The Burden on Cohabitants of Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study
Abstract
:1. Introduction
Objectives of the Study
2. Materials and Methods
2.1. Design
2.2. Patients
2.3. Inclusion Criteria
2.4. Exclusion Criteria
2.5. Ethics
2.6. Variables of Interest
2.6.1. Main Variables
- (1)
- Variables related to the severity and characteristics of the disease in patients:
- Urticaria Control Test: It consists of eight different questions about the physical and quality-of-life symptoms related to urticaria in the 4 weeks prior to the consultation. The questions are answered using a Likert scale that values the severity of the urticaria from 0 to 4. The values obtained range from 0 (indicating no control) to 32 (indicating total control) [19].
- The age of onset, evolution time of the disease, date of diagnosis and current treatments were collected.
- (2)
- Variables related to quality of life, anxiety and depression, sleep disturbance, sexual dysfunction and TDp in both patients and cohabitants. The following validated questionnaires were collected:
- Dermatology Life Quality Index (DLQI): It is an indicator of the general dermatologic quality of life in patients over 16 years of age. The questionnaire consists of 10 questions that are each scored on a Likert scale from 0 to 3, with a final score of 0 being the least affected and a final score of 30 being the most affected. The questions refer to the last 7 days [20].
- Chronic Urticaria Quality of Life Questionnaire (CUQoL): It is a questionnaire that includes physical, emotional and social characteristics and aspects of the urticaria itself. It consists of 23 Likert-type questions that are evaluated from 1 (never) to 5 (very much), finally obtaining a range of 0 (no quality-of-life impairment) to 100 (maximum quality-of-life impairment). Different subscales are collected in this questionnaire, including pruritus, swelling, impact on daily activities, sleep disturbances, daily limitations and physical aspects, as well as the overall CUQoL score [9].
- Family Dermatology Life Quality Index (FDLQI): It is an indicator of the general quality of life among cohabitants of patients suffering from skin diseases. The questionnaire consists of 10 questions that are scored on a Likert scale from 0 to 3 each, with 0 being the least affected and 30 being the most affected. The questions refer to the last 7 days [21].
- Hospital Anxiety and Depression Scale (HADS): This validated questionnaire is composed of 14 statements in which the patient must show the degree of agreement/disagreement, scoring each question using an adapted Likert scale. It is subdivided into two scales, with odd-numbered questions being scored for anxiety and even-numbered questions being scored for depression. A score ≥ 8 on any of the subscales was considered indicative of anxiety or depression, respectively [22].
- DS14 Questionnaire: It was used to evaluate the presence of TDp. TDp is described as the presence in the same individual of traits of negative affectivity and social inhibition. It consists of a Likert-type questionnaire composed of 14 items, 7 for negative affectivity and 7 for social inhibition. Each response is answered with values between 0 (completely false) and 4 (completely true). A score ≥ 10 in both spheres is established as a cut-off point as an indicator of TDp [23,24].
- International Index of Erectile Function (IIEF-5) [25] and Female Sexual Function Index (FSFI-6) [26] questionnaires: They were used to collect data on sexual dysfunction in men and women. The IIEF-5 covers all five spheres of sexual function in the males, and a score ≤ 21 was considered significant. The FSFI-6 assesses the six items of female sexual function, and a score ≤ 19 was established as indicative of dysfunction.
- Pittsburgh Sleep Quality Index (PSQI) Questionnaire: This is a validated questionnaire to study the patients’ quality of sleep. It consists of different questions in which the patient must mark one of the multiple answers offered. The global score is scored from 0–21 points, with 21 being the number that implies the greatest impairment of sleep quality. A global score greater than five is considered relevant from the point of view of sleep quality impairment [27].
- Numeric Rating Scale (NRS) for sexual impairment: The patients and cohabitants had to choose, from a scale of 1–10, the degree to which their sexual impairment was associated with their CSU, as has been previously reported [28].
