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Diagnostic accuracy of different diagnostic systems in estimating the incidence of delirium among surgery patients has not been investigated to date. Therefore, the authors evaluated the frequency of delirium according to DSM-IV and ICD-10 criteria and the cutoff values of the Memorial Delirium Assessment Scale (MDAS) and Delirium Index in 563 patients undergoing cardiac surgery. DSM-IV criteria were found as more inclusive, while ICD-10 criteria were more restrictive in establishing a diagnosis of postoperative delirium. The cutoff scores of 10 on the MDAS and 7 on the Delirium Index were optimal to the presence or absence of delirium.

Dermatitis artefacta is a disease that occurs as a result of a self-inflicted injury of the skin. The skin lesions are most often located on the areas within easy reach of the patient's dominant hand sparing the middle part of the back. Dermatitis artefacta may coexist with psychiatric disorders and imitate many dermatologic diseases. As most of the patients with self-inflicted dermatoses usually initially deny any psychiatric problems, what delays psychiatric intervention, they are typically first seen by dermatologists. We are reporting a case of a 35-year-old man with a 3-year-long history of schizophrenia who has been treated at a dermatologist's office sequentially with acne, bacterial lesions, suspected tuberculosis. However, the treatment was ineffective. He was diagnosed with dermatitis artefacta after 7 years of disease duration. During this time he was treated with many medicines e.g. isotretinoin, which is contraindicated in psychosis as it worsens the course of disease. After establishing the correct diagnosis and antipsychotic treatment, a significant improvement was obtained in both skin condition and mental state. These are the reasons why we would like to recommend close cooperation between dermatologists and psychiatrists.