ASSOCIATION BETWEEN PSYCHOLOGICAL STRESS AND SKIN SYMPTOMS AMONG MEDICAL STUDENTS STUDYING IN KARACHI

  • Mustafa Hussain Imam Liaquat National Hospital and Medical College, Karachi, Pakistan
  • Muzzamil Ahmed Karatela Liaquat National Hospital and Medical College, Karachi, Pakistan
  • Muskan Kamal Liaquat National Hospital and Medical College, Karachi, Pakistan
  • Muskan Baig Liaquat National Hospital and Medical College, Karachi, Pakistan
  • Muhammed Aalam Shah Liaquat National Hospital and Medical College, Karachi, Pakistan
  • Muhammad Umer Barry Liaquat National Hospital and Medical College, Karachi, Pakistan
  • Muhammad Shoaib Hussain Liaquat National Hospital and Medical College, Karachi, Pakistan
  • Muhammad Yahya ayan ali Liaquat National Hospital and Medical College, Karachi, Pakistan
  • Umm-e-Rabab Liaquat National Hospital and Medical College, Karachi, Pakistan
Keywords: Acne; Hair; Stress, Psychological; Students, Medical; Sweating

Abstract

OBJECTIVE: To determine any association between psychological stress and skin symptoms in medical students.

DESIGN OF STUDY: It is a cross-sectional study

PLACE AND DURATION: The study was conducted over a period of 12 months, from 30th September 2022 to 1st August 1 2023, on medical students enrolled in the MBBS programme at Liaquat National Hospital and Medical College.

METHOD: We studied medical students through self-reported, validated questionnaires that inquired about socio-demographic information, perceived stress, and skin complaints. Data analysis was done on SPSS version 22, and descriptive frequencies presented as the mean and standard deviation. Associations were assessed by applying the chi-square test among the variables.

RESULTS: A total of 401 questionnaires were used to analyse the data, with a mean age of 20.9 (SD =1.6). We found that 15.7% (n = 28) of the medical students were highly stressed, 77.3% (n = 310) were moderately stressed, and 7% (n = 63) were under low stress. The most common skin symptoms among medical students were hair fall (76.6%) (n = 315) and dark circles (77.3%) (n = 314). Individuals with high PS levels were more likely to develop skin symptoms such as itchy skin on the hands (p = 0.005), pimples or acne (p = 0.049), troublesome sweating (p = 0.04), dark circles (p = 0.01), and hair greying (p = 0.035).

CONCLUSIONS: Psychological stress is associated with skin symptoms reported by medical students, especially dark circles, loss of hair, greying of hair, troublesome sweating, and itchy rashes on the hands. Further studies and interventions should be done to assess and assist medical students.

Downloads

Download data is not yet available.

References

Sharma DK. Physiology of Stress and its Management. J Med Stud Res. 2018; 1(001): 1-5. doi:10.24966/MSR-5657/100001

Mental Health Foundation. Stress [Internet]. 2021 [cited 2023 Aug 21]. Available from: https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/stress

Stephanie Watson. Common causes of Stress & Their Effect on Your Health [Internet]. WebMD; 2022 [cited 2023 Aug 21]. Available from: https://www.webmd.com/balance/causes-of-stress

Neera Nathan M. Stress may be getting to your skin, but it’s not a one-way street [Internet]. 2021 [cited 2023 Aug 21]. Available from: https://www.health.harvard.edu/blog/stress-may-be-getting-to-your-skin-but-its-not-a-one-way-street-2021041422334

Jafri SAM, Zaidi E, Aamir IS, et al. Stress Level Comparison of Medical and Non-medical Students: A Cross Sectional Study done at Various Professional Colleges in Karachi, Pakistan. Acta Psychopathol. 2017, 3:2. doi: 10.4172/2469-6676.100080

Jin R, Luo L, Zheng J. The Trinity of Skin: Skin Homeostasis as a Neuro-Endocrine-Immune Organ. Life (Basel). 2022;12(5):725. doi:10.3390/life12050725

Law R, Clow A. Stress, the cortisol awakening response and cognitive function. Int Rev Neurobiol. 2020;150:187-217. doi:10.1016/bs.irn.2020.01.001

Schuurmans AAT, Nijhof KS, Cima M, Scholte R, Popma A, Otten R. Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls. Stress. 2021;24(6):876-887. doi:10.1080/10253890.2021.1900108

Bin Saif GA, Alotaibi HM, Alzolibani AA, et al. Association of psychological stress with skin symptoms among medical students. Saudi Med J. 2018;39(1):59-66. doi:10.15537/smj.2018.1.21231

Da Silva J, Santos D, Vilaça M, et al. Impact of Psychological Distress on Physiological Indicators of Healing Prognosis in Patients with Chronic Diabetic Foot Ulcers: A Longitudinal Study. Adv Wound Care (New Rochelle). 2023. doi:10.1089/wound.2023.0043

Tohid H, Shenefelt PD, Burney WA, Aqeel N. Psychodermatology: An Association of Primary Psychiatric Disorders With Skin. Rev Colomb Psiquiatr (Engl Ed). 2019;48(1):50-57. doi:10.1016/j.rcp.2017.07.002