2.6.2. Other Variables
2.7. Statistical Analysis
3. Results
3.1. Sociodemographic and Clinical Features of the Sample
3.1.1. Patients’ Characteristics
3.1.2. Cohabitants’ Characteristics
3.2. Association of Patients’ Quality-of-Life Indexes with Quality-of-Life Indexes, Mood Disturbances and Sexual Function in Cohabitants
3.3. Association of Patients’ Disease Control with Quality-of-Life Indexes, Mood Disturbances and Sexual Function in Cohabitants
3.4. Association of Patients’ Disease Duration with Quality-of-Life Indexes, Mood Disturbances and Sexual Function in Cohabitants
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Saini, S.S.; Kaplan, A.P. Chronic Spontaneous Urticaria: The Devil’s Itch. J. Allergy Clin. Immunol. Pract. 2018, 6, 1097–1106. [Google Scholar] [CrossRef] [PubMed]
- Hon, K.L.; Leung, A.K.C.; Ng, W.G.G.; Loo, S.K. Chronic Urticaria: An Overview of Treatment and Recent Patents. Recent Pat. Inflamm. Allergy Drug Discov. 2019, 13, 27–37. [Google Scholar] [CrossRef] [PubMed]
- Itakura, A.; Tani, Y.; Kaneko, N.; Hide, M. Impact of chronic urticaria on quality of life and work in Japan: Results of a real-world study. J. Dermatol. 2018, 45, 963–970. [Google Scholar] [CrossRef] [Green Version]
- Ograczyk-Piotrowska, A.; Gerlicz-Kowalczuk, Z.; Pietrzak, A.; Zalewska-Janowska, A.M. Stress, itch and quality of life in chronic urticaria females. Postep. Dermatol. Alergol. 2018, 35, 156–160. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sánchez-Díaz, M.; Salazar-Nievas, M.-C.; Molina-Leyva, A.; Arias-Santiago, S. Type D Personality Is Associated with Poorer Quality of Life in Patients with Chronic Spontaneous Urticaria: A Cross-sectional Study. Acta Derm Venereol. 102(SE-Articles). 26 April 2022. Available online: https://medicaljournalssweden.se/actadv/article/view/676 (accessed on 5 May 2022).
- Choi, G.-S.; Nam, Y.-H.; Park, C.-S.; Kim, M.-Y.; Jo, E.-J.; Park, H.-K.; Kim, H.-K. Anxiety, depression, and stress in Korean patients with chronic urticaria. Korean J. Intern. Med. 2020, 35, 1507–1516. [Google Scholar] [CrossRef]
- Chilicka, K.; Rogowska, A.M.; Szyguła, R.; Adamczyk, E. Association between Satisfaction with Life and Personality Types A and D in Young Women with Acne Vulgaris. Int. J. Environ. Res. Public Health 2020, 17, 8524. [Google Scholar] [CrossRef]
- Chilicka, K.; Rogowska, A.M.; Szyguła, R.; Taradaj, J. Examining Quality of Life After Treatment with Azelaic and Pyruvic Acid Peels in Women with Acne Vulgaris. Clin. Cosmet. Investig. Dermatol. 2020, 13, 469–477. [Google Scholar] [CrossRef] [PubMed]
- Mabuchi, T.; Yamaoka, H.; Kojima, T.; Ikoma, N.; Akasaka, E.; Ozawa, A. Psoriasis affects patient’s quality of life more seriously in female than in male in Japan. Tokai J. Exp. Clin. Med. 2012, 37, 84–88. [Google Scholar]
- Kouris, A.; Platsidaki, E.; Christodoulou, C.; Efstathiou, V.; Dessinioti, C.; Tzanetakou, V.; Korkoliakou, P.; Zisimou, C.; Antoniou, C.; Kontochristopoulos, G. Quality of Life and Psychosocial Implications in Patients with Hidradenitis Suppurativa. Dermatology 2017, 232, 687–691. [Google Scholar] [CrossRef] [PubMed]
