Psychosomatic factors in pruritus

Abstract

Pruritus and psyche are intricately and reciprocally related, with psychophysiological evidence and psychopathological explanations helping us to understand their complex association. Their interaction may be conceptualized and classified into 3 groups: pruritic diseases with psychiatric sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Management of chronic pruritus is directed at treating the underlying causes and adopting a multidisciplinary approach to address the dermatologic, somatosensory, cognitive, and emotional aspects. Pharmcotherapeutic agents that are useful for chronic pruritus with comorbid depression and/or anxiety comprise selective serotonin reuptake inhibitors, mirtazapine, tricyclic antidepressants (amitriptyline and doxepin), and anticonvulsants (gabapentin, pregabalin); the role of neurokinin receptor-1 antagonists awaits verification. Antipsychotics are required for treating itch and formication associated with schizophrenia and delusion of parasitosis (including Morgellons disease).

Serotonin and interleukin-6: Association with pruritus severity, sleep quality and depression severity in Prurigo Nodularis

“…Like many chronic skin conditions PN is associated with various psychiatric conditions (Coş kun et al, 2005). Although there are no studies assessing sleep quality in relation to itching in PN, studies report that the severity of depression correlates well with the severity of pruritus (Chrostowska-Plak et al, 2013;Tey et al, 2013).…”

“…Whether this manifestation is primary or secondary to repeated traumatic manipulation due to chronic pruritus is still not known (Vaidya and Schwartz, 2008). Although reviews on PN frequently mention psychosomatic aspects, there is little empirical research concerning this subject (Tey et al, 2013;Schneider et al, 2014). Like many chronic skin conditions PN is associated with various psychiatric conditions (Coş kun et al, 2005).…”

The Effect of Pruritus and Pain on the Quality of Life

“…Her iki hastalık da somatoform hastalık grubu içerisinde değerlendirilmektedir. Bu çerçeveden bakıldığında her iki hastalık da birbiriyle yakın ilişkilidir ve "tıbben açıklanamayan fiziksel bulgular" olarak gruplandırılmaktadırlar (10).…”

Geschlechtsspezifische Unterschiede bei chronischem Pruritus

“…Verursacht wird der Pruritus nicht nur durch dermatologische, sondern auch durch internistische, neurologische oder auch psychische Erkrankungen. Häufi g entsteht bei den Betroffenen durch den Pruritus ein starker Leidensdruck, der mit Ängsten oder Depressionen einhergeht (Chrostowska-Plak/Reich/Szepietowski 2013; Gupta et al 1994;Gupta/Gupta 1998;Tey/Wallengren/Yosipovitch 2013). Patientinnen und Patienten, die an chronischem Pruritus leiden, haben häufi g ein negativeres Körperbild als Gesunde (Stumpf et al 2013a).…”