Addiction and chronic skin diseases: A Pan-European study on prevalence, associations and patient impact

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dc.contributor.authorZiehfreund, Stefanie
dc.contributor.authorSaak, Magdalena
dc.contributor.authorMazilu, Roxana
dc.contributor.authorMahé, Emmanuel
dc.contributor.authorHajj, Carla
dc.contributor.authorJohansson, Emma Kristin
dc.contributor.authorLysell, Josefin
dc.contributor.authorSigurdardottir, Gunnthorunn
dc.contributor.authorLegat, Franz Josef
dc.contributor.authorSchmieder, Astrid
dc.contributor.authorGlatzel, Caroline Maria
dc.contributor.authorKirby, Brian
dc.contributor.authorPender, Emily Katherine
dc.contributor.authorZalewska-Janowska, Anna Małgorzata
dc.contributor.authorTomaszewska, Katarzyna A.
dc.contributor.authorCiccarese, Giulia
dc.contributor.authorBoffa, Michael John
dc.contributor.authorFarrugia, Stephanie
dc.contributor.authorPilz, Anna Caroline
dc.contributor.authorSchauer, Franziska
dc.contributor.authorTrzeciak, Magdalena
dc.contributor.authorZysk, Weronika
dc.contributor.authorGáspár, Krisztián
dc.contributor.authorSzegedi, Andrea
dc.contributor.authorDamiani, Giovanni
dc.contributor.authorCarugno, Andrea
dc.contributor.authorHartmane, Ilona V.
dc.contributor.authorMikažāns, Ingmārs
dc.contributor.authorValiukevičiene, Skaidra
dc.contributor.authorSzepietowski, Jacek Cezary
dc.contributor.authorJastrząb, Beata A.
dc.contributor.authorStaubach, Petra
dc.contributor.authorHadžavdić, Suzana Ljubojevicé
dc.contributor.authorŠtulhofer-Buzina, Daška
dc.contributor.authorPosch, Christian
dc.contributor.authorJochmann, J.
dc.contributor.authorWiala, Antonia
dc.contributor.authorScheffenbichler, Ludwig
dc.contributor.authorTrovato, E.
dc.contributor.authorCalabrese, Laura
dc.contributor.authorFekete, Gyula László
dc.contributor.authorChernyshov, P. V.
dc.contributor.authorKolodzinska, L.
dc.contributor.authorWelzel, Julia
dc.contributor.authorThölken, Karisa Farias Miksza
dc.contributor.authorMaul, Julia Tatjana
dc.contributor.authorMaul, Lara Valeska
dc.contributor.authorMeyersburg, Damian
dc.contributor.authorBowe, Stephanie B.
dc.contributor.authorDarlenski, Razvigor Borislavov
dc.contributor.authorTraidl, Stephan
dc.contributor.authorVestergaard, Christian
dc.contributor.authorPinto-Pulido, Elena Lucía
dc.contributor.authorKonstantinou, Maria Polina
dc.contributor.authorSzlávicz, Eszter
dc.contributor.authorHeidemeyer, Kristine
dc.contributor.authorYawalkar, Nikhil Y.
dc.contributor.authorLantzsch, Hanka
dc.contributor.authorSoplinska, Aleksandra
dc.contributor.authorSeitz, Anna Theresa
dc.contributor.authorTorres, Tiago
dc.contributor.authorBrzoza, Zenon K.
dc.contributor.authorSanader Vucemilovic, Ana
dc.contributor.authorManolache, Liana
dc.contributor.authorMagnolo, Nina
dc.contributor.authorScala, Emanuele
dc.contributor.authorEyerich, Kilian
dc.contributor.authorBiedermann, Tilo M.
dc.contributor.authorZink, Alexander G.S.
dc.contributor.funderEuropean Academy of Dermatology and Venereologyen
dc.date.accessioned2026-01-07T09:25:57Z
dc.date.available2024-09-12T10:32:41Z
dc.date.available2026-01-07T09:25:57Z
dc.date.issued2025
dc.description.abstractBackground: 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. en
dc.description.sponsorshipEuropean Academy of Dermatology and Venereology (PPRC-2022-19)en
dc.description.statusPeer-revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationZiehfreund, S., Saak, M., Schaal, A., Mazilu, R., Mahé, E., Hajj, C., Johansson, E. K., Lysell, J., Sigurdardottir, G., Legat, F. J. and Koch, C. (2025) 'Addiction and chronic skin diseases: A Pan‐European study on prevalence, associations and patient impact', Journal of the European Academy of Dermatology and Venereology. https://doi.org/10.1111/jdv.70245en
dc.identifier.doi10.1111/jdv.70245
dc.identifier.issn9269959
dc.identifier.journaltitleJournal of the European Academy of Dermatology and Venereologyen
dc.identifier.urihttps://hdl.handle.net/10468/18381
dc.language.isoenen
dc.publisherJohn Wiley and Sons Incen
dc.rights© 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 Dermatologyand Venereology.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided theoriginal work is properly cited.en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.statusPeer revieweden
dc.subjectAddictive behaviouren
dc.subjectAlcohol useen
dc.subjectAtopic dermatitisen
dc.subjectComorbidityen
dc.subjectCross-sectional studyen
dc.subjectEuropeen
dc.subjectGamblingen
dc.subjectHidradenitis Suppurativaen
dc.subjectInternet addictionen
dc.subjectPatient-reported outcomesen
dc.subjectPsoriasisen
dc.subjectQuality of lifeen
dc.subjectSkin diseasesen
dc.subjectStigmatizationen
dc.subjectUrticariaen
dc.subjectVitiligoen
dc.titleAddiction and chronic skin diseases: A Pan-European study on prevalence, associations and patient impacten
dc.typeArticle (peer-reviewed)en
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