Psychological Diagnosis in Pediatric Dermatology

Abstract

Relational dynamics that are an essential factor in the development of a person and in the structuring of his/her physical, psychological and social reality can be conditioned in various ways by the health or disease of the skin. Thus, the condition of the skin can cause serious mental and social problems. It has been shown that emotional dysphoric life experiences, above all the different types of anxiety, are significant cofactors in psychosomatic dermatopathies, apart from being a secondary (somatopsychic) consequence in every type of skin disease. Nevertheless, this psychological discomfort does not always result in structured psychopathological disorders, even though the percentage of these disorders in dermatological patients is noticeably higher when compared with that of the general population or that of patients suffering from other types of organic diseases. We analyzed a group of 490 subjects aged between 1 and 17 years who showed various types of skin diseases (predominantly alopecia areata, atopic dermatitis, psoriasis, urticaria, genodermatosis, irritant dermatitis and localized infectious diseases) at different levels of severity. Among these patients 64% were free from any kind of structured psychopathological disorder while 36% suffered from some form of structured disorder. Psychopathological disorders occurring more frequently were generalized anxiety disorder, dysthymic disorder, separation anxiety disorder, attention deficit / hyperactivity disorder, and mental retardation.

Anxiety, depression, and quality of life in children and adults with alopecia areata: A systematic review and meta-analysis

“…A small study of 14 children found 50% of the children to be eligible for a diagnosis of depressive disorder ( 44 ). Bigger studies reported that 10% of the children were diagnosed with dysthymia ( 40 ) and that children with AA were diagnosed with a depressive disorder more often than other patients ( 85 ).…”

“…However, this study included only 12 children and used the DSM-III-R, which was published in 1987. Two other studies reported that 7.1-16% had a generalized anxiety disorder, 7.1-8% had a separation anxiety disorder and 28.6% had a specific phobia (40,44). However, none of the studies specified the number of patients with more than one anxiety disorder.…”

The burden of alopecia areata: A scoping review focusing on quality of life, mental health and work productivity

“…Suicidal ideation and social anxiety were common, albeit additional studies are needed to confirm and further explore these latter findings 13,23,56,58,88 . In children, additional common comorbidity identified was ADHD spectrum whereas higher risk of dementia was seen in the elderly 38,40,57,89 . While being a woman and having a worse disease severity increased the risk of mental health comorbidities, patients with less extensive scalp hair loss and/or facial hair loss were also at high risk and hence, should also be carefully screened for psychiatric comorbidities and managed appropriately 23,28,90 .…”

“…13,23,56,58,88 In children, additional common comorbidity identified was ADHD spectrum whereas higher risk of dementia was seen in the elderly. 38,40,57,89 While being a woman and having a worse disease severity increased the risk of mental health comorbidities, patients with less extensive scalp hair loss and/or facial hair loss were also at high risk and hence, should also be carefully screened for psychiatric comorbidities and managed appropriately. 23,28,90 Similarly to QoL, anxiety and depression scores were significantly reduced in patients receiving systemic treatment as opposed to placebo.…”