Psychosomatic Assessment of Skin Diseases in Clinical Practice

Abstract

Background: Psychiatric disorders are frequent in dermatology patients, and many studies pointed out complex, mutual relationships between psyche and skin. Our aim was to provide a systematic psychosocial evaluation of a large and heterogeneous population of patients with skin diseases, including assessments of quality of life, psychiatric status according to the DSM-IV and psychological conditions with psychosomatic relevance according to established criteria (Diagnostic Criteria for Psychosomatic Research, DCPR). Methods: We studied 545 dermatological inpatients aged 18–65 years, free from dementia and cognitive impairment. They completed the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12) and were administered the SCID-I and the Structured Interview for Psychological Conditions of Psychosomatic Relevance by a trained mental health professional blinded to questionnaire scores. Results: Overall, 38% of patients received a DSM-IV diagnosis. The most common diagnoses were mood (20%) and anxiety disorders (16%); 48% of patients also received a DCPR diagnosis. The most common were demoralisation, irritable mood, type A behaviour and various forms of abnormal illness behaviour. Adjusting for gender, age, and education, the presence of DSM-IV or DCPR diagnoses was significantly associated with high scores on the GHQ-12 and on the Functioning and Emotions scales of the Skindex-29. Also, DCPR diagnoses were significantly associated with high scores on the Symptoms scale of the Skindex-29. Conclusions: These findings highlight the high frequency of psychosocial problems in patients with skin disease and suggest that the joint use of DSM-IV and DCPR criteria may help identify those patients in whom psychiatric issues are worthy of increased clinical attention.

Quality of life, depression, and anxiety in Turkish children with vitiligo and their parents

“…Low levels of anxiety detected in children might be related to low levels of parental anxiety. As a condition that would possibly disrupt the fantasy of the idealized child, the child might be affected too, in case of insufficient adaptive mechanisms and the probability of parents reflecting their psychological distress on their children [35,38,78]. Our findings of parental anxiety levels not being higher than those in the control group might have created a positive effect such as moderate levels of anxiety in children and medium levels of vitiligo severity.…”

“…As for caregivers, most commonly emerging psychiatric diagnoses following paediatric dermatosis have been defined as anxiety and depression [30][31][32][33][34][35]. In quality of life studies conducted with relatives of individuals with chronic skin conditions, anxiety and depression have frequently been underlined [28,[36][37][38].…”

Depression profiles in skin disorders

“…Many studies have highlighted the comorbidity of skin disorders and depression, occurring in 25% -30% of the cases examined, a considerably higher rate than that found in the general population [2][3][4].…”

Frequency And Magnitude Of Anxiety And Depression Among Acne Patients: A Study Of 100 Cases

“…3,4 On the contrary, the frequency of depression among dermatological patients can be as high as 25% to 40% in comparison with a frequency of 6-8% in generel clinics. [5][6][7] The psychosocial effect of acne was first recognized in 1948, when Sulzberger and Zaidens wrote, "There is no single disease, which causes more psychic trauma and more maladjustment between parents and children, more general insecurity and feelings of inferiority, and greater sums of psychic assessment than does acne vulgaris". 8 Acne has a demonstrable association with depression and anxiety; it affects personality, emotions, self-image and esteem, feelings of social isolation, and the ability to form relationships.…”