Treatment outcome and incidence of psychiatric disorders in dermatological out-patients

OBJECTIVE: Epidemiological studies have shown that the prevalence of psychiatric disorders among dermatological patients is high. We aimed at estimating the short-term incidence of psychiatric disorders among patients with skin disease. METHODS: The 12-item General Health Questionnaire (GHQ-12) was used to identify subjects free from psychiatric morbidity at their first dermatological visit. The GHQ-12 was administered again after 1 month during a computer-assisted telephone interview. RESULTS: A total of 277 subjects was included in the study. At the follow-up interview, 21 (7.6%) were found to have significant psychiatric morbidity. Only lack of improvement was associated with increased incidence of psychiatric morbidity (13.6%), with an odds ratio of 3.1 (95% confidence interval 1.2-7.8), after adjustment for gender, age, educational level and clinical severity. CONCLUSIONS: Physicians should devote special attention to the risk of psychiatric complications in patients who have not improved with treatment.     

Skin disorders in chronic psychiatric illness

Background Chronic psychiatric patients are prone to develop skin diseases. However, epidemiological data are scarce. Objective To describe the prevalence of skin complaints and dermatological disorders in residential psychiatric patients. Methods Ninety‐one randomly chosen patients of the residential wards of a general psychiatric hospital completed a short, structured interview concerning skin disease and underwent a physical examination of the skin. Results Of the examined patients, 69% reported symptoms of skin disease in the month prior to the interview and 77% had skin disorders at physical examination. In 34 (37%) patients, skin disorders were diagnosed, which were not mentioned in the interview. Patients with diabetes had infectious skin disease more often than their fellow patients [odds ratio (OR) 10.9; 95% confidence interval (CI): 2.40–49.75]. Moreover, overweight patients had infectious skin disease more often (OR 7.4; 95% CI: 1.38–39.3). Women reported more skin complaints (OR 6.4: 95% CI: 1.67–24.2), and also had skin problems other than infection, tumours or dermatitis more frequently (OR 3.7; 95% CI: 1.34–10.14). Clozapine use was associated with benign neoplasms of the skin. The nature of this association remains unclear and merits further investigation. Conclusions Many chronic psychiatric patients have skin problems. Clinical examination of the skin is important to discover these problems. Patients with diabetes mellitus are particularly at risk for skin infections. Because of their relationship with overweight and diabetes mellitus, atypical antipsychotics may be partly responsible for these serious complications. Only a few other relationships between psychiatric medication and specific skin problems were found.     

Psychiatric morbidity in dermatological outpatients: an issue to be recognized

BACKGROUND: There is a high prevalence of psychiatric disorders in dermatological outpatients. OBJECTIVES: To estimate the magnitude of this problem and to identify a set of variables associated with the presence of psychiatric disorder. METHODS: All adults attending the outpatient clinics of a dermatological hospital on predetermined days were given a questionnaire comprising the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12). RESULTS: In total, 4268 questionnaires were given at admission, and 3125 were returned. Of these, 546 were blank or incomplete, leaving 2579 respondents (response rate 60.4%). Using a stringent cut-off threshold (> or = 5) for psychiatric case identification with the GHQ-12, scored in the conventional way, the overall prevalence of psychiatric morbidity was 25.2% (95% confidence interval 23.6-27.0%). We found a higher prevalence of psychiatric disorders in women and in widows/widowers, controlling for age. Health-related quality of life was a much stronger predictor of psychiatric morbidity than physician-rated clinical severity. High prevalence rates (> 30%) were observed among patients with acne, pruritus, urticaria, alopecia and herpesvirus infections, and in subjects without objective signs of dermatological disease. CONCLUSIONS: Our study has depicted the situation that is actually faced by dermatologists in their everyday practice, where they are in a unique position to recognize psychiatric morbidity and to take appropriate measures. The GHQ-12, being easy for patients to compile and for physicians or nurses to score, may be a practical tool to increase identification of patients with substantial psychological distress or formal psychiatric disorder in order to provide more comprehensive and appropriate intervention.     

