PATTERN OF DERMATOSES AND UNDERLYING PSYCHO-PATHOLOGICAL DISORDERS IN PATIENTS ATTENDING DERMATOLOGY CLINIC IN EARTHQUAKE AFFECTED

AREAS OF AZAD KASHMIR

ABSTRACT

Background: Psychological stress such as sexual assault, major earthquake, or plane crashes has long been recognized as an etiological or precipitating factor in a wide range of dermatological disorders. Successful treatment of these patients depends not only on the management of dermatological disorders but also on recognizing and treating the underlying psychopathological diseases. These disorders can be identified by the application of the twelve item General Health Questionnaire (GHQ-12) which is a self-administered screening tool requiring only a few minutes to be completed and scored.

Objectives: To recognize different types of dermatoses and screen the patients for associated psychopathological disorders by using General Health Questionnaire (GHQ-12) in the earthquake affected areas of Azad Kashmir.

Subjects & Methods: An outpatient dermatology clinic was set up in the earthquake affected area of Muzaffarabad for four days. Sampling techniques used was non probability convenient sampling. Demographic data was filled by social workers and clinical data was recorded by dermatologists on a specially design proforma. The patients were asked to complete 12 items General Health Questionnaire. GHQ was filled by patients who were literate while rests of them were assisted by social workers. Chi-Square test was used for the analysis of data.

Results: A total of 522 patients with different skin diseases were enrolled. It was seen that infestations 207 (39%), infections 80 (15.3%) and eczemas 90 (17.3%) were most commonly encountered dermatological diseases. Stress mediated dermatological problems like acne 40 (7.6%) and psoriasis 27 (5%) were also found in considerably high proportion. About 192 (36.8%) patients were living in shelter based homeless situation and psychiatric morbidity was seen in 173 (55%) of the dermatological patients.

Conclusion: Infestation, infections and eczemas were the most common skin diseases seen and increased psychiatric morbidity may be responsible for rise in stress related dermatological disorders.

Keyword: Psychocutaneous diseases, earthquake