Temperament and character properties of the patients with essential hyperhidrosis

Objective: EH is a dermatological disorder characterized by excessive discharge of sympathetic cholinergic nerves on specified parts of the body for an unknown reason. Sympatho-adrenal system in these individuals is thought to be overactive. Histology and function of sweat gland is normal and emotional stress causes an increase in secretion of sweat while asleep is eliminated. In light of these findings in this study it is investigated the relationship between temperament and character properties of individuals with EH and sympathetic hyperactivity and sweating. Materials and Methods: A total of 80 EH patients, 42 women and 38 men and a total of 161 healthy people, 54 female and 27 male, aged 18 and older, who had applied to Celal Bayar University Hafsa Sultan Hospital Dermatology outpatient clinic between April 2011 - August 2013 were included in the study while people with a systemic disease that can lead to hyperhidrosis were excluded. EH patients' age, gender, visual analogue score (VAS) values were recorded and to those participating in the study Temperament and Character Inventory (TCI), Anxiety Sensitivity Index-3 (ASI-3), DLQI, Liebowitz Social Anxiety Scale (LSAS) and SCID-CV Diagnostic criteria were applied. Results: VAS scores ranged from 2-10 in the patient group, mean VAS was found to be 7.54 ± 1.89, which means sweating severity of the patients who participated in our study was higher. DLQI scores in patients ranged from 10 to 26, the mean DLQI was found to be 12.96 ± 4.11. The quality of life of patients were moderately affected by EH. 57In the patient group ASI-3 scores statistically significantly higher (p = 0.01), again in La-TOP score and Lb-TOP score than the control group were significantly higher (p = 0.01, p = 0.03). Between patient and control groups statistically significant difference couldn't be found in terms of P (persistece) scores (P = 0.93). NS2 (impulsiveness) scores were significantly higher in patients than in control group (p = 0.006). HA3 (shyness with strangers) and HA4 (fatigability and asthenia) scores in the patient group were significantly higher than the control group (p = 0.04, p = 0.01). RD4 (dependence) scores in the patient group were statistically significantly lower than the control group (p = 0.001). S2 (Purposefullness) score was lower in the patient group than the control group (p = 0.047). C1 (acceptance), C2 (empathy), C3 (helpfullness) and C-TOP (cooperativeness) scores in the patient group compared to control group was lower (p = 0.017, p = 0.07, p = 0.015, p = 0.044 ). ST1 (self-forgetfullness), ST3 (spiritual acceptance) and ST-TOP (self-transcendence) scores were significantly higher in the patient group (p = 0.02, p = 0.039, p = 0.035). In the patient group, in the past or the currently, it was revealed in 21 persons the social phobia, 12 persons major depressive disorder, 11 persons not otherwise specified anxiety disorders, 7 persons panic disorder, 7 persons specific phobia, 5 persons adjustment disorder, 3 persons obsessive-compulsive disorder, 3 persons posttraumatic stress disorder, and 3 persons generalized anxiety disorder. Conclusions: EH individuals, in parallel with impaired quality of life due to excessive sweating have observed that people who are with high levels of social anxiety and prone to anxiety. EH individuals, due to increased adrenergic discharge acts impulsive, which have low dependency and purposefulness, stay away from cooperation. In parallel with impaired quality of life in EH individuals with higher VAS scores, high levels of anxiety and social phobia have found. EH individuals are experiencing major problems doing their jobs and in social relationships due to hyperhidrosis which cause visual and functional problems, it is naturally increasing social concern and anxiety. For these people who acts 58impulsive and who doesn't comprehensively analyse the events because of their temperament to have higher fatigue scores, may be due to the high basal metabolism creating by increased adrenergic activity. Also it seems to be the view that they exert intense effort to ensure hygienic well-being are added to this situation. Beware of streangers scores which is one of the findings of Anxiety disorders is high in the EH group as we expected because of the social fobia and anxiety which created by EH. We observed EH patients with high levels of foreign hesitate are not to cooperate naturally and have low intentionality. "Self-transcendence" scores high in patients with EH detection of these people from an early age that they accept and internalize hyperhidrosis has been around since learned to live with this situation shows that. "Self-transcendence" scores high in patients with EH shows these people from an early age they accept and internalize hyperhidrosis has been learned to live with this situation. Our study so far on this subject is the first which consists of the highest number of participants and the first study of is used the combination of DLQI, ASI-3, Liebowitz Social Phobia Scale and SCID-CV. The difference of the findings of previous studies depends the small number of participants and without balanced on the distribution and control patients. In the first study (8) there are relatively low number of patients and healthy controls, whereas the pathological control group received renal failure is approximately twice the others. This disproportionate distribution reduces the reliability of statistical data. Both studies the patients and controls were not assessed in terms of psychiatric pathologies. In our study, patients known with active psychiatric disorder were not assessed. This situation increases the reliability of the control data. Increased sympathetic activity, the genetic factors of the early onset disease and social and hygienic problems caused by hyperhidrosis seem to affect the development of patient temperament and character. In these patients, the increase in the distribution of social phobia and anxiety, leads to a deterioration in socialization and extrovert behavior pattern. A better understanding of Disease activity, social and personal identity affected in 59these patients is likely to improve the quality of life and will increase our help on anxiety management and regulation of hyperhidrosis