Therapeutic implications of adding the psychotropic drug escitalopram in the treatment of patients suffering from moderate-severe psoriasis and psychiatric comorbidity: a retrospective study.

BACKGROUND: It is known that stress and/or psychiatric diseases can play an important role in determining psoriasis, including the well-known negative somato-psychiatric rebound that comes with the disease. METHODS: Samples of 38 subjects suffering from both moderate-severe psoriasis treated with anti-TNFα, and depressive and/or anxious mood disorders were studied. Part of them were additionally treated with escitalopram, whereas the other group only consulted to a dermatological and psychiatric follow-up. The aim of this study was to determine if an improvement in the dermatological manifestation as well as an improvement in the anxious-depressive disorder can be observed. RESULTS: The study revealed that patients treated with escitalopram had a reduction of psycho-diagnostic test scores that measure depression and anxiety levels as well as the values of pruritus. CONCLUSION: Our study suggests that psychological interventions and antidepressant medications may improve perceived symptom severity, quality of life and major compliance to the treatment in selected patients (suffering from psoriasis and mood disturbance), without a clinician necessarily being able to see an impact on psoriasis severity.

The importance of stressful family events in psoriatic patients: a retrospective study.

BACKGROUND: Psychosomatic stress events are believed to play an important role in psoriasis either by inducing or worsening the disease. OBJECTIVE: In this article, we compared the role of family stress events against other types of stress events on the psychological well being of patients and on their skin disease. We used our sample of psoriasis patients with said stress events. METHOD: Patients underwent a dermatological examination which was evaluated through the PASI index. Simultaneously, they underwent interviews for psychological evaluations. The Hamilton scales were administered to assess anxiety and depression (Ham-A scores significant >20, Ham-D >15). RESULTS: It has been demonstrated that family stress influences the psychological well being more than other types of daily stress events. In fact, people with family stress events reported higher value HAM-A (P = 0.03) and HAM-D (P = 0.02) compared with those who reported other types of stress events. Women reported higher values of HAM-A and HAM-D than men. The value of PASI in the two groups (with family stress events and those with other stress events) was not statistically significant. CONCLUSION: Results obtained from this analysis show the importance of family stress events on the quality of life and on psychiatric and dermatological status. For the psychological morbidity, a parallel approach of both bio-psychiatric and skin care is recommended, especially for women.

Simultaneous care and melanoma: preliminary report about the psychoncological approach.

AIM: The main aim of the study was to investigate the efficacy of a "take-in- charge" model of advanced stage melanoma patients by a multidisciplinary team and highlight the psychological patterns of the disease. METHODS: The study sample involved 44 patients, 27 females and 17 males, who were given a "Questionnaire on Health Status SF-12" which provides two synthetic indexes, one related to physical health PCS-12, and the other to mental health MCS-12. The statistical data was collected through a preliminary analysis of principal components P.C. A., carried out with SPSS software. RESULTS: Comparing the scores obtained by the PCS and MCS indexes, the mean score is low: 6.52 out of 10 for PCS and 3.23 out of 10 for MCS. At first consultation, there is evidence which supports patients' need for psycho-oncological support. By dividing the sample patients into two subgroups, cutaneous melanoma and visceral melanoma, it should be noted that the first group obtained a mean of 4.75 for PCS and 3.77 for MCS and the second group 7.53 for PCS and 2.92 for MCS respectively. Therefore, the results show, at first consultation, a more complex situation for patients with cutaneous melanoma. CONCLUSION: The results of the study highlight the need to supply some form of psycho-oncological support to help patients while they adapt to the disease. Furthermore, different problems and different coping styles also emerged depending on whether the patient has cutaneous or visceral melanoma. The study therefore demonstrates the need to take into account such variables when devising a personal care system centered on the patient.

Low power radiofrequency electromagnetic radiation for the treatment of pain due to osteoarthritis of the knee.

OBJECTIVE: To investigate the analgesic effect of low power radiofrequency electromagnetic radiation (RF) in osteoarthritis (OA) of the knee. METHODS: In a randomized study on 40 patients the analgesic effect of RF was compared with the effect of transcutaneous electrical nerve stimulation (TENS). RF and TENS applications were repeated every day for a period of 5 days. The therapeutic effect was evaluated by a visual analogue scale (VAS) and by Lequesne's index: tests were performed before, immediately after and 30 days after therapy. RESULTS: RF therapy induced a statistically significant and long lasting decrease of VAS and of Lequesne's index; TENS induced a decrease of VAS and of Lequesne's index which was not statistically significant. CONCLUSIONS: A therapeutic effect of RF was therefore demonstrated on pain and disability due to knee OA. This effect was better than the effect of TENS, which is a largely used analgesic technique. Such a difference of the therapeutic effect may be due to the fact that TENS acts only on superficial tissues and nerve terminals, while RF acts increasing superficial and deep tissue temperature.