Objective: To examine longitudinally the relationship between skin disease and psychological morbidity in young women, testing the hypothesis that psychological morbidity (depression, anxiety, and stress) is a factor in the causation of skin disease. Design: The Australian Longitudinal Study on Women's Health was designed to investigate multiple factors affecting the health and well-being of women over a 20-year period. Data from 3 surveys (conducted in 2000, 2003, and 2006) were analyzed. Multivariate longitudinal generalized estimating equation models, with and without time lag, were used to determine significant factors associated with skin disease (including anxiety, depressive symptoms, and stress). Setting: An Australian community-based study. Participants: Women, aged 22 to 27 years at the time of the first survey, were randomly selected from the Australian National Medicare database. Participant numbers for the surveys from the years 2000, 2003, and 2006 were 9688, 9081, and 8910, respectively. Main Outcome Measures: Outcome measures were the scores from the Center for Epidemiologic Studies Depression Scale, the Perceived Stress Questionnaire for Young Women, and an item to elicit reporting of anxiety symptoms. Results: Of 6630 women providing data on skin diseases on all 3 surveys, 8.0% (n = 523) reported having skin problems on all 3 occasions; 12.1% (n = 803) on 2 occasions; and 23.9% (n = 1582) on 1 occasion. On the 2000, 2003, and 2006 surveys, prevalence of skin problems was 24.2%, 23.9%, and 24.3%, respectively. In the generalized estimating equation models, depression symptoms and stress (but not anxiety) were significantly associated with skin problems (P < .005). Conclusion: The findings of this relationship of depression and stress to skin disease may have considerable clinical implications, including implications for adjunctive psychological interventions in the management of patients with skin disease.
Archives of Dermatology Vol. 145, Issue 8, p. 896-902