Abstract:

Being the largest organ of the body, the skin is known to respond to both exogenous and endogenous stimuli. Whereas it is known that having a dermatological ailment can have a negative effect on one’s body image, in addition to one’s mental state, it should also be noted that the opposite is also true. That is to say that possessing psychological issues can subsequently lead to dermatological ailments. Considering this, the study aimed to analyze the co-integration of the skin and mind, analyzing the comorbidity of psychiatric disorders and dermatological issues. 30 dermatological patients, 25 psychiatry patients, and 10 control patients were enrolled into the study. Patients were tasked to complete a 21-item Depression, Anxiety and Stress Scale (21-DASS) questionnaire and a 10-item Dermatology Life Quality Index. Each patient was then assessed by a dermatologist and a psychologist. It was found that when compared to the control group, the psychological out-patients were more likely to experience dermatological ailments (p<0.001). In addition, it was found that when compared to the control group, the dermatological patients experienced an overall lower quality of life and a higher 21-DASS test result. Ultimately, it can be seen that one’s mental state does in fact, have the potential to affect one’s dermatological condition. With that in mind, it has been proposed to utilize stress reduction techniques and psychological intervention as adjuvant treatments for dermatological ailments.

References:

[1] Toyoda M, Nakamura M, Makino T, 2002, Nerve growth factor and substance P are useful plasma markers of disease activity in atopic dermatitis. Br J Dermatology. 147, 71-79.

[2] Sands, GE, 1996 Three monosymptomatic hypochondriacal syndromes in dermatology. Dermatol Nurs. 421–425.

[3] Savin JA, Cotterill JA, 1992, Psychocutaneous disorders. In: Champion RH, Burton JL, Ebling FJG, eds. Textbook of Dermatology. Oxford, England: Blackwell Scientific Publications; 1992, 2479–2496.

[4] Humphreys F, Humphreys MS, 1998, Psychiatric morbidity and skin disease: what dermatologists think they see. Br J Dermatol. 679–681. https://pubmed.ncbi.nlm.nih.gov/9892914/.

[5] Attah Johnson FY, Mostaghimi H, 1995 Comorbidity between dermatologic diseases and psychiatric disorders in Papua New Guinea. Int J Dermatol. 244–248.

https://pubmed.ncbi.nlm.nih.gov/7790138/.

[6] Capoore HS, Rowland Payne CM, Goldin D, 1998, Does psychological intervention help chronic skin conditions? Postgrad Med J. 662–664.

[7] Koo JYM, Lee CS, 2003, General approach to evaluating psychodermatological disorders. Psychocutaneous Medicine. Marcel Dekker Inc. 1–29.

[8] Cotterill JA, 1990 Psychophysiological aspects of eczema. Semin Dermatol. 216–219. https://pubmed.ncbi.nlm.nih.gov/2206922/.

[9] Cotterill JA, 1981, Dermatological non-disease: a common and potentially fatal disturbance of cutaneous body image. Br J Dermatol. 611–619.

[10] Phillips KA, Dufresne RG Jr, 2002, Body dysmorphic disorder: a guide for primary care physicians. Prim Care 99–111. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1785389/.

[11] Hardy GE, Coterill JA, 1982, A study of depression and obsessionality in dysmorphophobic and psoriatic patients. Br J Psychiatry. 19–22. https://pubmed.ncbi.nlm.nih.gov/7059736/.

[12] Phillips KA, Taub SL, 1995, Skin picking as a symptom of body dysmorphic disorder. Psychopharmacol Bull; 31:279–288. [PubMed].

[13] Phillips KA, Albertini RS, and Siniscalchi JM. et al. FIX Effectiveness of pharmacotherapy for body dysmorphic disorder: a chart review study. J Clin Psychiatry. 2001 62:721-7.

[14] Hoffmann FS, Zogbi H, Fleck P, Müller MC, 2005 Mind and body integration in psycho dermatology. Rev Psicol.;7:51-60.

[15] Silva MN, Silva RN, Soares GMT, 2011 Influence of dermatoses on the psyche of dermatological patients. Med Cut Iber Lat Am.; 39: 209-210.sss.

[16] FIX Report on “Burden of Skin Disease” Workshop NIAMS, 2002 (J Investing Dermatol Symp Proc 9:111–119, 2004).

[17] Reebye, P, 2008, Psychodermatology: The Psychological Impact of Skin Disorders. J Can Acad Child Adolesc Psychiatry, 17(3), 169-171.

[18] Clay, R.A., 2015, The link between skin and psychology: how psychologists are helping patients with dermatological problems. American Psychological Association, 46(2), 56 http://www.apa.org//.

[19] Kono M, Nagata H, Umemura S, Kawana S, Osamura R Y, 2001, In situ expression of corticotropin-releasing hormone (CRH) and proopiomelanocortin (POMC) genes in human skin. FASEB J, 15(12), 2297-2299, https://pubmed.ncbi.nlm.nih.gov/11511529/.

[20] Slominski A, Wortsman J, Pisarchik A, Zbytek B, Linton E.A, Mazurkiewicz J.E, Wei E.T., 2001, Cutaneous expression of corticotropin-releasing hormone (CRH): urocortin and CRH receptors. FASEB J, 15(10), 1678-1693, https://pubmed.ncbi.nlm.nih.gov/11481215/.

[21] Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP, 1998, Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10, 176–81. https://psycnet.apa.org/record/1998-02891-012.

[22] 2021, Depression, Anxiety and Stress Scale, https://www.depression-test.net/support-files/dass21-dmz.pdf.

[23] Finlay AY, Khan GK, 1994, Dermatology Life Quality Index (DLQI): A simple, practical measure for routine clinical use. Clinical and Experimental Dermatology, 19, 210 https://pubmed.ncbi.nlm.nih.gov/8033378/.

[24] Khoudri I, Lamchahab FZ, Ismaili N, Senouci K, Hassam B, Abouqal R, 2013, Measuring quality of
life in patients with psoriasis using the Arabic version for Morocco of the Dermatology Life Quality Index. International Journal of Dermatology, 52, 795–802. https://pubmed.ncbi.nlm.nih.gov/8033378/.