- Randa, H.; Todberg, T.; Skov, L.; Larsen, L.S.; Zachariae, R. Health-related Quality of Life in Children and Adolescents with Psoriasis: A Systematic Review and Meta-analysis. Acta Derm. Venereol. 2017, 97, 555–563. [Google Scholar] [CrossRef] [Green Version]
- Molina-Leyva, A.; Cuenca-Barrales, C. Pruritus and Malodour in Patients with Hidradenitis Suppurativa: Impact on Quality of Life and Clinical Features Associated with Symptom Severity. Dermatology 2020, 236, 59–65. [Google Scholar] [CrossRef] [PubMed]
- Maurer, M.; Abuzakouk, M.; Bérard, F.; Canonica, W.; Oude Elberink, H.; Giménez-Arnau, A.; Grattan, C.; Hollis, K.; Knulst, A.; Lacour, J.-P.; et al. The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU. Allergy 2017, 72, 2005–2016. [Google Scholar] [CrossRef]
- Dortas, S.D., Jr.; Azizi, G.G.; Moret, R.N.; Bastos Junior, R.M.; Valle, S.O.R. Spiritual well-being and quality of life are impaired in chronic urticaria. Eur. Ann. Allergy Clin. Immunol. 2021, 53, 221–227. [Google Scholar] [CrossRef]
- Martínez-García, E.; Arias-Santiago, S.; Herrera-Acosta, E.; Affleck, A.; Herrera-Ceballos, E.; Buendía-Eisman, A. Quality of Life of Cohabitants of People Living with Acne. Acta Derm. Venereol. 2020, 100, adv00290. [Google Scholar] [CrossRef]
- Martínez-García, E.; Arias-Santiago, S.; Valenzuela-Salas, I.; Garrido-Colmenero, C.; García-Mellado, V.; Buendía-Eisman, A. Quality of life in persons living with psoriasis patients. J. Am. Acad. Dermatol. 2014, 71, 302–307. [Google Scholar] [CrossRef]
- Ramos-Alejos-Pita, C.; Arias-Santiago, S.; Molina-Leyva, A. Quality of Life in Cohabitants of Patients with Hidradenitis Suppurativa: A Cross-sectional Study. Int. J. Environ. Res. Public Health 2020, 17, 6000. [Google Scholar] [CrossRef] [PubMed]
- Aguayo-Carreras, P.; Ruiz-Carrascosa, J.C.; Molina-Leyva, A. Type D personality is associated with poor quality of life, social performance, and psychological impairment in patients with moderate to severe psoriasis: A cross-sectional study of 130 patients. Indian J. Dermatol. Venereol. Leprol. 2020, 86, 375–381. [Google Scholar] [CrossRef] [PubMed]
- García-Díez, I.; Curto-Barredo, L.; Weller, K.; Pujol, R.M.; Maurer, M.; Giménez-Arnau, A.M. Cross-Cultural Adaptation of the Urticaria Control Test From German to Castilian Spanish. Actas Dermosifiliogr. 2015, 106, 746–752. [Google Scholar] [CrossRef] [PubMed]
- Finlay, A.Y.; Khan, G.K. Dermatology Life Quality Index (DLQI)—A simple practical measure for routine clinical use. Clin. Exp. Dermatol. 1994, 19, 210–216. [Google Scholar] [CrossRef]
- Basra, M.K.A.; Sue-Ho, R.; Finlay, A.Y. The Family Dermatology Life Quality Index: Measuring the secondary impact of skin disease. Br. J. Dermatol. 2007, 156, 528–538. [Google Scholar] [CrossRef]
