PubMed Health⌕ Search

Biomedical subjects

M A Gupta

Publications and source records attributed to M A Gupta.

At least 19 recordsLinked to original sources
PubMed1997

Psoriasis and sex: a study of moderately to severely affected patients.

BACKGROUND: Psoriasis can have a significant impact upon sexual functioning for 30%-70% of patients. We examined the dermatologic and psychologic factors associated with the effect of psoriasis on this important dimension of quality of life. METHODS: One hundred and twenty consenting psoriasis patients (63 men and 57 women; mean +/- SD age, 46.8 +/- 15.7 years; mean +/- SD total body surface area affected, 53.4% +/- 22.9%) completed a battery of questionnaires which included their response (endorsed with a "Yes" or "No") to the following question: "Do you believe that since the onset of psoriasis your sexual activity has declined?" The differences in dermatologic and psychologic measures between the subgroup that endorsed a "Yes" response and the subgroup that endorsed a "No" response were examined. RESULTS: Forty-nine out of 120 patients (40.8%) were sexually affected, i.e. they endorsed a "Yes." There were no significant differences between the affected and unaffected groups with respect to marital status, age, sex, and duration of psoriasis. The affected group reported more joint pains (P = 0.01), marginally greater psoriasis severity affecting the groin region (P = 0.07), greater scaling (P = 0.06), and greater pruritus severity (P = 0.07). Psychologically, the affected group had higher depression scores (P = 0.02) which were in the range for clinical depression, a greater tendency (P = 0.02) to seek the approval of others, and a marginally greater tendency (P = 0.08) to drink alcohol. A decline in sexual activity was related to a decrease in the patient's sex drive for 42.6% of patients; however, only 14.9% of these patients attributed the decline in their sexual activity to decreased sex drive of their spouse/partner. CONCLUSION: In addition to some dermatologic factors, comorbid psychologic factors, such as depression and a tendency for alcohol use, may be important determinants of decreased sexual functioning in psoriasis.

Alcoholism↗
PubMed1997

Stress and alopecia areata: a psychodermatologic study.

Psychosocial stress has been reported to play a role in the onset and/or exacerbation of alopecia areata. Little is known about the clinical characteristics of alopecia areata patients whose alopecia is stress-reactive. We examined the relation between the stress reactivity of alopecia areata and a wide range of psychosocial measures among 16 patients with alopecia areata/totalis and 28 patients with alopecia universalis. The degree to which the alopecia was exacerbated by stress was measured by patient ratings on a 10-point scale. A wide range of psychologic measures correlated (p<0.05) with the stress reactivity score. Stepwise logistic regression analysis revealed that patients with higher depression scores were more likely to be in the high-stress reactor group. Patients whose alopecia is stress-reactive may suffer from depressive illness, a potentially important consideration in the overall management of such patients.

Adult↗
PubMed1996

Psychodermatology: an update.

It has been estimated that in at least one third of dermatology patients, effective management of the skin disorder involves consideration of associated emotional factors. This article provides an overview of psychodermatology with a focus on the more recent literature and an emphasis on the clinical aspects and psychologic therapies for (1) cutaneous associations of psychiatric disorders and (2) psychiatric associations of certain cutaneous disorders that are known to be influenced by psychosomatic factors. This article also provides an update on the use of psychotropic drugs (i.e., the antianxiety, antidepressant, and antipsychotic agents) for the treatment of mental disorders that occur in conjunction with cutaneous conditions. Some of their other pharmacologic properties, such as the antihistaminic and analgesic effects of some antidepressant agents are also reviewed.

Analgesics↗
PubMed1996

Early onset (< 40 years age) psoriasis is comorbid with greater psychopathology than late onset psoriasis: a study of 137 patients.

Early onset (< age 40 years) psoriasis has been reported to be more readily triggered by environmental factors such as stress, in contrast to late onset (> or = age 40 years) psoriasis. We examined whether certain psychopathologic factors differentiated the psoriasis patient with early onset versus late onset disease. One hundred and thirty-seven psoriasis inpatients completed a battery of psychosocial questionnaires. Logistics regression analysis, using the psychologic measures, age and TBSA affected as independent variables, revealed that higher Anger-in (Anger Expression Scale) scores significantly (p < 0.05) increased the odds or probability of having early versus late onset psoriasis. Psoriasis with onset prior to age 40 is comorbid with greater difficulties with assertion and expression of anger, a personality trait that may adversely affect the patient's capacity to cope with stress.

