TY - JOUR
T1 - Addiction and chronic skin diseases
T2 - A Pan-European study on prevalence, associations and patient impact
AU - Ziehfreund, Stefanie
AU - Saak, Magdalena
AU - Schaal, Alisa
AU - Mazilu, Roxana
AU - Mahé, Emmanuel
AU - Hajj, Carla
AU - Johansson, Emma K.
AU - Lysell, Josefin
AU - Sigurdardottir, Gunnthorunn
AU - Legat, Franz J.
AU - Koch, Catherina
AU - Schmieder, Astrid
AU - Glatzel, Caroline
AU - Kirby, Brian
AU - Pender, Emily
AU - Zalewska-Janowska, Anna
AU - Tomaszewska, Katarzyna
AU - Ciccarese, Giulia
AU - Lauriola, Pia
AU - Boffa, Michael J.
AU - Farrugia, Stephanie
AU - Pilz, Anna Caroline
AU - Schauer, Franziska
AU - Trzeciak, Magdalena
AU - Zysk, Weronika
AU - Gáspár, Krisztián
AU - Szegedi, Andrea
AU - Damiani, Giovanni
AU - Carugno, Andrea
AU - Hartmane, Ilona
AU - Mikažāns, Ingmārs
AU - Valiukeviciene, Skaidra
AU - Petrokaite, Livija
AU - Szepietowski, Jacek C.
AU - Jastrząb, Beata
AU - Staubach, Petra
AU - Hadžavdić, Suzana Ljubojević
AU - Buzina, Daška Štulhofer
AU - Posch, Christian
AU - Jochmann, Jakob
AU - Wiala, Antonia
AU - Scheffenbichler, Ludwig
AU - Trovato, Emanuele
AU - Calabrese, Laura
AU - Fekete, Gyula Laszlo
AU - Chernyshov, Pavel
AU - Kolodzinska, Lidiia
AU - Welzel, Julia
AU - Thölken, Karisa
AU - Maul, Julia Tatjana
AU - Maul, Lara Valeska
AU - Meyersburg, Damian
AU - Bowe, Stephanie
AU - Connor, Cathal O.
AU - Darlenski, Razvigor
AU - Traidl, Stephan
AU - Vestergaard, Christian
AU - Pinto-Pulido, Elena Lucía
AU - Konstantinou, Maria Polina
AU - Szlávicz, Eszter
AU - Heidemeyer, Kristine
AU - Yawalkar, Nikhil
AU - Lantzsch, Hanka Agnes Caroline
AU - Soplinska, Aleksandra
AU - Seitz, Anna Theresa
AU - Torres, Tiago
AU - Brzoza, Zenon
AU - Vučemilović, Ana Sanader
AU - Manolache, Liana
AU - Magnolo, Nina
AU - Scala, Emanuele
AU - Eyerich, Kilian
AU - Biedermann, Tilo
AU - Zink, Alexander
N1 - Publisher Copyright:
© 2025 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
PY - 2025
Y1 - 2025
N2 - Background: Chronic skin diseases such as psoriasis (PSO), atopic dermatitis (AD) and hidradenitis suppurativa (HS) are frequently associated with psychological distress, potentially promoting maladaptive coping mechanisms including addictive behaviours. Despite evidence of higher addiction rates among dermatology patients, comprehensive multicenter data across Europe are lacking. Objectives: To estimate the prevalence and patterns of addictive behaviours among patients with chronic skin diseases in European tertiary dermatology centres and explore associated sociodemographic and clinical factors. Methods: This multicentre cross-sectional study recruited adult patients with PSO, AD, HS, alopecia areata (AA), urticaria, or vitiligo from dermatology departments in 20 European countries. Participants completed a standardized questionnaire assessing sociodemographics, disease characteristics, and addictive behaviours (smoking, alcohol use, drug use, gambling, internet addiction, and eating disorders). Descriptive analyses and multivariate logistic regression were performed. Results: Among 3585 participants (median age 43 years; 51.1% female), the prevalence of addictive behaviours was notable: smoking (25.7%), pathological gambling (4.5%), hazardous drinking (8.8%), alcohol dependence (2.5%), drug use disorders (5.3%), eating disorders (1.8%), and internet addiction (29.7%). Smoking was most common among PSO and HS patients (48.6%), and gambling among AA and vitiligo patients (8.2%). Significant associations included male sex, younger age, single status, higher Dermatology Life Quality Index (DLQI) scores, and regional variation. Discussion: Addictive behaviours are prevalent in dermatology patients and are associated with both sociodemographic and disease-related factors. The DLQI was positively correlated with multiple addictions, suggesting that reduced quality of life may contribute to maladaptive coping. However, due to the absence of a control group, the tertiary care setting, limited center distribution, and unknown response rate, generalizability is restricted. Conclusion: Addiction screening and supportive mental health strategies should be integrated into dermatologic care, particularly for high-risk patients. Population-based studies with control groups are needed to confirm these findings.
AB - Background: Chronic skin diseases such as psoriasis (PSO), atopic dermatitis (AD) and hidradenitis suppurativa (HS) are frequently associated with psychological distress, potentially promoting maladaptive coping mechanisms including addictive behaviours. Despite evidence of higher addiction rates among dermatology patients, comprehensive multicenter data across Europe are lacking. Objectives: To estimate the prevalence and patterns of addictive behaviours among patients with chronic skin diseases in European tertiary dermatology centres and explore associated sociodemographic and clinical factors. Methods: This multicentre cross-sectional study recruited adult patients with PSO, AD, HS, alopecia areata (AA), urticaria, or vitiligo from dermatology departments in 20 European countries. Participants completed a standardized questionnaire assessing sociodemographics, disease characteristics, and addictive behaviours (smoking, alcohol use, drug use, gambling, internet addiction, and eating disorders). Descriptive analyses and multivariate logistic regression were performed. Results: Among 3585 participants (median age 43 years; 51.1% female), the prevalence of addictive behaviours was notable: smoking (25.7%), pathological gambling (4.5%), hazardous drinking (8.8%), alcohol dependence (2.5%), drug use disorders (5.3%), eating disorders (1.8%), and internet addiction (29.7%). Smoking was most common among PSO and HS patients (48.6%), and gambling among AA and vitiligo patients (8.2%). Significant associations included male sex, younger age, single status, higher Dermatology Life Quality Index (DLQI) scores, and regional variation. Discussion: Addictive behaviours are prevalent in dermatology patients and are associated with both sociodemographic and disease-related factors. The DLQI was positively correlated with multiple addictions, suggesting that reduced quality of life may contribute to maladaptive coping. However, due to the absence of a control group, the tertiary care setting, limited center distribution, and unknown response rate, generalizability is restricted. Conclusion: Addiction screening and supportive mental health strategies should be integrated into dermatologic care, particularly for high-risk patients. Population-based studies with control groups are needed to confirm these findings.
KW - addictive behaviour
KW - alcohol use
KW - atopic dermatitis
KW - comorbidity
KW - cross-sectional study
KW - Europe
KW - gambling
KW - Hidradenitis Suppurativa
KW - internet addiction
KW - patient-reported outcomes
KW - psoriasis
KW - quality of life
KW - skin diseases
KW - stigmatization
KW - urticaria
KW - Vitiligo
UR - https://www.scopus.com/pages/publications/105024806785
U2 - 10.1111/jdv.70245
DO - 10.1111/jdv.70245
M3 - Article
AN - SCOPUS:105024806785
SN - 0926-9959
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
ER -
