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The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients

John A. G. Gibson Orcid Logo, Thomas Dobbs, Rowena Griffiths, Jiao Song Orcid Logo, Ashley Akbari Orcid Logo, Owen Bodger Orcid Logo, Hayley Hutchings Orcid Logo, Ronan Lyons Orcid Logo, Ann John Orcid Logo, Iain Whitaker

BJPsych Open, Volume: 9, Issue: 6

Swansea University Authors: Thomas Dobbs, Rowena Griffiths, Jiao Song Orcid Logo, Ashley Akbari Orcid Logo, Owen Bodger Orcid Logo, Hayley Hutchings Orcid Logo, Ronan Lyons Orcid Logo, Ann John Orcid Logo, Iain Whitaker

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DOI (Published version): 10.1192/bjo.2023.547

Abstract

Background: Estimates suggest that 1 in 100 people in the UK live with facial scarring. Despite this incidence, psychological support is limited. Aims: The aim of this study was to strengthen the case for improving such support by determining the incidence and risk factors for anxiety and depression...

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Published in: BJPsych Open
ISSN: 2056-4724
Published: Royal College of Psychiatrists 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa64997
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Despite this incidence, psychological support is limited. Aims: The aim of this study was to strengthen the case for improving such support by determining the incidence and risk factors for anxiety and depression disorders in patients with facial scarring. Method: A matched cohort study was performed. Patients were identified via secondary care data sources, using clinical codes for conditions resulting in facial scarring. A diagnosis of anxiety or depression was determined by linkage with the patient's primary care general practice data. Incidence was calculated per 1000 person-years at risk (PYAR). Logistic regression was used to determine risk factors. Results: Between 2009 and 2018, 179 079 patients met the study criteria and were identified as having a facial scar, and matched to 179 079 controls. The incidence of anxiety in the facial scarring group was 10.05 per 1000 PYAR compared with 7.48 per 1000 PYAR for controls. The incidence of depression in the facial scarring group was 16.28 per 1000 PYAR compared with 9.56 per 1000 PYAR for controls. Age at the time of scarring, previous history of anxiety or depression, female gender, socioeconomic status and classification of scarring increased the risk of both anxiety disorders and depression. Conclusions: There is a high burden of anxiety disorders and depression in this patient group. Risk of these mental health disorders is very much determined by factors apparent at the time of injury, supporting the need for psychological support.</abstract><type>Journal Article</type><journal>BJPsych Open</journal><volume>9</volume><journalNumber>6</journalNumber><paginationStart/><paginationEnd/><publisher>Royal College of Psychiatrists</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2056-4724</issnElectronic><keywords>Anxiety or fear-related disorders, depressive disorders, epidemiology, risk assessment, trauma and stressor-related disorders</keywords><publishedDay>15</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-11-15</publishedDate><doi>10.1192/bjo.2023.547</doi><url>http://dx.doi.org/10.1192/bjo.2023.547</url><notes/><college>COLLEGE NANME</college><department>Medicine</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PMSC</DepartmentCode><institution>Swansea University</institution><apcterm>External research funder(s) paid the OA fee (includes OA grants disbursed by the Library)</apcterm><funders>This research was funded via the AFFECT project, which is part of the Scar Free Foundation Programme of Regenerative Research at the Reconstructive Surgery &amp; Regenerative Medicine Research Centre (ReconRegen), in partnership with Health &amp; Care Research Wales. A.J. was funded through the Medical Research Council (DATAMIND, grant number MR/W014386/1). This work was supported by Health Data Research UK (grant number HDR-9006), which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and the Wellcome Trust; and Administrative Data Research UK, which is funded by the Economic and Social Research Council (grant number ES/S007393/1).</funders><projectreference/><lastEdited>2023-12-13T10:06:34.8928731</lastEdited><Created>2023-11-16T13:32:03.8397588</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>John A. 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spelling v2 64997 2023-11-16 The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients d18101ae0b4e72051f735ef68f45e1a8 Thomas Dobbs Thomas Dobbs true false 381464f639f98bd388c29326ca7f862c Rowena Griffiths Rowena Griffiths true false 00048c7531209d3238534e0b319de731 0000-0002-4976-156X Jiao Song Jiao Song true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 8096440ab42b60a86e6aba678fe2695a 0000-0002-4022-9964 Owen Bodger Owen Bodger true false bdf5d5f154d339dd92bb25884b7c3652 0000-0003-4155-1741 Hayley Hutchings Hayley Hutchings true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 830074c59291938a55b480dcbee4697e Iain Whitaker Iain Whitaker true false 2023-11-16 PMSC Background: Estimates suggest that 1 in 100 people in the UK live with facial scarring. Despite this incidence, psychological support is limited. Aims: The aim of this study was to strengthen the case for improving such support by determining the incidence and risk factors for anxiety and depression disorders in patients with facial scarring. Method: A matched cohort study was performed. Patients were identified via secondary care data sources, using clinical codes for conditions resulting in facial scarring. A diagnosis of anxiety or depression was determined by linkage with the patient's primary care general practice data. Incidence was calculated per 1000 person-years at risk (PYAR). Logistic regression was used to determine risk factors. Results: Between 2009 and 2018, 179 079 patients met the study criteria and were identified as having a facial scar, and matched to 179 079 controls. The incidence of anxiety in the facial scarring