Psychiatric Sequelae of Chronic Pruritic Dermatoses

This comprehensive review investigates the significant psychological impact and profound psychological comorbidities found in individuals suffering from chronic pruritic dermatoses, including atopic dermatitis, chronic urticaria, and prurigo nodularis. Highlighting the complex, reciprocal relationship between pruritus and psychiatric conditions such as depression, anxiety, and sleep disturbances, this paper elucidates the comprehensive impact of dermatological disorders on the skin in addition to the far-reaching effects on an individual’s psychological well-being. By evaluating the efficacy of integrated psychodermatological interventions, including cognitive behavioral therapy, mindfulness practices, pharmacological treatments, and innovative telepsychiatry and digital health solutions, this review aims to lay the foundation for a more holistic approach to treatment of concurrent dermatological and psychiatric conditions. Future research endeavors should delve deeper into the mechanistic foundation of the pruritus-psychiatry interface, the refinement of tailored treatment strategies, and the evaluation of long-term patient outcomes. In doing so, this review seeks to contribute to the optimization of patient care and well-being, underscoring the pivotal role of addressing both dermatological and psychological needs in achieving comprehensive health outcomes.

Psychiatric Comorbidity in Patients with Acne

Acne vulgaris is a chronic inflammatory skin disorder which has a high prevalence among adolescents and young adults and can be associated with emotional and psychological burden on patients. This review aimed to explore psychological factors in patients with acne. Several forms of emotional distress and psychological complications can occur with acne. Such complications may be worse than the physical impact of the skin condition. Current literature suggests that skin changes in acne are associated with changed body image, psychological distress, anxiety, social phobia, suicidal ideation and depression. Population-based studies suggest a significant association between acne and mental distress among both male and female adolescents. Presence of psychological distress is related to severity of acne in some studies. However, other case-controlled studies suggest increased risk for psychological problems in patients with acne regardless of its severity. Stress is suspected to have a role in exacerbations of acne, and the quality of life (QoL) is affected particularly in cases with severe facial acne. Acne treatment can be associated with psychiatric side effects. Isotretinoin may be associated with depression and suicide attempts as shown in several studies but with conflicting results. On the other hand, psychotropic medications (such as antidepressants, antipsychotics and mood stabilizers) can also induce acne. The results of this review indicate the importance of vigilant psychiatric assessment for patients with acne, particularly those receiving isotretinoin, is needed for early diagnosis and treatment of the associated psychiatric co-morbidity.