Psychotropic drugs in dermatology

Gupta, Madhulika A.; Gupta, Aditya K.; Haberman, Herbert F.

doi:10.1016/s0190-9622(86)70081-9

Cited by 36 publications

(9 citation statements)

References 46 publications

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“…This means that skin diseases should be viewed within the framework of psychosomatic and/or somatopsychic disorders. According to Gupta et al [1986], about 40% of skin diseases have a psychosomatic component. Based on the results presented here, it can be concluded that psychosocial factors play a role not only in individual diagnosis groups but must be included in diagnostic and therapeutic considerations of skin diseases in general.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Clinical Relevance of Psychosomatic Complaints in Skin Patients

Seikowski¹,

Reinwardt²

2004

Dermatol Psychosom

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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.

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Section: Discussionmentioning

confidence: 99%

Frequency and Clinical Relevance of Psychosomatic Complaints in Skin Patients

Seikowski¹,

Reinwardt²

2004

Dermatol Psychosom

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“…Of the tricyclic antidepressants, amitriptyline and imipramine, have also been found effective in treating the dysesthesias [16], cutaneous compulsions [35,38], and the dermatoses associated with depression [10,15,19,21]. In a patient who is unable to acknowledge an emotional component to the physical condition, however, the side effects may prejudice compliance.…”

Section: Antidepressantsmentioning

confidence: 99%

“…Doxepin has both powerful sedative and antihistamine effects, and, in doses of 10-50 mg at bed-time, is an effective antipruritic [10,19,21]. It may be particularly helpful in patients with dermographism and chronic urticaria [17].…”

Section: Antidepressantsmentioning

confidence: 99%

“…If symptom-relief is not achieved after a period of 4-6 weeks at a therapeutic dose, another drug of the same class may be substituted, or an adjunctive medication added, as indicated in the tables [10,14,15,19,21]. After the patient has remained symptom-free for a period of 6 months, attempts may be made to withdraw the drug very slowly.…”

Section: Treatment Coursementioning

confidence: 99%

“…Attempts on our part, then to refer the patient to psychiatry may be misunderstood and interpreted as incompetence or rejection. For this reason the dermatologist must be willing to assume the responsibility of prescribing if the patient is to receive appropriate and effective treatment [10,21]. Clearly, in order to do this safely, the dermatologist must be able to recognize psychiatric symptoms, and must be prepared to make both a dermatologic and a psychiatric diagnosis [10, 13-15, 19, 21].…”

mentioning

confidence: 99%

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The Use of Psychotropic Drugs in Dermatology

Koblenzer¹

2001

Dermatol Psychosom

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Conditions resulting from interaction between skin and psyche are not uncommon, and are often difficult to treat for the practicing dermatologist. This paper presents a simplified classification of these conditions, and reviews the general principles of treatment. Since both a psychiatric and a dermatologic diagnosis are necessary for effective treatment, psychiatric symptoms are tabulated for ready reference. The dermatologic aspects of these conditions are not described in detail, because these can be found in any standard dermatology text. The probable mechanisms of action of current antidepressant, anxiolytic, and antipsychotic drugs are reviewed, dosage schedules commonly used in dermatology are tabulated, and clinical indications in dermatologic patients outlined. The expectable long-term prognosis in the various patient groups is described.

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