The psychosocial burden of hand eczema: Data from a European dermatological multicentre study.

BACKGROUND: The essential physical role, visibility and social importance of the hands place a major psychological burden on patients with hand eczema. OBJECTIVES: The aim of this study was to identify the psychological, social and clinical characteristics of patients with hand eczema, in particular the prevalences of depression, anxiety, suicidal ideation, and comorbidities. MATERIALS AND METHODS: Data on patients with hand eczema were analysed from a large European multicentre study conducted with dermatology outpatients from 13 countries. Groups of patients and controls were compared to analyse the psychological burden of hand eczema. RESULTS: Female patients with hand eczema had higher Hospital Anxiety and Depression Scale (HADS) scores for anxiety (n = 86, median = 7.0) than controls (n = 900, median = 5.0, P = .02), and for depression (median = 4.0) than controls (3.0, P < .001). Patients with high suicidal ideation, with low socioeconomic status and who were widowed or divorced were more likely to fulfil the HADS criteria for anxiety [odds ratio (OR) > 1, P = .038, P < .001, and P < .001, respectively]. The median Dermatology Life Quality Index score was 7.0 (n = 68). DISCUSSION: This study identifies a specific psychological burden experienced by hand eczema patients, highlighting the need for focused psychosocial interventions. Physicians in particular should be aware of the need to identify anxiety and depression in female patients.

The Influence of Parental Divorce on Educational Ambitions of 18/19 Year-Old Adolescents from Oslo, Norway.

Former studies have shown that children and adolescents of divorced parents have significantly poorer educational attainment than their peers from continuously married parents. Educational ambition is important because it has relationship with educational attainment. Our aim was to investigate the associations between parental divorce and educational ambitions among adolescents in the Scandinavian region. Data were used from Young-HUBRO surveys that were conducted in Oslo in the years 2000/2001 and 2004. A change in educational ambition was investigated in a prospective study (n = 1,861) by comparing 18/19 year-olds who experienced late parental divorce with adolescents of continuously married parents. 18/19 year-old adolescents who experienced parental divorce during childhood or adolescence were compared in a cross-sectional study (n = 2,391) with their peers from continuously married parents. Multinomial logistic regression models were fitted to include, among others, mental health problem as a potential confounder. The prospective study showed that a change from ambition for university/college education to having undecided educational ambition was significantly higher among adolescents with experience of late parental divorce than among adolescents of continuously married parents (OR 1.8; 95 % CI 1.1-3.0). In the cross-sectional study, adolescents who experienced parental divorce during childhood or adolescence were more likely to have undecided educational ambition, compared to their peers from continuously married parents (OR 1.3; 95 % CI 1.1-1.8). In conclusion, experience of parental divorce seems to be associated with undecided educational ambition among 18/19 year-old adolescents. Mechanisms that reduce the adverse influence of parental divorce on educational ambitions need to be in place.

Does Parental Divorce Increase Risk Behaviors among 15/16 and 18/19 year-old Adolescents? A Study from Oslo, Norway.

BACKGROUND: Several studies have reported an increase in risk behaviors among adolescents after experience of parental divorce. The aim of the study was to investigate whether parental divorce is associated with risk behavior among adolescents independent of mental health problems, first when early divorce was experienced, and second after experience of late parental divorce. METHOD: One prospective (n=1861) and one cross-sectional study (n=2422) were conducted using data from two Young-HUBRO surveys in Oslo, Norway. All 15/16 year-old 10(th) grade students who participated in the first survey in the school year 2000/01 were followed-up in 2004 when they were 18/19 year-olds. The follow-up rate was 68%. The prospective study investigated the influence of late parental divorce that occurred between the age of 15/16 and 18/19. In the cross-sectional study we focused on early parental divorce that occurred before the participants were 15/16 year-old. RESULTS: In the prospective study we could not discern a significant association between experiencing late parental divorce and an increase in risk behaviors among 18/19 year-old adolescents. In the cross-sectional study parental divorce was significantly associated with cigarette smoking and using doping agents. CONCLUSION: Parental divorce that occurs when the children of divorced parents are 15/16 year-old or younger is associated with an increase in cigarette smoking and use of doping agents. However, no evidence of significant association is found between experience of late parental divorce and risk behaviors in late adolescence.

Suicidal ideation, mental health problems, and social function in adolescents with eczema: a population-based study.

There are few studies on psychosocial problems in adolescents with eczema. We performed a cross-sectional, questionnaire-based study to explore the relationship of suicidal ideation, mental health problems, and social functioning with eczema. A total of 4,744 adolescents (18-19 years) were invited for the study, of whom 3,775 (80%) participated. The overall prevalence of current eczema was 9.7%. Among those with current eczema, 15.5% reported suicidal ideation compared with 9.1% among those without eczema, significantly associated in a multivariate model (odds ratio 1.87, 95% confidence interval 1.31-2.68). In a subgroup analyses, the prevalence of suicidal ideation in those with both eczema and itch was 23.8%, and was significantly associated, compared with those without eczema (3.57, 2.46-5.67). Eczema was associated with mental health problems assessed by the Strength and Difficulties Questionnaire (1.72, 1.21-2.45) and the Hopkins Symptom Checklist 10 (1.63, 1.23-2.16). Five questions assessed social function: feeling attached to family and friends; thriving at school; experiencing bullying; and romantic relationships. Boys with current eczema were less likely to have had romantic relationships (1.93, 1.21-3.08). Eczema in late adolescence is associated with suicidal ideation and mental health problems but rarely with social problems. Our findings point to the importance of addressing mental health issues in adolescents with eczema.

