피부 질환 환자의 자살 생각: 유럽 다기관 연구

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출처: https://onlinelibrary.wiley.com/doi/10.1111/jdv.70523?af=R

Suicidal ideation in patients with skin conditions: A multicentre European study

피부 질환 환자의 자살 생각: 유럽 다기관 연구

F. Sampogna, D. Abeni, C. Schut, J. Kupfer, I. K. Altunay, F. Balieva, A. Bewley, A. W. M. Evers, A. Y. Finlay, U. Gieler, T. Gracia-Cazaña, V. Grivcheva-Panovska, G. B. Jemec, F. J. Legat … See all authors

First published: 05 June 2026

https://doi.org/10.1111/jdv.70523Digital Object Identifier (DOI)

요약

배경

자살 생각은 피부과에서 중요한 문제이지만, 종종 간과됩니다. 피부 질환 환자들은 우울증, 불안, 사회적 낙인, 외모에 대한 불만족 등 심리적 고통을 흔히 경험하며, 이러한 모든 요인들은 자살 위험 요인으로 알려져 있습니다. 그럼에도 불구하고, 유럽 전역의 다양한 피부 질환에 대한 대규모 다기관 데이터는 여전히 부족합니다.

목적

본 연구는 유럽 전역의 피부과 외래 환자들 사이에서 자살 생각의 유병률을 파악하고, 일반적인 자살 생각 및 피부 질환 관련 자살 생각과 관련된 사회인구학적, 임상적, 심리적 요인을 규명하는 것을 목표로 합니다.

방법

본 횡단면 다기관 연구는 유럽 17개국의 22개 외래 진료소에서 피부 질환을 가진 성인 환자들을 대상으로 진행되었습니다. 자살 생각은 평생 동안의 자살 생각 경험과 피부 질환과의 연관성에 대한 질문을 통해 평가했습니다. 사회인구학적, 사회경제적, 임상적 변수와 함께 심리적 지표인 우울증(PHQ-2), 불안(GAD-2), 낙인에 대한 인식(PSQ), 외모 만족도를 수집했습니다. 그룹 간 비교는 카이제곱 검정, t-검정, 분산분석(ANOVA)을 사용했습니다. 다변량 로지스틱 회귀분석을 통해 자살 생각의 독립적인 예측인자를 확인했습니다.

결과

응답자 5386명 중 13.7%가 자살 생각을 경험했으며, 이 중 7.0%는 자신의 피부 질환과 자살 생각을 연관지었습니다. 대조군에서는 8.4%가 자살 생각을 경험했습니다. 자살 생각의 유병률은 하위 그룹별로 차이가 있었으며, 젊은 참가자, 미혼자, 저소득층, 스트레스 사건 또는 경제적 어려움을 경험한 사람들에게서 더 높게 나타났습니다. 또한 저체중 BMI, 질병 중증도 증가, 증상 악화, 가려움증이나 작열감과 같은 증상이 있는 경우에도 자살 생각의 유병률이 높았습니다. 정신피부 질환, 화농성 한선염, 다한증, 아토피 피부염, 만성 소양증 및 건선에서 가장 높은 유병률을 보였습니다. 다변량 분석에서 독립적인 예측인자로는 젊은 나이, 미혼, 낮은 BMI, 스트레스 사건, 우울증, 불안, 높은 사회적 낙인, 외모 불만족 등이 포함되었습니다.

결론

유럽 피부과 환자에서 자살 충동이 높은 수준으로 나타나며, 이는 심리적 고통, 사회경제적 취약성, 부정적인 신체 이미지와 밀접한 관련이 있습니다. 위험군 환자를 조기에 발견하고 지원하기 위해 정신 건강 증상 및 자살 충동에 대한 정기적인 선별 검사가 피부과 진료의 표준 구성 요소가 되어야 합니다.

Abstract

Background

Suicidal ideation is a significant, often overlooked, concern in dermatology. Individuals with skin diseases frequently experience psychological distress, including depression, anxiety, stigma and dissatisfaction with appearance, all of which are known risk factors for suicidality. Despite this, large-scale multicentre data across different dermatological conditions in Europe remain scarce.

Objectives

To determine the preval‎ence of suicidal ideation among dermatological outpatients across Europe and to identify sociodemographic, clinical and psychological factors associated with general and skin-related suicidal ideation.

Methods

This cross-sectional multicentre study included adults with dermatological conditions from 22 outpatient clinics in 17 European countries. Suicidal ideation was assessed through questions on lifetime suicidal thoughts and their attribution to skin disease. Sociodemographic, socio-economic and clinical variables were collected, together with psychological indicators: depression (PHQ-2), anxiety (GAD-2), perceived stigmatization (PSQ) and satisfaction with appearance. Group comparisons were conducted using chi-square tests, t-tests and ANOVA. Multivariable logistic regression identified independent predictors of suicidal ideation.

Results

Among 5386 respondents, 13.7% reported suicidal ideation and 7.0% attributed it to their skin condition, compared with 8.4% in controls. Preval‎ence varied across subgroups, being higher in younger participants, single individuals, those reporting low income, stressful events or economic difficulties. Higher rates were also associated with underweight BMI, greater disease severity, presence of flares and symptoms such as itch or burning. Psychodermatological conditions, hidradenitis suppurativa, hyperhidrosis, atopic dermatitis, chronic prurigo and psoriasis showed the highest preval‎ence. In multivariable analysis, independent predictors included younger age, being single, low BMI, stressful events, depression, anxiety, high stigmatization and dissatisfaction with appearance.

Conclusions

Suicidal ideation is elevated in European dermatology patients and is strongly associated with psychological distress, socio-economic vulnerability and negative body perception. Routine screening for mental health symptoms and suicidal ideation should become a standard component of dermatological care to ensure early identification and support of at-risk individuals.