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Background: There is limited data on anxiety and depression in subjects with severe cutaneous adverse drug reactions (SCADR), in a predominantly HIV - infected population. The aim of the study was to prospectively investigate the prevalence of anxiety and depression and quality of life in patients with SCADR. Methods: In this prospective study, SJS...
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Background
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Citations
... Two of the included studies were qualitative 34,35 and four were quantitative (Table 1). [36][37][38][39] Two of the studies were from the U.K., 34,35 two were from France, 36,37 one was from Canada 38 and one was from South Africa. 39 Following analysis, two overarching themes were identified, namely (i) the impact of diagnosis now and for the future and (ii) living with the psychosocial impact. ...
... [36][37][38][39] Two of the studies were from the U.K., 34,35 two were from France, 36,37 one was from Canada 38 and one was from South Africa. 39 Following analysis, two overarching themes were identified, namely (i) the impact of diagnosis now and for the future and (ii) living with the psychosocial impact. For each of these, two further subthemes were developed ( Table 2). ...
... Similarly, Raspaud 36 reported that following discharge with an initial diagnosis of TEN, 12 patients from a sample of 15 presented with anxiety, depression, irritability, insomnia and nightmares. Zitha 39 found that of 26 patients diagnosed with SJS, TEN or SJS/TEN overlap (16, 7 and 3, respectively), 11 had anxiety and 13 were depressed at 6 months following the initial diagnosis. Using the Hospital Anxiety Depression Scale (HADS), 41 42% of patients (n = 11) presented with a comorbidity of anxiety and depression, with Table 2 Themes, subthemes and representative quotes from qualitative papers 34,35 Theme 1 Impact of diagnosis for now and the future Subtheme 1 Healthcare practitioners not knowingthe distress on patients 'Well, I'd never heard of it, and when the doctors themselves didn't know anything about it, it was all a bit scary' (Patient 1) 34 'I definitely feel that the medical profession is not aware enough of Stevens-Johnson' (internet description 195) 35 'I was amazed at the lack of knowledge on the part of the medical professionals. ...
Clinical scenario:
A 65 year-old male presented with a 12 hour history of deteriorating rash. Two weeks previously, he had completed a course of neo-adjuvant chemotherapy for ductal carcinoma of the breast. On examination, there were bullae, widespread atypical targetoid lesions and 15% epidermal detachment. There was no mucosal involvement on presentation but, subsequently, it did evolve. Skin biopsy showed sub-epidermal blistering with epidermal necrosis. This confirmed our clinical diagnosis of overlap SJS-TEN. On transfer to ICU, he was anxious and fearful. What are the psychological impacts of SJS/TEN on this man's life?.
Background:
SJS and TEN have devastating outcomes for those affected.
Objectives:
To conduct a critically appraised topic (CAT) to (1) analyse existing research related to the psychological impact of SJS and TEN and (2) apply the results to the clinical scenario.
Methods:
Seven electronic databases were searched for publications focusing on the psychological impact of SJS TEN on adults over 18 years of age.
Results:
Six studies met inclusion criteria. Health care practitioners' (HCPs) lack of information around the disorder was highlighted. Patients experienced undue stress and fear. Some patients had symptoms aligned to post-traumatic stress disorder (PTSD), anxiety and depression.
Discussion and recommendation for clinical case:
The evidence suggests that SJS and TEN impact psychologically on patients' lives. Education of HCPs, to address their lack of awareness and information on SJS/TEN, should facilitate their capacity to provide information and support to patients, thereby reducing patient anxiety. On discharge, a follow up appointment with relevant HCPs to reduce the possibility of PTSD occurring should be considered.
Background
The existing evidence demonstrates that survivors of SJS/TEN have reported long-lasting psychological effects of their condition. Burns patients experience similar psychological effects. It is important to look at ways to help allay the psychological complications of SJS/TEN. As there is an absence of evidence on SJS/TEN psychotherapeutic interventions, it was judged to be beneficial to determine the evidence underpinning psychotherapeutic interventions used with burns patients.
Aims and objectives
The aim of this systematic integrative review was to synthesize the evidence relating to psychotherapeutic interventions used with adult burns patients and patients with SJS/TEN.
Method
The systematic review was guided by Whittemore and Knafl’s integrative review process and the PRISMA guidelines. Nine databases were searched for English and French language papers published January 2008 to January 2021. The protocol for the review was registered with PROSPERO.
Results
Following a screening process, 17 studies were included in the review. Two themes were identified using content analysis, (i) Empirically supported psychotherapeutic treatments, (ii) Alternative psychotherapeutic treatments. This review revealed no evidence on specific psychotherapeutic interventions for patients with SJS/TEN. Some of the interventions used with burns patients, viz. relaxation therapy, hypnosis and cognitive behavioral therapy showed some significant benefits. However, the evidence for burns patients is mainly focused on pain and pain anxiety as outcomes.
Conclusion
Following further research, some of the interventions deployed in burns patients may be applicable to SJS/TEN patients, particularly stress reduction techniques. In addition, the caring behaviours such as compassion, respect, and getting to know the patient as a person are important components to psychological care.