Parental divorce in late adolescence does not seem to increase mental health problems: a population study from Norway.

BACKGROUND: Former studies have shown increased mental health problems in adolescents after parental divorce all over the Western world. We wanted to see if that still is the case in Norway today when divorce turns to be more and more common. METHODS: In a prospective study design, two samples were constituted, adolescents at a baseline survey in 2001/02 (n = 2422) and those at follow-up in 2003/04 (n = 1861), when the adolescents were 15/16 and 18/19 years-old, respectively. They answered self-administered questionnaires in both surveys of Young-HUBRO in Oslo. Early parental divorce was defined as that which occured before age 15/16 years, and late divorce occured between age 15/16 and 18/19. Internalized and externalized mental health problems were measured by the Hopkin's Symptom Check List (HSCL-10) and the Strengths and Difficulties Questionnaire (SDQ). RESULTS: After linear regression models were adjusted for gender, ethnicity, family economy, social support, and mental health problem symptoms measured at baseline before parental divorce occured, late parental divorce did not lead to significant increase in mental health problems among adolescents in the city of Oslo. Early parental divorce was associated with internal mental health problems among young adolescents when adjusted only for the first four possible confounders. CONCLUSIONS: It seems that parental divorce in late adolescence does not lead to mental health problems in Norway any more, as has been shown before, while such problems may prevail among young adolescents. This does not mean that parental divorce create less problems in late adolescence than before but these youths might have developed adjustment abilities against health effects as divorce have turned to be more common.

Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: a population-based study.

We performed a cross-sectional, questionnaire-based study to explore the relationship of suicidal ideation, mental health problems, and social functioning to acne severity among adolescents aged 18-19 years. A total of 4,744 youth were invited and 3,775 (80%) participated. In all, 14% reported having substantial acne (a lot and very much). Among those with very much acne, as compared those with no/little acne, suicidal ideation was twice as frequently reported among girls (25.5 vs. 11.9%) and three times more frequently reported among boys (22.6 vs. 6.3%). Suicidal ideation remained significantly associated with substantial acne (odds ratio 1.80, 95% confidence interval 1.30-2.50) in a multivariate model including adjustments of symptoms of depression, ethnicity, and family income. Mental health problems, as assessed by the Strengths and Difficulties Questionnaire (2.25, 1.69-3.00), low attachment to friends (1.52, 1.21-1.91), not thriving at school (1.41, 1.12-1.78), never having had a romantic relationship (1.35, 1.05-1.70), and never having had sexual intercourse (1.51, 1.21-1.89) were all associated with substantial acne in a multivariate model. Acne is frequently found in late adolescence and is associated with social and psychological problems. Adverse events including suicidal ideation and depression that have been associated with therapies for acne may reflect the burden of substantial acne rather than the effects of medication.

Is the association between acne and mental distress influenced by diet? Results from a cross-sectional population study among 3775 late adolescents in Oslo, Norway.

BACKGROUND: Several studies with conflicting findings have investigated the association between acne and mental health problems. Acne usually starts in adolescents, as does an increase in the prevalence of depression and anxiety. Recently, there has been more focus on the link between diet and acne and diet and mental health problems. The objective of this study is to investigate the association between acne and mental distress and to explore a possible influence of dietary factors on the relation. METHODS: A population-based cross-sectional study in Oslo of 18 or 19 year old adolescents. The participation rate was 80%. Acne was self-reported. To measure mental distress, the Hopkins Symptom Checklist 10 was used. Diet and lifestyle variables were also collected by questionnaire and socio-demographic variables were obtained from Statistics Norway. RESULTS: The prevalence of acne was 14.4% among the males and 12.8% among the females. The mean score of mental distress increased when the severity of acne increased. In the crude analyses, the significant associations with acne among the males were: mental distress OR = 1.63, frequent consumption of chocolate/sweets OR = 1.40, frequent consumption of potato chips OR = 1.54. The significant crude associations with acne among the females were: mental distress OR = 2.16, infrequent consumption of raw vegetables OR = 1.41, non-Western background OR = 1.77 and low family income OR = 2.14. No crude associations with acne were identified in either gender for the consumption of sugary soft drinks, fatty fish, cigarette smoking or alcohol. In adjusted models which included diet and socio-demographic variables, the association between acne and mental distress was unchanged for both males (OR = 1.68) and females (OR = 2.04), and between acne and infrequent consumption of raw vegetables among the females (OR = 1.38). CONCLUSION: Among late adolescents in Oslo, self-reported acne is significantly associated with mental distress and, among girls, with infrequent consumption of raw vegetables. Our finding does not support the hypothesis that dietary factors alter the relationship between acne and mental distress.