Adolescent↗
PubMed1995

Touch deprivation has an adverse effect on body image: some preliminary observations.

Body image in childhood initially develops in response to the empathic reflections of the mother or caregiver that are communicated mainly by physical sensations such as touching, secure holding, or tactile nurturing. In a nonclinical sample of 173 shoppers, we observed an inverse correlation between perceived tactile nurturing during childhood and Drive for Thinness (Eating Disorder Inventory [EDI]; Pearson r = -.19, p < or = .05) and Body Dissatisfaction (EDI; Pearson r = -.23, p < or = .05) among the females (n = 102). Furthermore, among the females there was a direct correlation (r = .29, p < .05) between a current desire to get more tactile nurturance and Drive for Thinness. Our empirical finding are consistent with the earlier developmental literature and support the importance of tactile nurturance in the development of body image especially among females.

Adult↗
PubMed1995

Concerns about aging and a drive for thinness: a factor in the biopsychosocial model of eating disorders?

OBJECTIVE: Examine the association between concerns about aging and a drive for thinness. METHOD: Two groups were studied: (1) randomly selected nonclinical subjects (77 men, M +/- SD age: 44.4 +/- 18.3 years; 140 women, M +/- SD age: 41.9 +/- 15.3 years) from Ann Arbor, Michigan (replication of an earlier shopping mall-based survey); and (2) women (N = 54) who were concerned about their aging appearance (18 women with mild to moderate skin aging, M +/- SD age: 41 +/- 4 years; 36 women with moderate to severe skin aging, M +/- SD age: 62 +/- 6 years) and had volunteered for 24-week, prospective, controlled studies evaluating the efficacy of topical retinoic acid versus placebo for the treatment of aging skin. All subjects rated their aging-related concerns on previously developed scales, and completed the Drive for Thinness (DT) and Body Dissatisfaction (BD) subscales of the Eating Disorder Inventory (EDI). RESULT: In the random community survey there was a direct correlation between both concerns about the effect of aging on the appearance (men: r = .28, p < .05; women: r = .32, p < .01) and concerns about the cutaneous stigmata of aging (men: r = .38, p < .01; women: r = .28, p < .01) and DT (EDI). In the aging skin study both DT (EDI) and BD (EDI) were lower (p < .01) at 24 weeks posttherapy, in the retinoic acid (n = 32) but not the placebo (n = 22) group. DISCUSSION: Concerns about an aging appearance can be associated with a drive for thinness and excessive dieting, factors that are important in the development of eating disorders.

Administration, Topical↗
PubMed1995

Perceived touch deprivation and body image: some observations among eating disordered and non-clinical subjects.

The developmental literature suggests that touch, consisting of secure holding and hugging, plays an important role in the formation of body image. We tested the hypothesis that women with anorexia nervosa and/or bulimia nervosa (N = 59), conditions associated with body image problems, report a greater deprivation of tactile nurturance than a sample of non-clinical randomly selected women (N = 140) from the community. Measures of body image included the Drive for Thinness and Body Dissatisfaction subscales of the Eating Disorder Inventory. Perceived touch deprivation was rated on a 10-point scale, previously developed by the author. Analysis of covariance, controlling for the effects of age and body mass index, revealed that the eating disorder group reported greater (p < 0.0001) body image concerns and perceived greater (p < 0.0001) touch deprivation both during their childhood and their current life, than the non-clinical group. Our preliminary empirical findings suggest that touch deprivation may play a role in body image pathologies.

Adult↗
PubMed1995

Lithium therapy associated with hidradenitis suppurativa: case report and a review of the dermatologic side effects of lithium.

Lithium is frequently used in the management of several psychiatric disorders including acute mania, bipolar (manic-depressive) disorder, and recurrent depression. We describe a patient in whom hidradenitis suppurativa developed while the patient was receiving lithium. The cutaneous side effects of lithium are reviewed. The most frequent are psoriasis, acneiform lesions, folliculitis, alopecia, and a maculopapular/macular eruption. Many of these side effects respond less readily to conventional therapy while the patient is receiving lithium.

Acne Vulgaris↗
PubMed1995

Age and gender differences in the impact of psoriasis on quality of life.

