A considerable overlap exists between BDD and other psychiatric disorders such as OCD, anxiety, and delusional disorder, and this comorbidity should be considered in evaluation, management, and long-term follow-up of the disorder. Individuals with BDD usually consult dermatologists and cosmetic surgeons rather than psychiatrists. Collaboration between different specialties (such as primary care, dermatology, cosmetic surgery, and psychiatry) is required for better treatment outcome.
Psychocutaneous involvements are common among dermatologic patients. A large number of the surveyed dermatologists had no training or education in psychodermatology. A lack of familiarity with patient and family resources on psychocutaneous conditions was also evident. These findings support the need for improvement in training and education in psychodermatology.
Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome (SARS) in humans that is caused by SARS-associated coronavirus type 2 (SARS-CoV-2). In the context of COVID-19, several aspects of the relations between psychiatry and the pandemic due to the coronavirus have been described. Some drugs used as antiviral medication have neuropsychiatric side effects, and conversely some psychotropic drugs have antiviral properties. Chlorpromazine (CPZ, Largactil®) is a well-established antipsychotic medication that has recently been proposed to have antiviral activity against SARS-CoV-2. This review aims to 1) inform health care professionals and scientists about the history of CPZ use in psychiatry and its potential anti- SARS-CoV-2 activities 2) inform psychiatrists about its potential anti-SARS-CoV-2 activities, and 3) propose a research protocol for investigating the use of CPZ in the treatment of COVID-19 during the potential second wave. The history of CPZ’s discovery and development is described in addition to the review of literature from published studies within the discipline of virology related to CPZ. The early stages of infection with coronavirus are critical events in the course of the viral cycle. In particular, viral entry is the first step in the interaction between the virus and the cell that can initiate, maintain, and spread the infection. The possible mechanism of action of CPZ is related to virus cell entry via clathrin-mediated endocytosis. Therefore, CPZ could be useful to treat COVID-19 patients provided that its efficacy is evaluated in adequate and well-conducted clinical trials. Interestingly, clinical trials of very good quality are in progress. However, more information is still needed about the appropriate dosage regimen. In short, CPZ repositioning is defined as a new use beyond the field of psychiatry.
The skin is recognized as an important mode of communication between the external and the internal psychic and biological processes [1]. The skin and the psyche are closely related from historical, embryologic, biological, psychological developmental and cultural perspectives.The importance of the skin is that it is literally the initial point of contact between the external and internal environments. Exposure to external pollutants, toxins, allergens and other noxious environmental elements find symptomatic expression through the skin.Embryologically, the shared origins of brain and skin are well recognized. Both are developed from the same embryologic germ layer (ectoderm) and two-way communication influences seem to persist throughout the life cycle.Biologically, the contribution of stress to skin diseases is backed by neuroendocrine and immunologic sciences. Emotional factors influence many skin diseases, and the correlation between stressful life events and disease flares is well-recognized in dermatology [2]. Flares of psoriasis, herpes simplex and atopic eczema are influ enced by proinflammatory cytokines, which are also modulated by psychosocial stressors [3]. The cytokines regulate immunologic responses and also mediate inflammatory processes, with recurrent hormonal secretion leading to central biologic changes in mood, anxiety and vegetative conditions [4].Psychologically, the internal psychological factors and emotional suffer ing may eventually find the skin a suitable organ for a visible expression of turmoil. This close relationship between the skin and the psyche has long been recognized in the sci entific literature. On 7 July 1949, AW Watt read an article at the 25th annual meeting of the British Association for Dermatology and Syphilology in London (UK) in which he encouraged dermatologists to consider psycho logical factors related to dematologic conditions [201].In addition to Watt, there were many proponents of the concept of intercon nection between the skin and the psyche with proposed modelsThe skin and the psyche are linked from embryologic, biological, psychological and cultural perspectives. Both the skin and the brain are developed from the same ectodermic germ layer. New evidence in psychoneuroimmunology suggest that both the skin and the psyche are affected by immunologic vulnerabilities and endocrine reactions. Emotional stress may exacerbate many chronic dermatoses and can initiate a vicious cycle referred to as the 'itch-scratch cycle'; therefore, treatment of such cases may be difficult without addressing stress. The dynamic interaction between the skin and the psyche is also manifest in cosmetic behavior, whereby the psychological state of the individual is altered through the widely utilized cosmetics and cosmetic procedures. The motives for seeking cosmetic procedures may include a desire to enhance selfconfidence, body image and self-empowerment. Individuals of both genders are becoming concerned about their physical appearance and are increasingly seeking cosmetic procedure...
Anxiety, depression, perceived functional disability, impairment in quality of life, and disturbance of self-image were found to be common among participants in the study pursuing bariatric surgery for obesity. Recognition, assessment, and treatment of these symptoms are expected to be conducive to positive outcomes of bariatric surgery.
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