TY - JOUR
T1 - Psychiatric illness in patients referred to a dermatology-psychiatry clinic
AU - Woodruff, P W R
AU - Higgins, E M
AU - duVivier, A W P
AU - Wessely, S
PY - 1997/1
Y1 - 1997/1
N2 - There is a recognized psychiatric morbidity among those who attend dermatology clinics. We aimed to determine the pattern of psychological and social problems among patients referred to a liaison psychiatrist within a dermatology clinic. Notes from 144 patients were reviewed and more detailed assessments performed in a subgroup of 32 consecutive referrals. All but 5% merited a psychiatric diagnosis. Of these, depressive illness accounted for 44% and anxiety disorders, 35%. Less common general psychiatric disorders included social phobia, somatization disorder, alcohol dependence syndrome, obsessive-convulsive disorder, posttraumatic stress disorder, anorexia nervosa, and schizophrenia, Classical disorders such as dermatitis artefacta and delusional hypochondriasis were uncommon. Commonly, patients presented with longstanding psychological problems in the context of ongoing social difficulties rather than following discrete precipitants. Psychiatric intervention resulted in clinical improvement in most of those followed tip. Of the dermatological categories I) exacerbation of preexisting chronic skin disease; 2) symptoms out of proportion to the skin lesion; 3) dermatological nondisease; 4) scratching without physical signs, the commonest were dermatological nondisease and exacerbation of chronic skin disease. Anxiety was common in those from all dermatological categories. Patients with dermatological nondisease had the highest prevalence of depression. Skin patients with significant psychopathology may go untreated unless referred to a psychiatrist. The presence of dermatological nondisease or symptoms out of proportion to the skin disease should particularly alert the physician to the possibility of underlying psychological problems. (C) 1997 Elsevier Science Inc.
AB - There is a recognized psychiatric morbidity among those who attend dermatology clinics. We aimed to determine the pattern of psychological and social problems among patients referred to a liaison psychiatrist within a dermatology clinic. Notes from 144 patients were reviewed and more detailed assessments performed in a subgroup of 32 consecutive referrals. All but 5% merited a psychiatric diagnosis. Of these, depressive illness accounted for 44% and anxiety disorders, 35%. Less common general psychiatric disorders included social phobia, somatization disorder, alcohol dependence syndrome, obsessive-convulsive disorder, posttraumatic stress disorder, anorexia nervosa, and schizophrenia, Classical disorders such as dermatitis artefacta and delusional hypochondriasis were uncommon. Commonly, patients presented with longstanding psychological problems in the context of ongoing social difficulties rather than following discrete precipitants. Psychiatric intervention resulted in clinical improvement in most of those followed tip. Of the dermatological categories I) exacerbation of preexisting chronic skin disease; 2) symptoms out of proportion to the skin lesion; 3) dermatological nondisease; 4) scratching without physical signs, the commonest were dermatological nondisease and exacerbation of chronic skin disease. Anxiety was common in those from all dermatological categories. Patients with dermatological nondisease had the highest prevalence of depression. Skin patients with significant psychopathology may go untreated unless referred to a psychiatrist. The presence of dermatological nondisease or symptoms out of proportion to the skin disease should particularly alert the physician to the possibility of underlying psychological problems. (C) 1997 Elsevier Science Inc.
U2 - 10.1016/S0163-8343(97)00155-2
DO - 10.1016/S0163-8343(97)00155-2
M3 - Article
SN - 0163-8343
VL - 19
SP - 29
EP - 35
JO - GENERAL HOSPITAL PSYCHIATRY
JF - GENERAL HOSPITAL PSYCHIATRY
IS - 1
ER -
