Frequency and Clinical Relevance of Psychosomatic Complaints in Skin Patients

Abstract

Background: There are relatively few studies on the frequency and clinical relevance of psychosomatic complaints in skin patients. In the present study a larger group of dermatological patients was examined for the frequency with which clinically relevant psychosomatic complaints occur and for the prevalences of these complaints in different types of skin diseases. The results should be of assistance in determining the need for psychosocial interventions depending on the dermatological diagnosis. Patients and Methods: The data of 700 outpatients and inpatients of the Dermatology Clinic at the University of Leipzig were analyzed. Between 1984 and 1997 these patients filled out the following three standardized screening instruments: i) the Complaint Questionnaire (Beschwerdenfragebogen; BFB), ii) the Behavioral Questionnaire (Verhaltenssfragebogen; VFB) of Höck and Hess to measure neuroticism and make assignments to the categories ‘no neurosis’, ‘questionable neurosis’ and ‘probable neurosis’, and iii) the Psychosomatic Complaint Questionnaire (Beschwerdenerfassungsbogen; BEB) of Kasielke and Hänsgen to detect various psychosomatic problem areas (digestion, respiratory/cardiovascular balance, fluid balance; neurasthenia/psychasthenia; hypochondria/anancasm; social inhibition; anxiety/phobias). Data were obtained from 12 different diagnosis groups: urticaria, somatoform disorders, atopic dermatitis, psoriasis vulgaris, prurigo simplex subacuta, malignant melanoma, alopecia areata, alopecia diffusa, allergic reactions, orofacial pain syndrome, acne vulgaris, and mycoses. Results: Nearly 50% of all examined skin patients presented with clinically relevant psychosomatic complaints. The highest neuroticism values in the BFB were attained by patients with orofacial pain syndrome, followed by patients with allergies and by patients of the prurigo and the somatoform disorders groups. The values were lowest in the diagnosis groups urticaria, alopecia diffusa and melanoma. At the behavioral level patients with malignant melanoma, psoriasis, and somatoform disorders had the highest and patients with alopecia areata, alopecia diffusa, and acne vulgaris the lowest values. Physical-functional complaints as well as emotional complaints were found more frequently among patients with orofacial pain syndrome, somatoform disorders, psoriasis, and alopecia areata. They occurred less frequently in patients with malignant melanoma, urticaria, and mycoses. Conclusions: Based on various conflict coping concepts, the results were critically discussed with respect to their practical consequences for psychosocial intervention strategies in skin patients.

Psychological factors in prurigo nodularis in comparison with psoriasis vulgaris: results of a case-control study

“…An increased comorbidity with anxiety and depressive disorders was found for the patients with PN as well as for those with psoriasis, as has also been described for various other chronic skin diseases 10,42–50 . For the patients with PN, 18% showed a raised level of anxiety, 22% showed a raised level of depression and 9% showed hypochondriasis.…”

Dermatologisch-psychosomatische Rehabilitation

“…In den Rehabilitationsrichtlinien der DRV [9] ist der Psychosomatik in der Dermatologie ein eigener Abschnitt gewidmet, da bei jedem dritten bis vierten Hautkranken psychische Probleme angegeben werden [20,22,25]. Unterschieden [13].…”

When Emotional Problems Explode

“…Two casuistic contributions presented in this issue deal with special cases of self-inflicted practices [Garcia-Bustinduy et al, 2004;Capella, 2004]. Besides, you will find some interesting aspects on psychosomatic complaints [Seikowski and Reinwardt, 2004] and a psychoimmunological study on psoriasis and pruritus from the Polish research team of WiÊnicka et al [2004]. I would like to invite you to reading about the manifold aspects of factitious disorders in the present issue of DERMA-…”