Psychiatric comorbidity in adult eczema

Background  Atopic eczema (AE) is a common dermatological condition that causes significant problems in everyday life and high levels of illness-related stress in substantial proportions of patients. The extent to which adult AE is associated with clinically relevant psychiatric morbidity is unclear.
Objectives  To investigate the association between adult AE and major psychiatric/psychosomatic disorders.
Methods  Case–control study utilizing the GKV database Saxony, an interdisciplinary administrative outpatient database from Germany. All patients documented as having AE at least twice within the study period (2003–2004) ( n  =   3769, mean age 44 years) were individually matched by age and sex to 3769 controls without AE. Logistic regression models were fitted to investigate the relationship of AE with affective, stress-related, behaviour and schizophrenic disorders, considering sociodemographic characteristics, consulting behaviour and allergic comorbidities as potential confounding factors.
Results  Eczema was independently associated with affective [adjusted odds ratio (OR) 1·42, 95% confidence interval (CI) 1·13–1·79], stress-related (OR 1·55, 95% CI 1·35–1·77), behaviour (OR 1·52, 95% CI 1·03–2·23) and schizophrenic disorders (OR 2·12, 95% CI 1·22–3·71). For each psychiatric condition the likelihood of being affected significantly increased with each physician visit due to AE, suggesting that the risk of psychiatric comorbidity increases with the severity of AE.
Conclusions  This study indicates psychiatric comorbidity of adults with AE. Collaboration between dermatologists and mental health specialists may optimize medical care for a significant subgroup of patients with AE.     

Psoriasis is independently associated with psychiatric morbidity and adverse cardiovascular risk factors,but not with cardiovascular events in a population‐based sample

Background Psoriasis may significantly reduce quality of life. Previous studies reported an association of psoriasis and cardiovascular risk factors and cardiovascular events. The extent to which psoriasis is associated with psychiatric morbidity and the role of psychiatric comorbidity as a potential confounder of the association between psoriasis and cardiovascular morbidity require further investigation. Objectives To study the association between psoriasis, psychiatric morbidity and cardiovascular morbidity. Methods Case–control study utilizing an interdisciplinary administrative outpatient database from Germany. Patients with confirmed diagnosis of prevalent psoriasis within the study period (2003–2004) (n = 3147, mean age 57 years) were individually matched for age and gender with 3147 controls without psoriasis. The relationship of psoriasis with psychiatric morbidities (depression, stress‐related disorders, behaviour disorders and schizophrenic disorders), cardiovascular risk factors (diabetes, hypertension, obesity and dyslipidaemia) and cardiovascular events [myocardial infarction (MI), stroke] was investigated using logistic and linear regression models. Results Crude analyses suggested an association of psoriasis with depression, stress‐related disorders, behaviour disorders and cardiovascular risk factors, but not with MI [odds ratio (OR) 1.14; 95% confidence interval (95% CI) 0.81–1.62] or stroke (OR 0.97; 95% CI 0.61–1.54). Multivariate models controlling for age, gender and consulting behaviour indicated that psoriasis is independently associated with depression (OR 1.49; 95% CI 1.20–1.86), stress‐related disorders (OR 1.41; 95% CI 1.22–1.62), behaviour disorders (OR 1.58; 95% CI 1.05–2.39), diabetes (OR 1.21 95% CI 1.04–1.40), hypertension (OR 1.34; 95% CI 1.18–1.51), dyslipidaemia (OR 1.29; 95% CI 1.07–1.55), and obesity (OR 1.63; 95% CI 1.39–1.90). For each psychiatric condition, the likelihood of being affected significantly increased with each physician visit due to psoriasis, suggesting that the risk of psychiatric comorbidity increases with the severity of psoriasis. Conclusion Psoriasis appears to be independently associated with major psychiatric disorders and with cardiovascular risk factors, but not with cardiovascular events.     

Substantial skin disorders in psychiatric illness coincide with diabetes and addiction

Background Dermatological diseases in psychiatric patients are common; however, epidemiological data on this subject are scarce and to our knowledge integral studies of dermatological disease in psychiatric inpatients are not available yet. Aim The aim of this study was to describe the incidence of dermatological problems in psychiatric inpatients. Method This study evaluates the consultations for new dermatological problems by inpatients of a general psychiatric hospital of over 700 beds during a 6‐month period. Results A total of 255 patients consulted their physician because of a new dermatological problem. Diagnoses (n = 360) included skin infections (32%), accidents (7%), decubitus ulcers (7%), complications of medical treatment (3%), auto mutilation (1%) and neoplasms of the skin (1%). Patients with skin infections were likely to have diabetes [odds ratio (OR) = 3.6; 95% confidence interval (CI): 1.56–8.40]. Patients with decubitus ulcers were likely to have an addiction problem (OR = 6.4; 95% CI: 1.46–28.00). Dermatitis was associated with affective disorder (OR = 2.5; 95% CI: 1.12–5.43) but not with psychosis (OR = 0.5; 95% CI: 0.23–0.90). Only a poor correlation existed between the length of hospital stay and skin problems. Conclusions Dermatological problems are common in hospitalized psychiatric patients. Patients with diabetes mellitus are at high risk for skin infections. There are significant relationships between the psychiatric and the dermatological diagnoses. The length of the admission to a psychiatric hospital does not seem to play a major role in skin diseases.     

