Clinical Correlates of Itch Severity, Sleep Quality, and Depression in Patients with Chronic Pruritus: A Cross-Sectional Study from a Tertiary Care Centre
Yashi V. Garg, Som J. Lakhani, Krunal B. Tralsawala, Rajvi K. Sojitra
Author(s)2Professor and Head of Department, Department of Dermatology, Venereology and Leprosy, Parul University, Gujarat, India.
3Professor, Department of Dermatology, Venereology and Leprosy, Parul University, Gujarat, India.
43rd Year Resident, Department of Dermatology, Venereology and Leprosy, Parul University, Gujarat, India.
Abstract
Background: Chronic pruritus is a distressing symptom encountered in a wide spectrum of dermatological and systemic disorders. Beyond the physical discomfort caused by persistent itching, patients often experience impaired sleep quality and psychological distress, resulting in substantial deterioration in quality of life. Although the relationship between itch, sleep disturbance, and depression has been described in previous studies, data from Indian tertiary care settings remain limited. The objective is to evaluate itch severity, sleep quality, and depression among patients with chronic pruritus and to determine the correlations among these parameters. Material and Methods: A hospital-based cross-sectional observational study was conducted among 100 adult patients presenting with chronic pruritus of more than six weeks' duration. Itch severity was assessed using the Visual Analogue Scale (VAS), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Correlations among study variables were analysed using Spearson's correlation coefficient. Results: The mean age of the participants was 44.8 ± 13.6 years, with a female predominance. Eczematous dermatoses constituted the most common underlying diagnosis (34%). The mean VAS score was 7.4 ± 1.8, and severe pruritus was observed in 63% of patients. Poor sleep quality (PSQI >5) was present in 76% of participants, while clinically significant depressive symptoms (PHQ-9 ≥10) were observed in 37%. Significant positive correlations were found between VAS and PSQI scores (r = 0.68, p < 0.001), VAS and PHQ-9 scores (r = 0.55, p < 0.001), and PSQI and PHQ-9 scores (r = 0.61, p < 0.001). Conclusion: Chronic pruritus is associated with substantial sleep disturbance and depressive symptoms. The significant correlations observed among itch severity, sleep impairment, and depression highlight the multidimensional burden of chronic pruritus and emphasize the need for a holistic approach to patient management. Keywords: Chronic pruritus; Sleep quality; Depression; Pittsburgh Sleep Quality Index; Patient Health Questionnaire-9; Visual Analogue Scale.