Schneider G, Gieler U
Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster, Münster, Germany.
Z Psychosom Med Psychother. 2001;47(4):307-31.
Based on the current literature, the paper gives an overview of the state of knowledge in psychosomatic dermatology. The authors propose the following classification: (1.) Dermatologic problems as a consequence of psychic disorders (e.g. factitious disorder, trichotillomania, dysmorphophobia, delusions of parasitosis etc.); (2.) Multifactorial dermatologic disorders, which can be substantially influenced by psychological factors (e.g. atopic dermatitis, psoriasis, chronic urticaria etc.); (3.) Psychic disorders developing as a consequence of disfiguring or life-threatening dermatoses (e.g. adjustment disorder, depressive disorder, anxiety disorder); (4.) Comorbidity with other psychiatric disorders. Psychosomatic dermatology developed from an anecdotal initial stage to more systematic research with larger numbers of patients, employing control groups and psychometric instruments. During the last decade, research focused on psychophysiological and psychoneuroimmunological mechanisms which influence dermatologic disorders. This course of development and the current state of knowledge are presented for atopic dermatitis and psoriasis.
基于当前文献,本文概述了心身皮肤病学的知识现状。作者提出以下分类:(1)作为精神障碍后果的皮肤病问题(例如做作性障碍、拔毛癖、畸形恐惧症、寄生虫妄想症等);(2)多因素皮肤病,可受到心理因素的显著影响(例如特应性皮炎、银屑病、慢性荨麻疹等);(3)因毁容性或危及生命的皮肤病而产生的精神障碍(例如适应障碍、抑郁症、焦虑症);(4)与其他精神障碍的共病。心身皮肤病学从最初的轶事阶段发展到对更多患者进行更系统的研究,采用对照组和心理测量工具。在过去十年中,研究集中在影响皮肤病的心理生理和心理神经免疫学机制上。本文针对特应性皮炎和银屑病介绍了这一发展过程和当前的知识状态。