- Zigmond, A.S.; Snaith, R.P. The hospital anxiety and depression scale. Acta Psychiatr. Scand. 1983, 67, 361–370. [Google Scholar] [CrossRef] [Green Version]
- Alcaraz, S.; Hidalgo, M.D.; Godoy, C.; Fernandez, E. Spanish Validation of the Type D Personality Scale (DS14). Behav. Psychol. Conduct. 2018, 26, 195. [Google Scholar]
- Denollet, J. DS14: Standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom. Med. 2005, 67, 89–97. [Google Scholar] [CrossRef]
- Rosen, R.C.; Cappelleri, J.C.; Smith, M.D.; Lipsky, J.; Peña, B.M. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int. J. Impot. Res. 1999, 11, 319–326. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Isidori, A.M.; Pozza, C.; Esposito, K.; Giugliano, D.; Morano, S.; Vignozzi, L.; Corona, G.; Lenzi, A.; Jannini, E.A. Development and validation of a 6-item version of the female sexual function index (FSFI) as a diagnostic tool for female sexual dysfunction. J. Sex. Med. 2010, 7, 1139–1146. [Google Scholar] [CrossRef]
- Buysse, D.J.; Reynolds, C.F., 3rd; Monk, T.H.; Berman, S.R.; Kupfer, D.J. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989, 28, 193–213. [Google Scholar] [CrossRef]
- Cuenca-Barrales, C.; Molina-Leyva, A. Risk Factors of Sexual Dysfunction in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study. Dermatology 2020, 236, 37–45. [Google Scholar] [CrossRef]
- Ertaş, R.; Erol, K.; Hawro, T.; Yılmaz, H.; Maurer, M. Sexual Functioning Is Frequently and Markedly Impaired in Female Patients with Chronic Spontaneous Urticaria. J. Allergy Clin. Immunol. Pract. 2020, 8, 1074–1082. [Google Scholar] [CrossRef]
- Staubach, P.; Eckhardt-Henn, A.; Dechene, M.; Vonend, A.; Metz, M.; Magerl, M.; Breuer, P.; Maurer, M. Quality of life in patients with chronic urticaria is differentially impaired and determined by psychiatric comorbidity. Br. J. Dermatol. 2006, 154, 294–298. [Google Scholar] [CrossRef] [PubMed]
- López-Vico, M.; Sánchez-Capilla, A.D.; Redondo-Cerezo, E. Quality of Life in Cohabitants of Patients Suffering Inflammatory Bowel Disease: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2021, 19, 115. [Google Scholar] [CrossRef]
- Molina-Leyva, A.; Caparros-delMoral, I.; Ruiz-Carrascosa, J.C.; Naranjo-Sintes, R.; Jimenez-Moleon, J.J. Elevated prevalence of Type D (distressed) personality in moderate to severe psoriasis is associated with mood status and quality of life impairment: A comparative pilot study. J. Eur. Acad. Dermatol. Venereol. 2015, 29, 1710–1717. [Google Scholar] [CrossRef] [PubMed]
- Raykh, O.I.; Sumin, A.N.; Kokov, A.N.; Indukaeva, E.V.; Artamonova, G.V. Association of type D personality and level of coronary artery calcification. J. Psychosom. Res. 2020, 139, 110265. [Google Scholar] [CrossRef] [PubMed]
- Kupper, N.; Denollet, J. Type D Personality as a Risk Factor in Coronary Heart Disease: A Review of Current Evidence. Curr. Cardiol. Rep. 2018, 20, 104. [Google Scholar] [CrossRef] [Green Version]
