Assessment of Psychological Burden and Suicidal Ideation in Dermatological Inpatients
DOI:
https://doi.org/10.66344/jpad.v36i2.3402Keywords:
Psychodermatology, Anxiety, Depression, Severity of Illness Index, InpatientsAbstract
Background Psychological distress is increasingly recognized among patients with dermatological diseases because of the chronic, recurrent, and visibly disfiguring nature of many skin disorders. Anxiety, depression, and suicidal ideation may significantly affect quality of life and treatment outcomes, particularly among hospitalized patients with severe disease.
Objective To estimate the prevalence of anxiety and depression among dermatological inpatients and determine the correlation between clinical disease severity and psychological morbidity.
Methods This cross-sectional study was conducted on 151 patients admitted to the dermatology ward, Services Hospital Lahore over a period of one year. Demographic data and disease characteristics were recorded. The Hospital Anxiety and Depression Scale (HADS) was utilized to quantify psychological distress. Statistical analysis was performed to identify significant correlations (P<.05).
Results Of the 151 patients, 59.6% were male. Anxiety (HADS-A ≥8) and depression (HADS-D ≥8) were present in 59.6% and 65.6% of patients, respectively. Clinical disease severity was highly correlated with HADS-A (P<0.001) and HADS-D (P<0.001). Gender was a significant factor for anxiety (P=.002), with females showing higher scores. Alarmingly, 9.9% of patients reported suicidal ideation, which was significantly correlated with depression severity.
Conclusion Hospitalized dermatology patients in Lahore carry a substantial psychological burden. Routine screening and a multidisciplinary approach involving psychiatrists are necessary to improve patient outcomes and safety.
References
1. Sarkar S, Rajadhyaksha A, Das S. Psychodermatology: An Indian perspective. Indian J Dermatol Venereol Leprol. 2021;87(4):475-84.
2. Thompson AR, Montgomery K. Psychodermatology: The psychological impact of skin conditions. Psychol Health Med. 2021;26(1):1-10.
3. Jafferany M, Pastolero P. Psychodermatology: The combined expertise of dermatologist and psychiatrist. Clin Dermatol. 2023;41(1):15-22.
4. Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflamm Allergy Drug Targets. 2014;13(3):177-90.
5. Dalgard FJ, Gieler U, Tomas-Aragones L, et al. The psychological burden of skin diseases: a cross-sectional multicenter study. J Invest Dermatol. 2015;135(4):984-91.
6. Picardi A, Mazzotti E, Pasquini P. Prevalence and correlates of suicide ideation among patients with skin disease. J Am Acad Dermatol. 2006;54(3):420-6.
7. Zia S, Khan S, Hassan D, et al. Burden of depression and its correlates among patients of skin diseases in Karachi, Pakistan. J Pak Assoc Dermatol. 2023;33(2):412-19.
8. Shahzad A. Psychological impact of vitiligo on quality of life in Lahore. J Pak Assoc Dermatol. 2021;31(3):445-50.
9. Hisam A, Zafar H, Akbar A, Sultan Bhatti RS, Hussain MR. Anxiety, depression and quality of life in dermatology patients at a tertiary care hospital. J Pak Med Assoc. 2024 Oct;74(10):1761-6.
10. Aslam R, Qadir A, Asad F. Psychiatric morbidity in dermatological outpatients. J Pak Assoc Dermatol. 2007;17(4):235-9.
11. Nawaz S, Abbas M, Ali S. Why dermatology patients are hospitalized? A study from Pakistan. Acta Dermatovenerol Croat. 2009;17(2):101-5.
12. O'Leary RE, Diehl J, Levins PC. Dermatologic conditions in the psychiatric inpatient setting. Clin Dermatol. 2022;40(5):540-7.
13. Matusiak Ł, Szczęch J, Bieniek A, et al. Relationships between depression and anxiety in patients and disease severity. Sci Rep. 2026;16(1):1284.
14. Mumtaz Khan J, Rathore MU, Tahir M. Dermatology life quality index in patients of psoriasis. J Ayub Med Coll Abbottabad. 2020;32(1):64-67.
15. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
16. Rodriguez-Cerdeira C. Psychodermatology: A systematic review. Int J Womens Dermatol. 2022;8(1):14-22.
17. Gupta MA, Gupta AK. Sleep-wake disorders and dermatology. Clin Dermatol. 2023;41(1):56-62.
18. Luqman N, Hassan S, Asghar R. Dermatological morbidity among inpatients with primary psychiatric disorders. J Pak Psychiatr Soc. 2021;18(3):22-5.
19. Erfan M. Frequency of depression and anxiety among melasma patients presented at tertiary care hospital. Med Forum Mon. 2023;34(10):30-3.
20. Tariq H, Malik S. Disease severity and HADS correlation in Pakistani patients. SIMS Med J. 2025;4(2):88-92.
21. Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35(2):121-6.
22. Waqas A, Aedma KK, Tariq M, Meraj H, Naveed S. Validity and reliability of the Urdu version of the Hospital Anxiety & Depression Scale for assessing antenatal anxiety and depression in Pakistan. Asian J Psychiatr. 2019 Oct;45:20-25.
23. Nawaz S, Abbas M, Ali S. Why dermatology patients are hospitalized? A study from Pakistan. Acta Dermatovenerol Croat. 2009;17(2):101-5.
24. Al-Dolat W, Al-Abed MN, Al-Hajji M, et al. Assessment of depressive and anxiety symptoms and health-related quality of life in rosacea patients. J Clin Med. 2025;14(2):345-52.
25. Rodriguez-Cerdeira C. Psychodermatology: A systematic review of social and economic impacts. Int J Womens Dermatol. 2022;8(1):14-22.
26. Dieris-Hirche J, Kupfer J, Gieler U, Salewski C, Milkart J, Gieler U. Suicidal ideation in patients with atopic dermatitis. J Health Psychol. 2009 Nov;14(8):1231-9.
doi: 10.1177/1359105309346342.
27. Layegh P, Mohebbi E, Mossavi Z. A comparative study on the prevalence of depression and suicidal ideation in dermatology patients. J Mashhad Univ Med Sci. 2010;53(2):107-12.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Journal of Pakistan Association of Dermatologists
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.