The impact of skin diseases on patients: comparing dermatologists' opinions with research data collected on their patients

BACKGROUND: Research data suggest that the detection of psychiatric disorders by dermatologists is not completely satisfactory, and that patients and dermatologists often assess patients' quality of life differently. Given that expectations influence perception and cognitia, these discrepancies might at least in part descend from conceptual models of skin disease that are prevalent among dermatologists. OBJECTIVES: We explored to what degree dermatologists' opinions about quality of life and prevalence of psychiatric disorders in several dermatological conditions corresponded to the actual data collected on their patients. METHODS: All dermatologists working in a large institution were asked to express on a five-point scale their opinion about the quality of life and the prevalence of depressive and anxiety disorders in different skin conditions. Physicians' opinions were then compared with the results of a large research project on quality of life and psychological well-being in dermatological out-patients performed in their institution some months before. RESULTS: Forty-six dermatologists (82%) agreed to participate and completed the research questionnaire. We observed a fairly good concordance between dermatologists' opinion about the impact of the various skin conditions on patients' lives and survey data on quality of life impairment. With regard to psychiatric morbidity, we found that dermatologists believe that psychiatric disorders are substantially less frequent than they actually are in many skin conditions. CONCLUSIONS: The belief that psychiatric morbidity is rare in patients with certain skin conditions might hamper, at least in part, the recognition of psychiatric disorders in these patients. Dermatologists probably should be more alert to the question of psychiatric morbidity in their patients. Allocating more space to this issue in training programmes for dermatologists might favour a shift in their conceptual models of skin disease.     

流动已婚育龄妇女避孕方法的使用对性生活满意度的影响

目的：了解城市流动已婚育龄妇女的性生活满意度以及避孕方法使用对满意度的影响。方法：采用分层-整体-随机的方法,于2010年4月至2013年3月,在乌鲁木齐市六区一县流动人口较集中的社区,对18～50岁的流动已婚育龄妇女进行性生活情况与避孕措施使用情况的问卷调查。结果：在105422名对象中,对性生活“满意”的占50.43％、“偶尔满意”的占48.53％、“不满意”的占1.04％。多因素logistic回归分析显示,与未避孕的对象相比,使用宫内节育器、绝育术和药物避孕的对象,其“偶尔满意”的可能性较高,OR值分别为1.96（95％CI：1.86-2.07）、1.88（95％CI：1.69-2.08）、2.08（95％CI：1.97-2.20）;使用宫内节育器的对象性生活“满意”的可能性也较高（OR＝1.44,95％CI：1.16-1.79）。结论：有效的避孕措施,特别是宫内节育器的使用,能够提高流动已婚育龄妇女的性生活满意度。     

Burnout and job satisfaction comparing healthcare staff of a dermatological hospital and a general hospital

BACKGROUND: Psychological distress among healthcare professionals can have negative effects on the well-being of the professionals and also on the quality of care they provide to patients. OBJECTIVES: To evaluate burnout and job satisfaction of dermatologists and nurses working with dermatological patients compared with physicians and nurses of other specialties. METHODS: A self-completed anonymous questionnaire was distributed to the personnel of two hospitals in Rome, Italy: a dermatological hospital (IDI) and a general hospital (GH), belonging to the same non-profit organization. Standardized instruments were used to assess burnout (Maslach Burnout Inventory) and job satisfaction. Multiple logistic regression was used to examine the association between burnout and working in dermatology vs. other specialties, job satisfaction, years of employment and respondents' sex and age. RESULTS: We distributed 929 questionnaires to clinical and non-clinical staff of IDI and 494 questionnaires to the GH staff (response rates: 53% at IDI and 50% at the GH). Among respondents there were 67 physicians and 59 nurses at IDI and 70 physicians and 148 nurses at the GH. Subsequent analyses refer only to this clinical subsample. Factor analysis showed that among physicians and nurses the two main factors explaining job satisfaction were respondents 'satisfaction with the management of their unit' and 'opportunities for personal growth'. Among nurses the likelihood of burnout decreased significantly with higher levels of job satisfaction [odds ratio (OR) = 0.78; 95% confidence interval (95% CI) 0.7-0.9] and working in dermatology compared with other specialties (OR = 0.46; 95% CI 0.2-0.9). Among physicians a lower likelihood of burnout was associated with job satisfaction (OR = 0.66; 95% CI 0.5-0.8) and older age (OR = 0.28; 95% CI 0.1-0.8). CONCLUSIONS: Among both physicians and nurses, job satisfaction was associated with a lower likelihood of burnout, independently of clinical specialty and other factors. Burnout was similar for dermatologists and other specialists. Nurses of the GH compared with those working in dermatology had a higher probability of burnout and were significantly less satisfied with the management of their units and with opportunities for personal growth.     