- Kim, S.R.; Nho, J.-H.; Nam, J.-H. Relationships among Type-D personality, symptoms and quality of life in patients with ovarian cancer receiving chemotherapy. J. Psychosom. Obstet. Gynaecol. 2018, 39, 289–296. [Google Scholar] [CrossRef]
- Kim, S.R.; Nho, J.-H.; Kim, H.Y.; Ko, E.; Jung, S.; Kim, I.-Y.; Jang, W.-Y. Type-D personality and quality of life in patients with primary brain tumours. Eur. J. Cancer Care 2021, 30, e13371. [Google Scholar] [CrossRef]
- van Beugen, S.; van Middendorp, H.; Ferwerda, M.; Smit, J.V.; Zeeuwen-Franssen, M.E.J.; Kroft, E.B.M.; de Jong, E.M.G.J.; Donders, A.R.T.; van de Kerkhof, P.C.M.; Evers, A.W.M. Predictors of perceived stigmatization in patients with psoriasis. Br. J. Dermatol. 2017, 176, 687–694. [Google Scholar] [CrossRef]
- Mols, F.; Holterhues, C.; Nijsten, T.; van de Poll-Franse, L.V. Personality is associated with health status and impact of cancer among melanoma survivors. Eur. J. Cancer 2010, 46, 573–580. [Google Scholar] [CrossRef] [PubMed]
- Alidost, F.; Pakzad, R.; Dolatian, M.; Abdi, F. Sexual dysfunction among women of reproductive age: A systematic review and meta-analysis. Int. J. Reprod. Biomed. 2021, 19, 421–432. [Google Scholar] [CrossRef]
- McCool-Myers, M.; Theurich, M.; Zuelke, A.; Knuettel, H.; Apfelbacher, C. Predictors of female sexual dysfunction: A systematic review and qualitative analysis through gender inequality paradigms. BMC Women’s Health 2018, 18, 108. [Google Scholar] [CrossRef]
Variables Patients (n = 31) | |||||
---|---|---|---|---|---|
Sociodemographic features | |||||
Age (years) | 46.41 (SD 8.92) | Occupation | Employed | 74.2% (23/31) | |
Unemployed | 25.8% (8/31) | ||||
Sex (%) | Male: | 35.5% (11/31) | Educational level | No studies or compulsory education | 19.4% (6/31) |
Female: | 64.5% (20/31) | Professional or university studies | 80.6% (25/31) | ||
Disease characteristics | |||||
Disease duration (years) | 10.70 (SD 11.67) | Urticaria Control Test score | 16.29 (SD 6.73) | ||
Disease duration | <10 years | 61.3% (19/31) | Current treatment for CSU | Antihistamines | 61.3% (19/31) |
>10 years | 38.7% (12/31) | Omalizumab | 38.7% (12/31) | ||
Quality-of-life indicators | |||||
DLQI | 10.35 (SD 7.24) | Overall CUQOL | 33.45 (SD 21.61) | ||
DS14 (% of positive test) | 29% (9/31) | PSQI | 10.16 (SD 4.53) | ||
HADS depression (% of positive test) | 48.4% (15/31) | HADS Anxiety (% of positive test) | 38.7% (12/31) | ||
FSFI (% of female sexual dysfunction) | 60% (12/20) | IIEF (% of male sexual dysfunction) | 54.5% (6/11) |
Variables Cohabitants (n = 31) | |||||
---|---|---|---|---|---|
Sociodemographic features | |||||
Age (years) | 45.67 (SD 10.87) | Occupation | Employed | 64.5% (20/31) | |
Unemployed | 35.5% (11/31) | ||||
Sex (%) | Male: | 51.6% (16/31) | Educational level | No studies or compulsory education | 38.7% (12/31) |
Female: | 48.4% (15/31) | Professional or university studies | 61.3% (19/31) | ||
Quality-of-life indicators | |||||
FDLQI | 8.35 (SD 6.15) | PSQI | 5.32 (SD 3.04) | ||
DS14 (% of positive test) | 35.48% (11/31) | HADS Anxiety (% of positive test) | 22.6% (7/31) | ||
