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Regular Article

Psychosomatic Assessment of Skin Diseases in Clinical Practice

Picardi A.a · Pasquini P.a · Abeni D.a · Fassone G.a · Mazzotti E.a · Fava G.A.b, c

Author affiliations

aDermatological Institute IDI-IRCCS, Rome, and bDepartment of Psychology, University of Bologna, Bologna, Italy; cDepartment of Psychiatry, State University of New York at Buffalo, Buffalo, N.Y., USA

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Psychother Psychosom 2005;74:315–322

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: August 10, 2005
Issue release date: August 2005

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 3

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

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.

© 2005 S. Karger AG, Basel


References

  1. Hughes JE, Barraclough BM, Hamblin LG, White GE: Psychiatric symptoms in dermatology patients. Br J Psychiatry 1983;143:51–54.
  2. Wessely SC, Lewis GH: The classification of psychiatric morbidity in attenders at a dermatology clinic. Br J Psychiatry 1989;155:686–691.
  3. Aktan S, Ozmen E, Sanli B: Psychiatric disorders in patients attending a dermatology outpatient clinic. Dermatology 1998;197:230–234.
  4. Picardi A, Abeni D, Melchi CF, Puddu P, Pasquini P: Psychiatric morbidity in dermatological outpatients: An issue to be recognized. Br J Dermatol 2000;143:983–991.
  5. Niemeier V, Harth W, Kupfer J, Mayer K, Linse R, Schill WB, Gieler U: Prevalence of psychosomatic disorders in dermatologic patients. Experiences in 2 dermatology clinics with a liaison therapy model (in German). Hautarzt 2002;53:471–477.
  6. Gupta MA, Gupta AK: Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol 1998;139:846–850.
  7. Colón EA, Popkin MK, Callies AL, Dessert NJ, Hordinsky MK: Lifetime prevalence of psychiatric disorders in patients with alopecia areata. Compr Psychiatry 1991;32:245–251.
  8. Koblentzer CS: Psychosomatic concepts in dermatology. Arch Dermatol 1983;119:501–512.
  9. Van Moffaert M: Psychodermatology: An overview. Psychother Psychosom 1992;58:125–136.
  10. Picardi A, Abeni D: Stressful life events and skin diseases: Disentangling evidence from myth. Psychother Psychosom 2001;70:118–136.
  11. Schneider G, Gieler U: Psychosomatic dermatology – state of the art (in German). Z Psychosom Med Psychother 2001;47:307–331.
  12. Picardi A, Abeni D, Renzi C, Braga M, Melchi CF, Pasquini P: Treatment outcome and incidence of psychiatric disorders in dermatological outpatients. J Eur Acad Dermatol Venereol 2003;17:155–159.
  13. Regier DA, Boyd JH, Burke Jr JD, Rae DS, Myers JK, Kramer M, Robins LN, George LK, Karno M, Locke BZ: One-month prevalence of mental disorders in the United States. Arch Gen Psychiatry 1988;45:977–986.
  14. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
  15. Fortune DG, Richards HL, Griffiths CE, Main CJ: Psychological stress, distress and disability in patients with psoriasis: Consensus and variation in the contribution of illness perceptions, coping and alexithymia. Br J Clin Psychol 2002;41:157–174.
  16. Fava GA, Freyberger H, Bech P, Christodoulou G, Sensky T, Theorell T, Wise TN: Diagnostic criteria for use in psychosomatic research. Psychother Psychosom 1995;63:1–8.
  17. Chren MM, Lasek RJ, Flocke SA, Zyzanski SJ: Improved discriminative and evaluative capability of a refined version of Skindex, a quality-of-life instrument for patients with skin diseases. Arch Dermatol 1997;133:1433–1440.
  18. Jones-Caballero M, Penas PF, Garcia-Diez A, Badia X, Chren MM: The Spanish version of Skindex-29. Int J Dermatol 2000;39:907–912.
  19. Abeni D, Picardi A, Pasquini P, Melchi CF, Chren MM: Further evidence of the validity and reliability of Skindex-29: An Italian study on 2,242 outpatients. Dermatology 2002;204:43–49.
  20. Goldberg DP: The detection of psychiatric illness by questionnaire. London, Oxford University Press, 1972.
  21. Piccinelli M, Bisoffi G, Bon MG, Cunico L, Tansella M: Validity and test-retest reliability of the Italian version of the 12-item General Health Questionnaire in general practice: A comparison between three scoring methods. Compr Psychiatry 1993;34:198–205.
  22. Picardi A, Abeni D, Pasquini P: Measuring psychological distress in patients with skin disease: Validity, reliability and factor structure of the GHQ-12. J Eur Acad Dermatol Venereol 2001;15:410–417.
