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SOMATIC COMPLAINTS AND LIFE EVENTS IN PATIENTS WITH SKIN DISEASES

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Supervisor: Richard Uwakwe
Faculty: PSYCHIATRY
Month: 11
Year: 2011

Abstract

Background: The Somatoform Disorders are a disabling group of conditions occurring with high frequency in both general practice and hospital environments. Much research has recently been conducted on somatoform disorders demonstrating their clinical importance, associated health-service burden and economic cost. These conditions are often co-morbid with other mental and physical disorders. There is a dearth of information on this subject in the West African region. Information about the prevalence of somatoform disorders in patients with skin diseases is pivotal in implementation and intervention programmes. The present study was designed to determine the rates of skin diseases and the life events and socio-demographic correlates. Rationale: Not uncommonly a number of Nigerians present with bodily complaints. To what extent these complaints are associated with somatoform disorders, and the role of life events in the interrelationship has been understudied. An understanding of the complex relationship between skin diseases, bodily complaints, sub-types of somatoform disorders, life events and socio-demographic variables would be important to clinicians, researchers and policy makers. It is hoped that this report would contribute to the corpus of knowledge in this field. Methods: Between October and December, 2010, 400 participants attending the dermatology clinics of Lagos University Teaching Hospital were systematically selected. The participants’ socio-demographic profiles were obtained with a structured questionnaire. The symptom checklist-90 (SCL-90) was used to assess psychopathological symptoms (including somatic complaints), and the WHO Composite International Diagnostic Interview (CIDI), was used to diagnose somatoform disorders based on ICD-10 DCR. The Holmes and Rahe Life events scale was employed for the determination of life events at different time points. Results: The commonest somatoform disorder was persistent somatoform pain disorder and patients at slight risk of an illness for the life event scores. Also, the most common type of skin disease was the chronic infections group. On bivariate analysis, the participants with somatoform disorders were more likely to be employed compared to unemployed participants (p = 0.03). The participants with the different types of somatoform disorders, scored more on the slightly at risk range compared to those who were moderately at risk of an illness (p < 0.001). At one year and one month prevalence of somatoform disorders, participants with somatoform disorders were more likely to have experienced one form of life event or another (p < 0.001). Participants whose skin diseases had lasted over 2 years were more likely to have somatoform disorder (p = 0.03). Life events appeared to relate not only to presence of somatoform disorders (p < 0.001), but also with the different types of skin diseases (p = 0.008). There was a higher proportion of the employed (p = 0.05), Ibo ethnic group (p = 0.003) and the Christian participants (p < 0.001) to be on the slightly and moderately at risk ranges of the life event scale. Another significant finding was the association between skin diseases with age (p = 0.007) and marital status (p < 0.001). Conclusion: The result obtained in this study is similar to previous research findings indicating that the higher the life event scores of patients, the more the likelihood of developing a somatoform disorder. There is a need for early specialist referral as well as an increase for more consultation liaison psychiatrists in all primary, secondary and tertiary health institutions in the country.

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