BACKGROUND: The impact of psoriasis upon the quality of life contributes significantly to the overall morbidity associated with the disease. An older age at onset of psoriasis and being a man have been associated previously with lower psychosocial morbidity. In order to further evaluate these potentially important mitigating factors, we examined the relation of age and gender on some aspects of psoriasis-related psychosocial morbidity. METHODS: Two hundred and fifteen consenting psoriasis patients, representing a wide range of disease severity, were studied. They included 110 men and 105 women, age range 19-87 years (age: mean +/- SD: 48.0 +/- 15.9 years); all endorsed a list of 30 items (by checking a "Yes" or "No") pertaining to life events related to psoriasis that they had experienced in the previous one month. The patients self-rated the severity of their psoriasis. The patients were categorized into four age groups of 18-29 years (N = 28), 30-45 years (N = 77), 46-65 years (N = 76), and > 65 years (N = 34), respectively, for the statistical analyses. RESULTS: No age or gender differences in the severity of psoriasis were observed. Patients of both sexes in the 18 to 29 and 30 to 45 year age groups reported more frequent (P < or = 0.05) problems related to both appearance/socialization and occupation/finances, in contrast to patients in the 46-65 and over-65-year age groups. No gender differences (P < or = 0.05) were observed in the frequency of items related to appearance and socialization; however, men reported greater work-related stresses. CONCLUSION: Psoriasis has a greater impact upon the quality of life of patients in the 18 to 45 year age range and affects the socialization of both sexes equally. Men face greater work-related stresses as a result of their psoriasis.

Adult↗
PubMed1995

The Psoriasis Life Stress Inventory: a preliminary index of psoriasis-related stress.

The psychosocial impact of psoriasis may result in significant daily stress for the patient. We present a questionnaire, the Psoriasis Life Stress Inventory (PLSI), which provides a rating of psoriasis-related stress. Two hundred and seventeen psoriasis patients endorsed a list of psoriasis-related items they had experienced over the previous one month and rated the degree of stress associated with each item on a 4-point scale. The final version of the PLSI consisted of 15 items, each of which had been endorsed by at least 15% of patients. A PLSI score of > or = 10 (range 0 to 43) delineated patients with greater overall psoriasis severity (p = 0.007), more cosmetically disfiguring psoriasis (p < 0.01), greater number of flare-ups of psoriasis (p = 0.009) and greater pruritus severity (p = 0.001). This preliminary instrument provides a clinically useful index of psoriasis-related stress and needs to be tested among patients from different centers and in prospective studies.

Activities of Daily Living↗
PubMed1995

Chronic idiopathic urticaria associated with panic disorder: a syndrome responsive to selective serotonin reuptake inhibitor antidepressants?

We present two patients with a history of chronic idiopathic urticaria occurring in conjunction with a panic disorder (DSM-IIIR), in whom both the urticaria and panic disorder responded favorably to a course of the selective serotonin reuptake inhibitor antidepressants fluoxetine and sertraline, respectively. Both patients had previously required systemic corticosteroids to manage their urticaria. Panic disorder is an anxiety disorder characterized by the presence of recurrent unexpected panic attacks. Serotoninergic mechanisms play an important role in panic disorder. In contrast to antidepressants such as doxepin, which have previously been found to be effective in the treatment of chronic urticaria, the newer selective serotonin reuptake inhibitor antidepressants are only weakly antihistaminic and anticholinergic. The response of both the urticaria and panic disorder to selective serotonin reuptake inhibitor antidepressants may suggest a common pathogenic factor involving serotoninergic mechanisms.

1-Naphthylamine↗
PubMed1994

Psychosocial correlates of the treatment of photodamaged skin with topical retinoic acid: a prospective controlled study.