Non adherent patients in dermatology

Non compliance to therapy is frequent in dermatological disorders. Many factors related to the disease, treatment, the physician-patient relationship, the physician, and the patient explain this poor compliance during the course of dermatological treatments. Better knowledge of the non compliant patient-related factors could improve treatment compliance, resulting in better treatment efficacy. The patient parameters playing a part in therapy compliance are numerous and closely intertwined: age, sex, marital status, employment, education level, acceptance of the disease, perception of the treatment, associated psychiatric disorders, addictive behaviors, quality of life, the environment, and the relationship with the physician. It is important to take into account these noncompliance factors related to patient typology so as to optimize management of dermatological disorders. This requires knowing the patient's situation and habits well so that the treatment can be adapted as best possible to his or her lifestyle.     

长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗甲真菌病疗效的Meta分析

目的:通过Meta分析方法评价长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗甲真菌病的疗效.方法:搜集PubMed、Web of Science、Sinomed、FMRS、知网、中国生物医学文献数据库、维普和万方数据库自建库至2021年3月1日收纳的长脉冲1064 nm Nd:YAG激光联合外用抗真菌药治疗...     

Health-related quality of life and nail disorders

Health-related quality of life (HRQoL) measurements in clinical practice ensure that treatment and evaluations focus on the patient rather than the disease. To verify whether these measurements are also relevant in a minor dermatological disease and whether a generic routine assessment is sufficient to capture different aspects of quality of life, we studied patients affected by nail disorders. The Skindex-29, the 12-item General Health Questionnaire and the 36-item Short Form of the Medical Outcomes Study questionnaires were used. A total of 114 patients were enrolled: 31% men aged 48 +/- 15 years and 69% women aged 49 +/- 14 years (mean +/- SD). The mean values of SF-36 scales in nail disorders were higher than those reported for minor skin diseases, and Skindex-29 values were lower. A duration of disease > or =1 year was associated with higher Skindex-29 scores on the symptom and emotions scales. Patients with onychomycosis have higher values on the Skindex-29 social functioning scale compared with other nail disorders. The use of HRQoL measurements in routine clinical activities allows us to depict how nail disorders affect patients and show how relevant some neglected aspects, such as pain or emotional trauma, are and offers us the opportunity to address these issues in a patient-centred approach to treatment.     

Participation, satisfaction and knowledge level of patients with cutaneous psoriasis or psoriatic arthritis

There have been few studies about the participation in health care and the satisfaction of patients with psoriasis and with psoriatic arthritis. The objective of this study was to examine the attitudes of and satisfaction with decision-making of patients with psoriasis. The study was based on a self-completed questionnaire, given after a routine medical visit to a consecutive sample of 240 patients with psoriasis [207 with cutaneous psoriasis (CP) and 33 with psoriatic arthritis (PA)]. Of the patients with CP and PA, only about a third (27.3% and 28.1%, respectively) preferred to leave decisions entirely to their doctor, whereas the majority (72.7% and 71.9%, respectively) wanted to be involved in decision-making. However, the level of knowledge about the disease was not as high, with 17.0% and 21.4% of patient with CP and PA, respectively, having a good level of knowledge about psoriasis treatment. Participation, knowledge and overall satisfaction were not significantly different between patients with CP and those with PA. Information on treatment side-effects (OR = 5.11; 95% CI 2.5-15.0; P < 0.001) and information on treatment options (OR = 3.15; 95% CI 1.4-7.1; P = 0.006) were significantly associated with overall patient satisfaction.     

