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Keywords:

  • dermatology;
  • pruritus;
  • psychology;
  • psychosomatic;
  • stress

ABSTRACT

Background  Psychological stress resulting from stressful major life events is known to exacerbate a wide range of skin disorders.

Objective  To examine the relationship between stressful major life events and dermatological symptoms among a non-clinical sample.

Design  A cross-sectional survey.

Setting  Community-based subjects from London, Ontario, Canada were recruited from the local university, schools and churches.

Participants  Out of 600 consecutive, consenting volunteers 316 subjects [73 men and 243 women; age 38.7 ± 14.8 (mean ± SD) years; marital status 54% married; race 94%‘white’] completed the survey for this study. The exclusion criterion was a history of a major dermatological or medical disorder.

Main outcome measure  The number of major life events experienced over the previous 6 months measured using the Social Readjustment Rating Scale (SRRS) of Holmes and Rahe, and the frequency and severity of a range of cutaneous symptoms (‘burning’, ‘crawling sensation’, ‘tingling’, ‘pricking’ or ‘pins and needles’, ‘pain’, ‘tenderness’ of skin, ‘numbness’, ‘moderate to severe itching’, and ‘easy bruising’) that the subject may have experienced over the previous month.

Results  The most frequently reported body region affected was the scalp (59.5%) and the most frequently reported symptom was itching (69.3%). The total number of major life events experienced over the previous 6 months correlated with the severity of the individual cutaneous symptoms (0.22 ≤ Pearson r ≤ 0.41, P < 0.001) and with the total cutaneous symptom severity score (sum of all cutaneous severity ratings) (Pearson r = 0.40, P < 0.001). This correlation remained significant after the possible confounding effect of psychological factors on cutaneous symptoms was partialled out statistically (partial r = 0.19, P = 0.001).

Discussion  We observed a direct correlation between the number of major life events experienced over the previous 6 months and cutaneous symptoms experienced over the previous 1 month by non-clinical subjects. The correlation remained significant after the effect of psychological factors was partialled out, suggesting that this relationship holds even if the subject does not acknowledge psychological distress in reaction to the major life event.