Povezanost atopijskoga dermatitisa i stresa određenoga salivarnim kortizolom i psihološkim testovima kvalitete života

doctoral thesis

• Title (english): The association between atopic dermatitis and the stress defined by salivary cortisol and psychological testing of the quality of life
• Author: Jelena Meštrović Štefekov; VIAF: 305665995
• Mentor: Liborija Lugović Mihić (mentor)
• Mentor: Dalibor Karlović (komentor)
• Committee member: Mirna Šitum (predsjednik povjerenstva)
• Committee member: Gorka Vuletić (član povjerenstva)
• Committee member: Branka Marinović (član povjerenstva)
• Committee member: Božana Lončar Brzak (član povjerenstva)
• Committee member: Ana Matošić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Chair of Dermatovenerology); Zagreb
• Defense date and country: 2019-10-02, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Među brojnim čimbenicima u etiopatogenezi atopijskog dermatitisa (AD) navodi se psihički stres, čiji utjecaj na bolest nije do kraja poznat i istražen. Prema dosadašnjim spoznajama, kod oboljelih od AD-a postoji poremećaj regulacije hipotalamičko-hipofizno-adrenalne (HPA, engl. hypothalamic-pituitary-adrenal) osi s promijenjenim odgovorom kortizola na stres, povezanim s pogoršanjem bolesti. Istraživanje je obuhvatilo 84 ispitanika s AD-om: 42 s manifestacijama AD-a (simptomatski) i 42 u fazi remisije (asimptomatski), kojima je uzet uzorak sline za procjenu razine kortizola. Također, ispunili su psihološke upitnike za procjenu percepcije stresa, kvalitete života i obilježja osobnosti. Ispitanicima sa simptomatskim oblikom bolesti određena je težina AD-a indeksom SCORAD (engl. SCORing atopic dermatitis) te provedena druga procjena parametara nakon dva mjeseca prospektivnog praćenja. Niži je salivarni kortizol uočen kod simptomatskog AD-a nego kod asimptomatskog oblika [niska snaga efekta (p=0,011; r=0,276)], a vrijednosti nisu bile ovisne o SCORAD-u i percipiranoj razini stresa (PSS). Zabilježeni SCORAD najjače je korelirao s dermatološkim indeksom kvalitete života (DLQI) (r=0,551; p<0,001). Kod bolesnika s teškim AD-om (SCORAD > 50) utvrđen je znatno niži salivarni kortizol nego kod onih s umjerenim i blagim AD-om [umjerena snaga efekta (p=0,042; r=0,313)]. Percipirana razina stresa (PSS) nije ovisila o SCORAD-u, ali je korelirala s percipiranim utjecajem bolesti na emocionalno stanje (IPQ 8) (r=0,397; p<0,001), dimenzijama kvalitete života WHOQOL BREF [fizičkim i psihičkim zdravljem, socijalnim odnosima i okolinom (r=-0,398 - (-0,483); p<0,001)] te obilježjima osobnosti [osobito s anksioznosti i depresijom (r=0,633 i 0,605; p<0,001), s čijim se porastom povećavao i stupanj PSS-a]. Potrebno je dalje istraživati način utjecaja psihičkog stresa na AD radi poboljšanja kvalitete života bolesnika i osmišljavanja novih terapijskih mogućnosti.

Abstract (english)

One of the numerous factors in the etiopathogenesis of atopic dermatitis (AD) is psychological stress, the influence of which is unknown and under-researched. According to current knowledge, AD patients have a disturbance in the hypothalamic-pituitary-adrenal (HPA) axis with a changed cortisol response to stress associated with the worsening of the disease.
The study included 84 subjects with AD: 42 subjects with symptoms of AD (symptomatic) and 42 subjects in remission (asymptomatic). A sample of saliva was taken from each subject to estimate the cortisol level, and each subject filled out a psychological questionnaire to assess their perception of stress, quality of life and personality traits. Symptomatic subjects were assigned an AD severity scoring (SCORAD index), and a second parameter evaluation was performed after two months of prospective monitoring. Lower salivary cortisol was observed more frequently in symptomatic AD than in the asymptomatic form [low power effect (p = 0.011; r = 0.276)], and these values were not dependent on SCORAD and perceived stress level (PSS). Recorded SCORAD values strongly correlated with the dermatological quality of life index (DLQI) (r = 0.551, p <0.001). In patients with severe AD (SCORAD> 50), significantly lower salivary cortisol was found than in those with moderate and mild AD [moderate effect power (p = 0.042; r = 0.313)]. The Perceived Stress Level (PSS) was not dependent on SCORAD but correlated with the following: perceived effect of the disease on emotional states (IPQ 8) (r = 0.397; p <0.001); the quality of life dimensions WHOQOL BREF [physical and psychological health, interpersonal interactions and the social environment (R = -0.398 - (- 0.483), p <0.001)]; and personality traits, especially connected with anxiety and depression (r = 0.633 and 0.605, p <0.001) which positively correlated with PSS] . Further research is needed on the effect of psychological stress on AD, with the aim of improving the quality of life of patients and developing new therapeutic possibilities.

• Keywords: stres; kortizol u slini; psihološki testovi percepcije stresa; atopijski dermatitis
• Keywords (english): stress; salivary cortisol; stress perception psychological questionnaire; atopic dermatitis
• Language: croatian
• URN:NBN: urn:nbn:hr:127:164520
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina (doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Rad dostavljen u dva word dokumenta s naslovima: zaglavlje i disertacija.
• Created on: 2020-01-22 12:54:36