  23. First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV Axis I Disorders, Clinical Version (SCID-I CV). Italian version by Mazzi F, Morosini P, de Girolamo G, Lussetti M, Guaraldi GP. Florence, Organizzazioni Speciali, 2000.
  24. Fava GA, Mangelli L, Ruini C: Assessment of psychological distress in the setting of medical disease. Psychother Psychosom 2001;70:171–175.
  25. Mangelli L, Rafanelli C, Porcelli P, Fava GA: Interview for the Diagnostic Criteria for Psychosomatic Research (DCPR). Psychother Psychosom 2003;72:346–348
  26. Galeazzi GM, Ferrari S, Mackinnon A, Rigatelli M: Interrater reliability, prevalence, and relation to ICD-10 diagnoses of the Diagnostic Criteria for Psychosomatic Research in consultation-liaison psychiatry patients. Psychosomatics 2004;45:386–393.
  27. Dean AG, Dean JA, Burton AH, Dicker RC: Epi Info: A general purpose microcomputer program for health information systems. Am J Prev Med 1991;7:178–182.
  28. Norusis MJ: SPSS for windows professional and advanced statistics, release 8.0. Chicago, SPSS Inc., 1998.
  29. Renzi C, Picardi A, Abeni D, Agostini E, Baliva G, Pasquini P, Puddu P, Braga M: Association of dissatisfaction with care and psychiatric morbidity with poor treatment compliance. Arch Dermatol 2002;138:337–342.
  30. Mangelli L, Fava GA, Grandi S, Grassi L, Ottolini F, Porcelli P, Rafanelli C, Rigatelli M, Sonino N: Assessing demoralization and depression in the setting of medical disease. J Clin Psychiatry 2005;66:391–394.
  31. Wu SF, Kinder BN, Trunnell TN, Fulton JE: Role of anxiety and anger in acne patients: A relationship with the severity of the disorder. J Am Acad Dermatol 1988;18:325–333.
  32. Fried RG, Friedman S, Paradis C, Hatch M, Lynfield Y, Duncanson C, Shalita A: Trivial or terrible? The psychosocial impact of psoriasis. Int J Dermatol 1995;34:101–105.
  33. Ginsburg IH, Prystowsky JH, Kornfeld DS, Wolland H: Role of emotional factors in adults with atopic dermatitis. Int J Dermatol 1993;32:656–660.
  34. Clarke P, Ebel C, Catotti DN, Stewart S: The psychosocial impact of human papillomavirus infection: Implications for health care providers. Int J STD AIDS 1996;7:197–200.
  35. Fava GA, Grandi S, Savron G, Bartolucci G, Santarsiero G, Trombini G, Orlandi C: Psychosomatic assessment of hirsute women. Psychother Psychosom 1989;51:96–100.
  36. White A, Horne DJ, Varigos GA: Psychological profile of the atopic eczema patient. Australas J Dermatol 1990;31:13–16.
  37. Niemeier V, Fritz J, Kupfer J, Gieler U: Aggressive verbal behaviour as a function of experimentally induced anger in persons with psoriasis. Eur J Dermatol 1999;9:555–558.
  38. Gupta MA, Gupta AK, Watteel GN: Early onset (<40 years age) psoriasis is comorbid with greater psychopathology than late onset psoriasis: A study of 137 patients. Acta Derm Venereol 1996;76:464–466.
  39. Bankier B, Littman AB: Psychiatric disorder and coronary heart disease in women. Psychother Psychosom 2002;71:133–140.
  40. Rafanelli C, Roncuzzi R, Finos L, Tossani E, Tomba E, Mangelli L, Urbinati S, Pinelli G, Fava GA: Psychosocial assessment in cardiac rehabilitation. Psychother Psychosom 2003;72:343–349.
  41. Porcelli P, De Carne M, Fava GA: Assessing somatization in functional gastrointestinal disorders. Psychother Psychosom 2000;69:198–204.
  42. Pilowsky F: Abnormal illness behaviour. Psychother Psychosom 1986;46:76–84.
  43. Sonino N, Navarrini C, Ruini C, Ottolini F, Paoletta A, Fallo F, Boscaro M, Fava GA: Persistent psychological distress in patients treated for endocrine disease. Psychother Psychosom 2004;73:78–83.
  44. Sobrinho LG: Psychopathology in endocrine disorders: Why so persistent after the cure? Psychother Psychosom 2004;73:65–67.
  45. Fava GA, Ruini C, Rafanelli C: Psychometric theory is an obstacle to the progress of clinical research. Psychother Psychosom 2004;73:145–148.
  46. Bech P: Modern psychometrics in clinimetrics. Psychother Psychosom 2004;73:134–138.
  47. Faravelli C: Assessment of psychopathology. Psychother Psychosom 2004;73:139–141.
  48. Nierenberg AA, Sonino N: From clinical observation to clinimetrics. Psychother Psychosom 2004;73:131–133.

Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: August 10, 2005
Issue release date: August 2005

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 3

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS


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