Open Access

Stefanie Ziehfreund, Magdalena Saak, Alisa Schaal, Roxana Mazilu, Emmanuel Mahé, Carla Hajj, Emma K. Johansson, Josefin Lysell, Gunnthorunn Sigurdardottir, Franz J. Legat, Catherina Koch, Astrid Schmieder, Caroline Glatzel, Brian Kirby, Emily Pender, Anna Zalewska‐Janowska, Katarzyna Tomaszewska, Giulia Ciccarese, Pia Lauriola, Michael J. Boffa, Stephanie Farrugia, Anna Caroline Pilz, Franziska Schauer, Magdalena Trzeciak, Weronika Zysk, Krisztián Gáspár, Andrea Szegedi, Giovanni Damiani, Andrea Carugno, Ilona Hartmane, Ingmars Mikazans, Skaidra Valiukeviciene, Livija Petrokaite, Jacek C. Szepietowski, Beata Jastrząb, Petra Staubach, Suzana Ljubojević Hadžavdić, Daška Štulhofer Buzina, Christian Posch, Jakob Jochmann, Antonia Wiala, Ludwig Scheffenbichler, Emanuele Trovato, Laura Calabrese, Gyula Laszlo Fekete, Pavel Chernyshov, Lidiia Kolodzinska, Julia Welzel, Karisa Thölken, Julia‐Tatjana Maul, Lara Valeska Maul, Damian Meyersburg, Stephanie Bowe, Cathal O. Connor, Razvigor Darlenski, Stephan Traidl, Christian Vestergaard, Elena Lucía Pinto‐Pulido, Maria Polina Konstantinou, Eszter Szlávicz, Kristine Heidemeyer, Nikhil Yawalkar, Hanka Agnes Caroline Lantzsch, Aleksandra Soplinska, Anna‐Theresa Seitz, Tiago Torres, Zenon Brzoza, Ana Sanader Vučemilović, Liana Manolache, Nina Magnolo, Emanuele Scala, Kilian Eyerich, Tilo Biedermann, Alexander Zink

• Background Chronic skin diseases such as psoriasis (PSO), atopic dermatitis (AD) and hidradenitis suppurativa (HS) are frequently associated with psychological distress, potentially promoting maladaptive coping mechanisms including addictive behaviours. Despite evidence of higher addiction rates among dermatology patients, comprehensive multicenter data across Europe are lacking. Objectives To estimate the prevalence and patterns of addictive behaviours among patients with chronic skin diseases in European tertiary dermatology centres and explore associated sociodemographic and clinical factors. Methods This multicentre cross-sectional study recruited adult patients with PSO, AD, HS, alopecia areata (AA), urticaria, or vitiligo from dermatology departments in 20 European countries. Participants completed a standardized questionnaire assessing sociodemographics, disease characteristics, and addictive behaviours (smoking, alcohol use, drug use, gambling, internet addiction, andBackground Chronic skin diseases such as psoriasis (PSO), atopic dermatitis (AD) and hidradenitis suppurativa (HS) are frequently associated with psychological distress, potentially promoting maladaptive coping mechanisms including addictive behaviours. Despite evidence of higher addiction rates among dermatology patients, comprehensive multicenter data across Europe are lacking. Objectives To estimate the prevalence and patterns of addictive behaviours among patients with chronic skin diseases in European tertiary dermatology centres and explore associated sociodemographic and clinical factors. Methods This multicentre cross-sectional study recruited adult patients with PSO, AD, HS, alopecia areata (AA), urticaria, or vitiligo from dermatology departments in 20 European countries. Participants completed a standardized questionnaire assessing sociodemographics, disease characteristics, and addictive behaviours (smoking, alcohol use, drug use, gambling, internet addiction, and eating disorders). Descriptive analyses and multivariate logistic regression were performed. Results Among 3585 participants (median age 43 years; 51.1% female), the prevalence of addictive behaviours was notable: smoking (25.7%), pathological gambling (4.5%), hazardous drinking (8.8%), alcohol dependence (2.5%), drug use disorders (5.3%), eating disorders (1.8%), and internet addiction (29.7%). Smoking was most common among PSO and HS patients (48.6%), and gambling among AA and vitiligo patients (8.2%). Significant associations included male sex, younger age, single status, higher Dermatology Life Quality Index (DLQI) scores, and regional variation. Discussion Addictive behaviours are prevalent in dermatology patients and are associated with both sociodemographic and disease-related factors. The DLQI was positively correlated with multiple addictions, suggesting that reduced quality of life may contribute to maladaptive coping. However, due to the absence of a control group, the tertiary care setting, limited center distribution, and unknown response rate, generalizability is restricted. Conclusion Addiction screening and supportive mental health strategies should be integrated into dermatologic care, particularly for high-risk patients. Population-based studies with control groups are needed to confirm these findings.…