Self-reported skin morbidity and mental health. A population survey among adults in a Norwegian city.

BACKGROUND: Several studies among dermatological patients have shown a link between various chronic dermatological diseases and mental morbidity.
OBJECTIVES: To explore the association between self-reported skin morbidity and psychosocial factors in the general population.
METHODS: This population-based cross-sectional study is part of the Oslo Health Study conducted during 2000-2001. All individuals in Oslo County, Norway, born in 1924/25, 1940/41, 1955, 1960 and 1970 received a postal questionnaire, which 18,770 men and women answered. The questionnaire provided information on sociodemographic factors and self-reported health and psychosocial factors. Dichotomous variables for 10 self-reported skin complaints were used. These were previously validated and refer to the most common chronic skin diseases. Mental distress was measured with a validated 10-item instrument, the Hopkins Symptom Check List-10; social support with the number of confidants; and negative life events with a 12-item validated instrument.
RESULTS: The odds ratio (OR) for mental distress was 1.70 [95% confidence interval (CI) 1.21-2.38] for having itch, 1.64 (95% CI 1.15-2.34) for pimples and 1.72 (95% CI 1.06-2.80) for face rash in an adjusted model. In an adjusted model the OR for skin disease was 1.60 (95% CI 1.39-1.84) when the individual had experienced more than two negative life events; and 2.52 (95% CI 2.12-3.00) for mental distress. Skin morbidity increased for both genders, with poor social support network. There was a significant interaction between social support network and negative life events in the logistic regression model for skin disease when adjusted for sociodemographic factors.
CONCLUSIONS: The study quantifies the association between dermatological problems and psychosocial factors at a population level. It underlines the need to focus on these issues in research and needs assessment in dermatology.