group was 10.05 per 1000 PYAR compared with 7.48 per 1000 PYAR for controls. The incidence of depression in the facial scarring group was 16.28 per 1000 PYAR compared with 9.56 per 1000 PYAR for controls. Age at the time of scarring, previous history of anxiety or depression, female gender, socioeconomic status and classification of scarring increased the risk of both anxiety disorders and depression. Conclusions: There is a high burden of anxiety disorders and depression in this patient group. Risk of these mental health disorders is very much determined by factors apparent at the time of injury, supporting the need for psychological support. Journal Article BJPsych Open 9 6 Royal College of Psychiatrists 2056-4724 Anxiety or fear-related disorders, depressive disorders, epidemiology, risk assessment, trauma and stressor-related disorders 15 11 2023 2023-11-15 10.1192/bjo.2023.547 http://dx.doi.org/10.1192/bjo.2023.547 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University External research funder(s) paid the OA fee (includes OA grants disbursed by the Library) This research was funded via the AFFECT project, which is part of the Scar Free Foundation Programme of Regenerative Research at the Reconstructive Surgery & Regenerative Medicine Research Centre (ReconRegen), in partnership with Health & Care Research Wales. A.J. was funded through the Medical Research Council (DATAMIND, grant number MR/W014386/1). This work was supported by Health Data Research UK (grant number HDR-9006), which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and the Wellcome Trust; and Administrative Data Research UK, which is funded by the Economic and Social Research Council (grant number ES/S007393/1). 2023-12-13T10:06:34.8928731 2023-11-16T13:32:03.8397588 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science John A. G. Gibson 0000-0002-7944-8347 1 Thomas Dobbs 2 Rowena Griffiths 3 Jiao Song 0000-0002-4976-156X 4 Ashley Akbari 0000-0003-0814-0801 5 Owen Bodger 0000-0002-4022-9964 6 Hayley Hutchings 0000-0003-4155-1741 7 Ronan Lyons 0000-0001-5225-000X 8 Ann John 0000-0002-5657-6995 9 Iain Whitaker 10 64997__29252__f4eadc08f5954680af531f56937fe8d1.pdf 64997.VOR.pdf 2023-12-13T10:04:32.1947605 Output 475718 application/pdf Version of Record true Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. Distributed under the terms of a Creative Commons Attribution 4.0 International License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
title The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients
spellingShingle The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients
Thomas Dobbs
Rowena Griffiths
Jiao Song
Ashley Akbari
Owen Bodger
Hayley Hutchings
Ronan Lyons
Ann John
Iain Whitaker
title_short The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients
title_full The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients
title_fullStr The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients
title_full_unstemmed The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients
title_sort The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients
author_id_str_mv d18101ae0b4e72051f735ef68f45e1a8
381464f639f98bd388c29326ca7f862c
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8096440ab42b60a86e6aba678fe2695a
bdf5d5f154d339dd92bb25884b7c3652
83efcf2a9dfcf8b55586999d3d152ac6
ed8a9c37bd7b7235b762d941ef18ee55
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author_id_fullname_str_mv d18101ae0b4e72051f735ef68f45e1a8_***_Thomas Dobbs
381464f639f98bd388c29326ca7f862c_***_Rowena Griffiths
00048c7531209d3238534e0b319de731_***_Jiao Song
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
8096440ab42b60a86e6aba678fe2695a_***_Owen Bodger
bdf5d5f154d339dd92bb25884b7c3652_***_Hayley Hutchings
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
830074c59291938a55b480dcbee4697e_***_Iain Whitaker
author Thomas Dobbs
Rowena Griffiths
Jiao Song
Ashley Akbari
Owen Bodger
Hayley Hutchings
Ronan Lyons
Ann John
Iain Whitaker
author2 John A. G. Gibson
Thomas Dobbs
Rowena Griffiths
Jiao Song
Ashley Akbari
Owen Bodger
Hayley Hutchings
Ronan Lyons
Ann John
Iain Whitaker
format Journal article
container_title BJPsych Open
container_volume 9
container_issue 6
publishDate 2023
institution Swansea University
issn 2056-4724
doi_str_mv 10.1192/bjo.2023.547
publisher Royal College of Psychiatrists
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1192/bjo.2023.547
document_store_str 1
active_str 0
description Background: Estimates suggest that 1 in 100 people in the UK live with facial scarring. Despite this incidence, psychological support is limited. Aims: The aim of this study was to strengthen the case for improving such support by determining the incidence and risk factors for anxiety and depression disorders in patients with facial scarring. Method: A matched cohort study was performed. Patients were identified via secondary care data sources, using clinical codes for conditions resulting in facial scarring. A diagnosis of anxiety or depression was determined by linkage with the patient's primary care general practice data. Incidence was calculated per 1000 person-years at risk (PYAR). Logistic regression was used to determine risk factors. Results: Between 2009 and 2018, 179 079 patients met the study criteria and were identified as having a facial scar, and matched to 179 079 controls. The incidence of anxiety in the facial scarring group was 10.05 per 1000 PYAR compared with 7.48 per 1000 PYAR for controls. The incidence of depression in the facial scarring group was 16.28 per 1000 PYAR compared with 9.56 per 1000 PYAR for controls. Age at the time of scarring, previous history of anxiety or depression, female gender, socioeconomic status and classification of scarring increased the risk of both anxiety disorders and depression. Conclusions: There is a high burden of anxiety disorders and depression in this patient group. Risk of these mental health disorders is very much determined by factors apparent at the time of injury, supporting the need for psychological support.
published_date 2023-11-15T10:06:36Z
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