The aim of this study was to investigate self-image and coping ability among patients with hand eczema and to compare those findings with a normal population to find out if these personality components are important prognostic factors for the progress of symptoms and for work capability. Furthermore we compared the self-image and coping ability of the hand eczema patients with other patients whose symptoms are attributed to their indoor environment (SBS) and patients whose symptoms are attributed to electromagnetic fields, IEI/EMF.
The patients were examined, diagnosed and given treatment at appropriate clinics in Norrlands University Hospital, in Umeå, Sweden. For follow-up a postal questionnaire containing questions including medical and social status, treatment , self-image and coping skills was sent to 383 patients, response rate 68.1 %. Measurement of personality traits was done using the Structural analysis of Social Behaviour (SASB) and the Coping Resources Inventory (CRI) to assess coping skills. Similar follow-up questionnaires for patient groups with SBS and perceived electrical sensitivity were used and response rates were 79.1 % respectively 73%. Comparisons were made between self-image and coping among patients with hand eczema, SBS patients and patients with electrical hypersensitivity, and a selection from the general population.
Hand eczema patients scored higher on spontaneous and positive self-image (SASB) than a comparison group. They also had a high score on negative self-image similar to IEI/EMF patients. On the CRI cognitive domain, hand eczema patients had a lower score than the comparison group. Self-image or coping ability was not associated with persistent hand eczema symptoms or work capability at follow-up. Previous atopic dermatitis was the only consistent predictor of hand eczema at follow-up.
Differences in personality traits were seen in a well-established condition and not only in patients with medically unexplained symptoms such as SBS and perceived sensitivity to electromagnetic fields. This can imply that patients with chronic symptoms in general can deviate from the general population with respect to self-image and coping ability.