Quality of life in patients with chronic urticaria is differentially impaired and determined by psychiatric comorbidity

BACKGROUND: Chronic urticaria (CU), one of the most common skin disorders, is characterized by spontaneous recurrent bouts of weals and pruritus and associated with severely impaired quality of life (QoL). OBJECTIVES: To determine what aspects of life quality are affected and to characterize the factors that impact on QoL in CU patients. SUBJECTS AND METHODS: This interdisciplinary interview/questionnaire-based study included 100 patients admitted to a University Hospital Dermatology Department for the identification of underlying causes of CU; 96 healthy subjects matched for age and sex were used as controls. QoL was assessed using Skindex-29, a validated instrument to measure the effects of skin disease on overall QoL (composite score) and three defined QoL aspects (emotions, symptoms, functioning). RESULTS: CU patients exhibited markedly reduced overall QoL compared with healthy control subjects. CU had distinct effects on the three QoL aspects assessed (functioning = emotions > symptoms). The age or sex of patients, the absence or presence of angio-oedemas, and the duration or cause of CU did not significantly influence QoL impairment. Interestingly, psychiatric comorbidity (depression, anxiety, somatoform disorders) was associated with a more pronounced reduction of QoL compared with CU patients without a psychiatric diagnosis and the severity of psychiatric disease was found to correlate with QoL impairment. CONCLUSIONS: Our data confirm that overall QoL is markedly reduced in CU patients. Social functioning and emotions were found to be the areas of QoL most affected in CU patients. Psychiatric comorbidity significantly increased QoL impairment, whereas QoL in CU patients was not significantly affected by age or sex, the absence or presence of angio-oedema, or the course or cause of CU.     

Metabolic syndrome,C-reactive protein and cardiovascular risk in psoriasis patients: a cross-sectional study

Background:Psoriasis has been associated with co-morbidities and elevated cardiovascular risk.Objectives:To analyze the relationships among metabolic syndrome, cardiovascular risk, C-reactive protein, gender, and Psoriasis severity.Methods:In this cross-sectional study, plaque Psoriasis patients (n=90), distributed equally in gender, were analyzed according to: Psoriasis Area and Severity Index, cardiovascular risk determined by the Framingham risk score and global risk assessment, C-reactive protein and metabolic syndrome criteria (NCEPT-ATP III).Results:Metabolic syndrome frequency was 43.3% overall, without significance between genders (P=0.14); but women had higher risk for obesity (OR 2.56, 95%CI 1.02-6.41; P=0.04) and systemic arterial hypertension (OR 3.29, 95%CI 1.39-7.81; P=0.006). The increase in the Psoriasis Area and Severity Index also increased the risk for metabolic syndrome (OR 1.060, 95%CI 1.006-1.117; P=0.03). Absolute 10-year cardiovascular risk was higher in males (P=0.002), but after global risk assessment, 51.1% patients, 52.2% women, were re-classified as high-intermediate cardiovascular risk; without significance between genders (P=0.83). C-reactive protein level was elevated nearly six-fold overall, higher in metabolic syndrome (P=0.05), systemic arterial hypertension (P=0.004), and high-intermediate 10-year cardiovascular risk patients (P<0.001); positively correlated to: Framingham risk score (P<0.001; r=0.60), absolute 10-year cardiovascular risk (P<0.001; r=0.58), and age (P=0.001; r=0.35); but not to Psoriasis Area and Severity Index (P=0.14; r=0.16); increased the 10-year cardiovascular risk (R2=33.6; P<0.001), MetS risk (OR 1.17, 95%CI 0.99-1.37; P=0.05) and with age (P=0.001). HDL-cholesterol level was higher in normal C-reactive protein patients (t=1.98; P=0.05).Study limitations:Restricted sample, hospital-based and representative of a single center and no specification of psoriatic arthritis.Conclusions:Psoriasis, metabolic syndrome, systemic arterial hypertension and age share the increase in C-reactive protein, which could implicate in additional burden for increasing the cardiovascular risk and be an alert for effective interventions.     