BACKGROUND: The psychosocial aspects of the treatment of photodamaged skin have received little attention. OBJECTIVE: We prospectively examined the psychosocial correlates of the treatment of mildly to severely photodamaged skin. DESIGN: Sixty subjects (age, 53.3 +/- 1.3 years [mean +/- standard error]; 35 receiving retinoic acid and 25 the inactive vehicle) completed a battery of psychosocial ratings before starting therapy and after 24 weeks of therapy with retinoic acid or vehicle. RESULTS: Before therapy, the subjects had pathologically high obsessive-compulsiveness scores (measured by the Brief Symptom Inventory [BSI]). From before to after therapy, the retinoic acid group reported decreased obsessive-compulsiveness (BSI) (p = 0.01), and decreased phobic anxiety (BSI) (p = 0.04), whereas the vehicle group reported an increase (p < 0.05) in both these symptom dimensions. CONCLUSION: High obsessive-compulsiveness (BSI), which is associated with excessive perfectionism and need for control, probably predisposed the subjects to seek treatment of their wrinkles. In the retinoic acid group but not the vehicle group there was an improvement in obsessive-compulsiveness and decreased anxiety in previously anxiety-provoking situations.

Administration, Cutaneous↗
PubMed1994

Psychosomatic study of self-excoriative behavior among male acne patients: preliminary observations.

BACKGROUND: Studies of the psychosomatic correlates of self-excoriative behavior in acne have involved mainly women with acne excorieé. Little is written about the psychosomatic factors that affect men with acne. Excessive self-excoriation of acne lesions is an important clinical factor because it can prolong the course of the disease and exacerbate the deeper inflammatory process with an increase in the severity of scarring. METHODS: Thirteen men (mean +/- SE: age: 22.2 +/- 1.4 years) with mild to moderate facial acne, whose self-excoriative behavior was not severe enough to result in acne excorieé, completed a battery of self-rated questions assessing their self-excoriative behaviors, the severity of their acne, and various psychologic factors. RESULTS: Certain aspects of self-excoriative behavior (e.g., a tendency to pick or squeeze the acne lesions when stressed) correlated directly with depression (brief symptom inventory (BSI)) (Pearson r = 0.64, P = 0.02) and anxiety (BSI) (Pearson r = 0.61, P = 0.03) scores. The dermatologic indices of acne severity such as inflammation (Pearson r = 0.82, P = 0.0004) and pustules (Pearson r = 0.62, P = 0.03) were the strongest correlates of self-excoriative behavior. CONCLUSION: Self-excoriative behavior in men with acne may be exacerbated by a coexisting depressive or anxiety disorder. In contrast, women with acne excorieé have been reported to suffer from an immature personality where the cutaneous condition may serve as "an appeal for help." Men who excessively pick their acne will benefit from aggressive dermatologic therapies and should be assessed for underlying depressive and anxiety disorders.

Acne Vulgaris↗
PubMed1993

Aging-related concerns and body image: possible future implications for eating disorders.

We observed a direct correlation between aging-related concerns about the appearance and Drive for Thinness (Eating Disorders Inventory [EDI]), among males (n = 71) (Pearson r = .36, p < .01) and females (n = 102) (Pearson r = .44, p < .01) from a nonclinical sample of shoppers. Among the women there was a direct correlation between the belief that weight loss is associated with youthful looks and both Drive for Thinness (EDI) (Pearson r = .44, p < .01) and Body Dissatisfaction (EDI) (Pearson r = .27, p < .01). Concerns about the cutaneous stigmata of aging, a commonly recognized sign that a person is older, correlated directly with Drive for Thinness (Pearson r = .27, p < .01) and Body Dissatisfaction (Pearson r = .38, p < .01) among the women. These correlations were all obtained after statistically controlling for the effects of age and body mass index. Our empirical observations may have important future implications in the development of eating disorders, as our society continues to place an inordinate value on youthful looks.

Adult↗
PubMed1993

Alcohol intake and treatment responsiveness of psoriasis: a prospective study.

BACKGROUND: Alcohol has been reported to be a risk factor in psoriasis mainly based on the observation that there is a higher prevalence of alcohol abuse in persons with psoriasis, especially in men. OBJECTIVE: We prospectively examined the relation between pretreatment average daily ethanol consumption and treatment outcome in inpatients with moderate to severe psoriasis. METHODS: The severity of psoriasis of 94 inpatients (48 men and 46 women) was assessed before and after treatment. Ethanol use was determined by obtaining the patients' reports of their average daily consumption of alcoholic beverages during the 6 months before admission. RESULTS: The average daily ethanol intake of more than 80 gm before treatment was more frequently associated with less treatment-induced improvement (less than 10%) (p = 0.02) in the percentage of the total body surface area affected by psoriasis in men but not in women. CONCLUSION: Ethanol abuse may have an adverse effect on treatment outcome in men with psoriasis.

Adult↗