Kowalewska B, Jankowiak B, Krajewska-Kułak E, Khvorik DF, Niczyporuk W. Quality of life in skin diseases as perceived by patients and nurses. Postepy Dermatol Alergol. 2020;37(6):956-961. doi:10.5114/ada.2019.86182

Na CH, Chung J, Simpson EL. Quality of Life and Disease Impact of Atopic Dermatitis and Psoriasis on Children and Their Families. Children (Basel). 2019;6(12):133. doi:10.3390/children6120133

Montero-Vílchez T, Sánchez-Díaz M, Martínez-López A, Arias-Santiago S. Quality of Life in Patients with Skin Disease and Their Cohabitants [Internet]. Health-Related Quality of Life - Measurement Tools, Predictors and Modifiers. IntechOpen; 2022. Available from: http://dx.doi.org/10.5772/intechopen.97450

Dean AG, Sullivan KM, Soe MM. OpenEpi epidemiologic statistics [Internet]. [cited 2023 June 30]. Available from: https://www.openepi.com/

Rizvi AH, Awaiz M, Ghanghro Z, Jafferi MA, Aziz S. Pre-examination stress in second year medical students in a government college. J Ayub Med Coll Abbottabad. 2010;22(2):152-155.

1. Cohen S. Perceived stress scale [Internet]. Mind garden; 1994 [cited 2024 Mar 5]. Available from: https://www.mindgarden.com/documents/PerceivedStressScale.pdf

Dalgard F, Svensson A, Holm JØ, Sundby J. Self-reported skin complaints: validation of a questionnaire for population surveys. Br J Dermatol. 2003;149(4):794-800. doi:10.1046/j.1365-2133.2003.05596.x

Sahu PK, Nayak BS, Rodrigues V, Umakanthan S. Prevalence of Psychological Distress among Undergraduate Medical Students: A Cross-Sectional Study. Int J Appl Basic Med Res. 2020;10(4):270-275. doi:10.4103/ijabmr.IJABMR_100_19

Marek-Jozefowicz L, Czajkowski R, Borkowska A, et al. The Brain-Skin Axis in Psoriasis-Psychological, Psychiatric, Hormonal, and Dermatological Aspects. Int J Mol Sci. 2022;23(2):669. doi:10.3390/ijms23020669

Slominski AT, Slominski RM, Raman C, Chen JY, Athar M, Elmets C. Neuroendocrine signaling in the skin with a special focus on the epidermal neuropeptides. Am J Physiol Cell Physiol. 2022;323(6):C1757-C1776. doi:10.1152/ajpcell.00147.2022

Pondeljak N, Lugović-Mihić L. Stress-induced Interaction of Skin Immune Cells, Hormones, and Neurotransmitters. Clin Ther. 2020;42(5):757-770. doi:10.1016/j.clinthera.2020.03.008

Ferreira BR, Pio-Abreu JL, Figueiredo A, Misery L. Pruritus, Allergy and Autoimmunity: Paving the Way for an Integrated Understanding of Psychodermatological Diseases?. Front Allergy. 2021;2:688999. doi:10.3389/falgy.2021.688999

Woźniak E, Owczarczyk-Saczonek A, Placek W. Psychological Stress, Mast Cells, and Psoriasis-Is There Any Relationship?. Int J Mol Sci. 2021;22(24):13252. Published 2021 Dec 9. doi:10.3390/ijms222413252

Graubard R, Perez-Sanchez A, Katta R. Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology. Dermatol Pract Concept. 2021;11(4):e2021091. doi:10.5826/dpc.1104a91

Mavrogiorgou P, Mersmann C, Gerlach G, Herpertz S, Juckel G. Skin Diseases in Patients with Primary Psychiatric Disorders. Psychiatry Investig. 2020;17(2):157-162. doi:10.30773/pi.2019.0193

Motawa SS, Fayed HR, Abdelaziz A, Elsaadouni N, Elwasify M. Prevalence of obsessive compulsive spectrum disorder in patients seeking dermatological consultation. Egypt J Psychiatr. 2020;41:97-102.

Schut C, Dalgard FJ, Bewley A, et al. Body dysmorphia in common skin diseases: results of an observational, cross-sectional multicentre study among dermatological outpatients in 17 European countries. Br J Dermatol. 2022;187(1):115-125. doi:10.1111/bjd.21021

Kanji A. Perspective on Living With a Skin Condition and its Psychological Impact: A Survey. J Patient Exp. 2019;6(1):68-71. doi:10.1177/2374373518774397

Clarke EN, Norman P, Thompson AR. How does self-compassion help people adjust to chronic skin conditions? A template analysis study. Front Med (Lausanne). 2022;9:974816. doi:10.3389/fmed.2022.974816

Published
2023-12-30
How to Cite
1.
Imam MH, Karatela MA, Kamal M, Baig M, Shah MA, Barry MU, Hussain MS, ali MY ayan, Umm-e-Rabab. ASSOCIATION BETWEEN PSYCHOLOGICAL STRESS AND SKIN SYMPTOMS AMONG MEDICAL STUDENTS STUDYING IN KARACHI. J Pak Psychiatr Soc [Internet]. 2023Dec.30 [cited 2024Dec.21];20(04):15-0. Available from: https://jpps.pk/index.php/journal/article/view/289