Addictive behavior and diseases in patients with chronic skin diseases: preliminary findings of a cross-sectional study in Europe

Introduction & Objectives: Skin diseases affect nearly one-third of the global population, ranking as the fourth most common human disease. This prevalence is linked to considerable morbidity, contributing significantly to the global disease burden. While studies suggest higher rates of addictive disorders among individuals with psoriasis or atopic dermatitis (AD), research on other chronic skin conditions is lacking. Thus, this study aims to investigate the prevalence of addictive disorders among European patients with chronic skin diseases. Materials & Methods: Within the framework of a project sponsored by the EADV, patients with alopecia areata, AD, hidradenitis suppurativa (HS), psoriasis, urticaria, and vitiligo are invited to participate in an anonymized cross-sectional web- or paper-based questionnaire survey in dermatological clinics. This survey collects demographic and disease-related data, as well as the Dermatology Life Quality Index (DLQI) and happiness score (range 0-10(extremely happy)). Additionally, it was screened for alcohol, drug, gambling, eating, internet, and smoking addiction using validated screening tools in the respective national languages. For languages where validated screening tools were not available, the English version of these tools was initially translated into the respective national language using artificial intelligence and subsequently validated by the participating centers. The questionnaire survey began on 1 July 2023 and is expected to end on 30 June 2024. This preliminary analysis is based on descriptive statistics. Results: In this preliminary analysis, 1,456 patients were enrolled, with a median age of 42.0 years [interquartile range: 30.0; 55.0] and 50.3% being women. The majority of patients were diagnosed with psoriasis (43.1%), followed by AD (25.4%), urticaria (11.1%), HS (10.4%), alopecia areata (5.1%), and vitiligo (4.9%). These conditions moderately impacted the patients' quality of life, with a median DLQI of 6.0 [2.0; 12.0] and a median happiness score of 7.0 [5.0; 8.0]. A majority of patients (52.3%) displayed at least one risk or addictive behavior, with men being more affected than women (57.5% vs. 47.1%, p <.001). Additionally, patients with AD and HS showed a higher prevalence compared to other diseases reviewed. The most prevalent addiction was smoking (24.9%), followed by mild internet addiction (22.5%) and severe internet addiction (6.3%). Harmful or hazardous drinking was identified in 10% of patients, with 2.5% indicating alcohol dependence. Drug-related problems were reported in 5.2% of patients, and 0.3% exhibited drug dependence. Gambling was reported in 3% of patients, while 1.7% were screened for eating disorders. Conclusion: The preliminary findings highlight a notable elevation in addiction prevalence among the studied patient cohort compared to the general population, except for eating disorders. Particularly, individuals with AD and HS, alongside men, exhibit a disproportionate susceptibility to these behaviors. Our further data will provide more precise insights, enabling differentiation among European regions and identifying potential risk factors. These results emphasize the urgent need for targeted interventions and enhanced awareness within healthcare settings to address the unique challenges faced by individuals with chronic skin conditions and concurrent addictive tendencies.