Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
J Am Acad Dermatol. 2013 Jan;68(1):47-52. doi: 10.1016/j.jaad.2012.04.007. Epub 2012 Sep 3.
Dermatologists provide the bulk of psychocutaneous care; however, recent studies suggest that dermatologists believe they are largely underprepared to treat most psychocutaneous conditions.
We sought to identify gaps in psychodermatologic knowledge among practicing dermatologists in two academic institutions.
An online survey was sent to 59 dermatologists at the Massachusetts General Hospital (Boston, MA) and Brigham and Women's Hospital (Boston, MA) from July 2010 through October 2011.
The response rate was 40 of 59 (68%). More than 50% of dermatologists were comfortable making diagnoses for 8 of 10 psychocutaneous disorders. In all, 57% were comfortable making a diagnosis of depression. A total of 11% were comfortable starting antidepressants; 3%, antipsychotics; and 66%, medications for neuropathic pain. In all, 72%, 68%, and 21% of dermatologists never prescribe antidepressants, antipsychotics, or medications for neuropathic pain, respectively. Only 38% believed they were successful treating compulsive skin picking; 15%, body dysmorphic disorder; 27%, delusions of parasitosis; and 24%, depression.
Limitations include small sample size, data extraction from an academic setting, self-reporting of outcome measures, and response bias.
Although the majority of the physicians surveyed believed they were capable of diagnosing psychocutaneous disease, very few were comfortable starting psychotropics or thought they were successful treating such conditions.
皮肤科医生提供了大部分的皮肤心理治疗服务；然而，最近的研究表明，皮肤科医生认为他们在治疗大多数皮肤心理疾病方面准备不足。
我们旨在确定两所学术机构的皮肤科医生在心理皮肤病学知识方面的差距。
我们于 2010 年 7 月至 2011 年 10 月期间向马萨诸塞州总医院（波士顿，MA）和布莱根妇女医院（波士顿，MA）的 59 名皮肤科医生发送了一份在线调查。
回应率为 40/59（68%）。超过 50%的皮肤科医生对 10 种皮肤心理障碍中的 8 种有信心做出诊断。总的来说，57%的皮肤科医生有信心做出抑郁症的诊断。共有 11%的皮肤科医生有信心开始使用抗抑郁药；3%的人使用抗精神病药；66%的人使用治疗神经病理性疼痛的药物。总的来说，72%、68%和 21%的皮肤科医生分别从未开过抗抑郁药、抗精神病药或治疗神经病理性疼痛的药物。只有 38%的皮肤科医生认为他们在治疗强迫性皮肤搔抓方面取得了成功；15%的人认为他们在治疗躯体变形障碍方面取得了成功；27%的人认为他们在治疗寄生虫妄想症方面取得了成功；24%的人认为他们在治疗抑郁症方面取得了成功。
研究的局限性包括样本量小、从学术环境中提取数据、自我报告的结果测量以及应答偏倚。
尽管大多数接受调查的医生认为他们能够诊断皮肤心理疾病，但很少有医生愿意开始使用精神药物或认为自己能够成功治疗此类疾病。