The clinical significance of drug interactions between dermatological and psychoactive medications

Dermatological disease is commonly associated with psychological morbidity because of its visible nature. The burden of living with a chronic dermatological illness can contribute to the development of psychiatric illness and conversely, such conditions can result in the exacerbation of preexisting dermatological disease. It may also reduce a patient's compliance to treatment, result in loss to follow‐up and a decreased level of functioning and quality of life. In dermatological patients who suffer from psychiatric symptoms, medical management used in their treatment may have significant interactions with systemic medications used to treat their dermatological condition. A well‐known example of this is lithium's ability to exacerbate psoriasis. Such interactions can result in suboptimal treatment of their psychiatric and/or dermatological condition. The present paper aimed to review the literature for documented interactions and the level of clinical significance between dermatological and psychoactive medications. Such information is clinically relevant to the practicing dermatologist in order to minimize adverse effects and drug–drug interactions in dermatological patients.     

带状疱疹后遗神经痛的危险因素分析

目的 评估带状疱疹患者发生后遗神经痛(postherpetic neuralgia,PHN)的相关风险因素.方法 收集安徽医科大学第一附属医院皮肤性病科2017年1月至2018年1月间确诊的带状疱疹住院患者256例,采用问卷调查及电话等随访方式,综合评估患者发病年龄、性别等因素与PHN的关联性.结果 256例患者最终随...     

Blind sampling is superior to anoscope guided sampling for screening for anal intraepithelial neoplasia

OBJECTIVES: Anal cytology smears are either collected "blind" (swab inserted 4 cm into anal canal and rotated) or guided through an anoscope (transformation zone visualised and then sampled). We compared these smear techniques with respect to sample quality and patient acceptability. METHODS: Using a paired, random sequence clinical trial, 151 homosexual men (n = 95 HIV positive) underwent both smear techniques at a single visit; smear order was randomised and specimens were read blind. Both techniques utilised a Dacron swab, with water lubrication. Cytological specimens were prepared using a liquid based collection method (ThinPrep). The outcome measures were cytological specimen adequacy, cytological classification, presence of rectal columnar, squamous and metaplastic cells, contamination, patient comfort and acceptability, and volume of fluid that remained after the ThinPrep procedure. RESULTS: Regardless of smear order, guided smears were less likely to detect higher grade abnormalities than blind smears (15 v 27 cases, p = 0.001). Controlling for smear order, guided smears were more likely to be assessed as "unsatisfactory" for cytological assessment (OR 6.93, 95% CI 1.92 to 24.94), and contain fewer squamous (OR 0.20, 95% CI 0.04 to 0.94) and metaplastic cells (OR 0.12, 95% CI 0.03 to 0.54) than blind smears; there were no other statistically significant differences between techniques. Regardless of smear technique, first performed smears were more likely to detect a higher grade abnormality than second performed smears (23 v eight cases, p < 0.001). CONCLUSIONS: Blind cytology smears are superior to anoscope guided smears for screening for anal neoplasia in homosexual men.     

2000-2019年广东省新发麻风病例2级畸残情况及影响因素分析

 目的:了解广东省新发麻风病例2级畸残情况及其影响因素,为麻风病防控提供理论依据。方法：从《全国麻风病防治管理信息系统（LEPMIS）》中收集广东省2000-2019年报告的新发麻风病例资料,建立数据库并经逻辑检错后,用SPSS 20.0软件进行统计分析。人口学特征、临床信息、畸残情况等采用描述性分析,畸残情况的影响因素采用Logistic回归分析。结果：共收集2000-2019年1 985例新发麻风病例资料,60岁及以上者占40.26%（798/1 982）,平均年龄为（54.33±18.25）岁。已婚占72.19%（1 015/1 406）,广东籍占84.03%（1 668/1 985）,汉族占95.82%（1 902/1 985）,职业主要为农牧民（60.59%,1 144/1 888）,文化程度主要为小学及以下（43.28%,544/1 257）。2级畸残比例为18.29%（363/1 985）。多因素Logistic回归显示2级畸残的危险因素包括男性（OR=2.61,95%CI:1.63~4.20）、汉族（OR=5.90,95%CI:1.70~20.53）、延迟诊断（OR=4.00,95%CI:2.67~5.98）、体重过低（OR=4.63,95%CI:2.06~10.42）和确诊时有神经损害（OR=31.94,95%CI:9.95~102.58）。结论：导致麻风病患者发生畸残的因素较为复杂,主要因素有麻风病例延迟诊断期的长短、身体健康状况以及神经损害情况等。各级医疗机构应加强对麻风病疑似症状的筛查,早发现、早诊断、早治疗,降低新发麻风病畸残比例,提高麻风病例生活质量。