Characteristics of Patients Receiving Psychotherapeutic Interventions within a Psychosomatic Liaison Service in Dermatology

Abstract

Objective: To determine how patients undergoing psychotherapeutic intervention in the dermatological psychosomatic liaison service differ from patients without such intervention. Patients and Methods: From a total of 112 patients in one ward of the University Dermatology Hospital 86 patients were consecutively enrolled in the study. Mental disorders, psychosocial distress, coping with disease and motivation for treatment (FBB) as well as psychotherapeutic interventions of the psychosomatic liaison service were recorded using a psychodiagnostic interview and self-rating instruments (HADS, FQCI, SOMS, EDLQ). Results: The patients who received psychotherapeutic interventions differed significantly from untreated patients in the following factors: severity of the dermatological disease, gender, anxiety, depression, depressive coping with disease, stress in everyday living and the presence of a mental disorder according to ICD-10. They were more likely to be motivated for psychological intervention and were also rated by external experts as being in need of treatment. There were no differences between groups regarding the duration of disease, stress in social life or in the coping strategies ‘active problem-oriented coping’ and ‘minimization and wishful thinking’. Conclusion: Most of the patients treated by the liaison therapist fulfilled the objective criteria for psychosocial distress. Male patients and patients with maladaptive strategies of coping with disease and stress in social life require increased attention. In addition, because the points of view of patients, experts, and caregivers differ, it is important that all three levels should be taken into account in rating the need for psychosocial intervention.

Psychosomatic services for melanoma patients in tertiary care

“…For patients with atopic dermatitis, increased anxiety and depression values, as well as symptoms of neurosis and hypochondria, were reported 26 . Psychosocial factors are important in the onset and exacerbation of psoriasis in 40–80% of the cases 16,27,28 . Today there is wide consensus about the need to take associated emotional problems into consideration to manage skin disorders effectively 6…”

“…26 Psychosocial factors are important in the onset and exacerbation of psoriasis in 40-80% of the cases. 16,27,28 Today there is wide consensus about the need to take associated emotional problems into consideration to manage skin disorders effectively. 6 Yet, patients with melanoma are also confronted with an illness that impacts their skin, particularly if located in an area of the body usually not covered by clothes, which can cause pronounced distress.…”

“…More and more, they are becoming part of regular care provision in general hospitals. Research has reviewed such CLS for the general hospital patient population, 11 for particular patient groups without cancer, 12 oncological patients, 13,14 patients with a specific cancer diagnosis, 15,16 and even the subpopulation of patients suffering from dermatological diseases 17 . Yet, only one report could be identified that describes psychosomatic–psychotherapeutic CLS for patients diagnosed with melanoma 18 .…”

The Skin Satisfaction Questionnaire – an Instrument to Assess Attitudes toward the Skin in Healthy Persons and Patients

“…Other aspects, however, like the role of the skin in regulating closeness and distance, are not assessed by these tests. Up to now, standardized psychological questionnaires have usually been used in clinical studies [Fritzsche et al, 2001;Linnet and Jemec, 2001]. Deep-psychologically orientated test procedures have scarcely been used or their conception is very complicated [Freni et al, 2001].…”

Psychodermatology Has Grown out of Its Infancy

“…those of Niemeier et al [2002] on acne, Harth et al [2002] on lifestyle drugs, and Koblenzer [2001] on psychotropic drugs in dermatology. Aspects of a psychosomatic liaison service in dermatology have been described by Fritzsche et al [2001], and the review article on education programs for atopic dermatitis [Gieler et al, 2000] is regularly cited in other journals. The issues described there seem to provide an important aspect for many psychotherapeutic and dermatologic practitioners.…”