HADS depression (% of positive test) | 16.1% (15/31) | IIEF (% of male sexual dysfunction) | 25% (4/16) | ||
FSFI (% of female sexual dysfunction) | 60% (9/15) |
Factors | Patient DLQI | Patient CUQOL | ||
---|---|---|---|---|
Mean/Beta | p Value | Mean/Beta | p Value | |
FDLQI | 0.41 (SD 0.13) | 0.005 | 0.14 (SD 0.04) | 0.004 |
Cohabitant anxiety (HADS-A ≥ 8) | Yes: 14.42 (SD 2.64) | 0.04 | Yes: 44.56 (SE 7.97) | 0.06 |
No: 9.16 (SD 1.43) | No: 30.21 (SE 4.30) | |||
Cohabitant depression (HADS-D ≥ 8) | Yes: 13.80 (SD 3.22) | 0.25 | Yes: 40 (SE 9.74) | 0.47 |
No: 9.69 (SD 1.41) | No: 32.19 (SE 4.27) | |||
Cohabitant type D personality | Yes: 10.63 (SD 2.22) | 0.87 | Yes: 30.92 (SD 6.6) | 0.63 |
No: 10.20 (SD 1.64) | No: 34.83 (SD 4.89) | |||
Cohabitant NRS for sexual impairment | 0.17 (SD 0.008) | 0.043 | 0.06 (SD 0.02) | 0.047 |
Male cohabitant sexual impairment index (Men–IIEF) | 0.01 (SD 0.14) | 0.90 | 0.03 (SD 0.04) | 0.47 |
Female cohabitant sexual impairment index (Women–FSFI) | 0.02 (SD 0.41) | 0.94 | 0.02 (SD 0.14) | 0.82 |
Cohabitant PSQI | 0.007 (SD 0.7) | 0.92 | 0.03 (SD 0.025) | 0.33 |
Factors | Disease Control (Urticaria Control Test) | Disease Duration (Years) | ||
---|---|---|---|---|
Mean/Beta | p Value | Mean/Beta | p Value | |
FDLQI | −0.61 (SD 0.12) | <0.0001 | 0.10 (SD 0.09) | 0.27 |
Cohabitant anxiety (HADS-A ≥ 8) | Yes: 18.05 (SD 1.36) | 0.045 | Yes: 15.85 (SE 4.35) | 0.05 |
No: 11.71 (SD 2.63) | No: 9.20 (SE 2.35) | |||
Cohabitant depression (HADS-D ≥ 8) | Yes: 15.40 (SD 3.05) | 0.75 | Yes: 11.40 (SE 5.30) | 0.88 |
No: 16.46 (SD 1.34) | No: 10.57 (SE 2.32) | |||
Cohabitant type D personality | Yes: 15.63 (SD 2.05) | 0.87 | Yes: 16.45 (SD 3.32) | 0.04 |
No: 16.65 (SD 1.52) | No: 7.55 (SD 42.46) | |||
Cohabitant NRS for sexual impairment | −0.19 (SD 0.15) | 0.69 | 0.009 (SD 0.05) | 0.87 |
Male cohabitant sexual impairment index (Men–IIEF) | −0.03 (SD 0.14) | 0.90 | 0.04 (SD 0.11) | 0.67 |
Female cohabitant sexual impairment index (Women–FSFI) | −0.64 (SD 0.40) | 0.13 | 0.04 (SD 0.20) | 0.84 |
Cohabitant PSQI | −0.05 (SD 0.08) | 0.52 | 0.08 (SD 0.04) | 0.08 |
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Sánchez-Díaz, M.; Salazar-Nievas, M.-C.; Molina-Leyva, A.; Arias-Santiago, S. The Burden on Cohabitants of Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study. J. Clin. Med. 2022, 11, 3228. https://doi.org/10.3390/jcm11113228
Sánchez-Díaz M, Salazar-Nievas M-C, Molina-Leyva A, Arias-Santiago S. The Burden on Cohabitants of Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study. Journal of Clinical Medicine. 2022; 11(11):3228. https://doi.org/10.3390/jcm11113228
Chicago/Turabian StyleSánchez-Díaz, Manuel, Maria-Carmen Salazar-Nievas, Alejandro Molina-Leyva, and Salvador Arias-Santiago. 2022. "The Burden on Cohabitants of Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study" Journal of Clinical Medicine 11, no. 11: 3228. https://doi.org/10.3390/jcm11113228