examination times. The patients showed significantly higher anxiety, depression and emotional excitability, and self-ratings of inactivity clearly distinguished acute phases from remission. Conclusion:There is an increased vegetative excitability level in patients with atopic dermatitis, which cannot be attributed solely to increased disease activity.展开更多
Objective:To develop a simple, valid, repeatable, and readily understandable patient-oriented assessment measure for monitoring disease activity in children and adults with atopic eczema. Design:Qualitative semistruct...Objective:To develop a simple, valid, repeatable, and readily understandable patient-oriented assessment measure for monitoring disease activity in children and adults with atopic eczema. Design:Qualitative semistructured patient inter views identified a list of symptoms of atopic eczema. These symptoms were quanti tatively analyzed in a larger patient population to identify which symptoms were important to patients and amenable to monitoring as part of a scoring system. S etting:The outpatient Department of Dermatology at the Queen’s Medical Centre, University Hospital, Nottingham, England, and 5 local general practices. Patien ts:Four hundred thirty-five patients with atopic eczema. Results:Seven sympto ms were incorporated into the final patient-oriented eczema measure using a sim ple 5-point scale of frequency of occurrence during the previous week, with a m aximum total score of 28. Validity testing against the Dermatology Life Quality Index, Children’s Dermatology Life Quality Index, and patients’global severity assessments showed good correlation (r=0.78, r=0.73, and r=0.81, respectively; P < .001). Internal consistency was high (Cronbach α=0.88), and test-retest reliability was good, with 95%of scores falling within 2.6 point s on repeat testing (mean score difference, 0.04; SD, 1.32). Individual variable s in the measure demonstrated sensitivity to change during a 4-week in-clinic period and an 18-week randomized controlled clinical trial. Conclusion:The pat ient-oriented eczema measure is a practical self-assessed measurement tool for monitoring aspects of atopic eczema that are important to patients in routine c linical practice or in the clinical trial setting.展开更多
文摘Background:An association of mental stress with atopic dermatitis is widely accepted. However, no long-term evaluation of psychophysiological reactivity over the course of disease has yet been performed. Objective:We examined whether atopic dermatitis patients have an increased psychophysiological reactivity compared to healthy controls and in between acute and disease-free phases, and whether they differ in psychological state and trait variables. Methods:Fifteen patients with atopic dermatitis underwent a stress test during acute exacerbation and after symptom improvement and were compared to matched controls. Results:Psychophysiological responses to stress were not stronger in the patient group than in the controls. Nevertheless, the patients had a higher heart rate and lower vagal activity throughout the resting and stress phases at both examination times. The patients showed significantly higher anxiety, depression and emotional excitability, and self-ratings of inactivity clearly distinguished acute phases from remission. Conclusion:There is an increased vegetative excitability level in patients with atopic dermatitis, which cannot be attributed solely to increased disease activity.
文摘Objective:To develop a simple, valid, repeatable, and readily understandable patient-oriented assessment measure for monitoring disease activity in children and adults with atopic eczema. Design:Qualitative semistructured patient inter views identified a list of symptoms of atopic eczema. These symptoms were quanti tatively analyzed in a larger patient population to identify which symptoms were important to patients and amenable to monitoring as part of a scoring system. S etting:The outpatient Department of Dermatology at the Queen’s Medical Centre, University Hospital, Nottingham, England, and 5 local general practices. Patien ts:Four hundred thirty-five patients with atopic eczema. Results:Seven sympto ms were incorporated into the final patient-oriented eczema measure using a sim ple 5-point scale of frequency of occurrence during the previous week, with a m aximum total score of 28. Validity testing against the Dermatology Life Quality Index, Children’s Dermatology Life Quality Index, and patients’global severity assessments showed good correlation (r=0.78, r=0.73, and r=0.81, respectively; P < .001). Internal consistency was high (Cronbach α=0.88), and test-retest reliability was good, with 95%of scores falling within 2.6 point s on repeat testing (mean score difference, 0.04; SD, 1.32). Individual variable s in the measure demonstrated sensitivity to change during a 4-week in-clinic period and an 18-week randomized controlled clinical trial. Conclusion:The pat ient-oriented eczema measure is a practical self-assessed measurement tool for monitoring aspects of atopic eczema that are important to patients in routine c linical practice or in the clinical trial setting.
