Zhou Stephanie, Mukovozov Ilya, Chan An-Wen
1 Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
2 Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
J Cutan Med Surg. 2018 Jan/Feb;22(1):44-50. doi: 10.1177/1203475417719045. Epub 2017 Jul 10.
Psychodermatology focuses on the interaction between skin and mental health. Existing research discusses the recognition and treatment of these disorders. However, little is known about the operational structure of subspecialised psychodermatology clinics.
To identify literature on the structure and logistics of delivering a psychodermatology service.
A systematic search of MEDLINE, PsycINFO, Embase, and Google Scholar was performed. Articles were included if they discussed the concept and organisation of a psychodermatology practice.
We identified 693 studies; after screening titles and abstracts, 35 full-text articles were assessed, and 17 were included in the scoping review. Most articles discussed aspects of clinic organisation in general; others discussed management of a clinic in the context of specific diseases or made recommendations on incorporating psychotherapeutic techniques in a solo practitioner setting. A weekly multidisciplinary clinic or resident teaching clinic with joint dermatologist-psychiatrist consultation is the most commonly reported model. Specifically, a stepped level of care approach is often used, where patients in increasing level of distress are stratified to the appropriate team of trained professionals. A corresponding curriculum to supplement practitioners' knowledge is recommended.
Various clinic models have been described to provide specialised psychodermatology care in specific settings. Research is needed to assess the impact of these multidisciplinary models of care on patient outcomes and health care costs.
心理皮肤病学专注于皮肤与心理健康之间的相互作用。现有研究探讨了这些疾病的识别与治疗。然而,对于专科心理皮肤病诊所的运营结构却知之甚少。
识别有关提供心理皮肤病服务的结构与后勤保障方面的文献。
对MEDLINE、PsycINFO、Embase和谷歌学术进行系统检索。如果文章讨论了心理皮肤病诊疗实践的概念和组织,则将其纳入。
我们共识别出693项研究;在筛选标题和摘要后,对35篇全文进行了评估,其中17篇纳入了范围综述。大多数文章总体上讨论了诊所组织的各个方面;其他文章则讨论了特定疾病背景下诊所的管理,或就个体执业环境中纳入心理治疗技术提出了建议。最常报道的模式是每周一次的多学科诊所或住院医师教学诊所,皮肤科医生和精神科医生联合进行会诊。具体而言,通常采用分级护理方法,将痛苦程度不断增加的患者分层到合适的专业训练团队。建议设置相应课程以补充从业者的知识。
已描述了各种诊所模式,以便在特定环境中提供专业的心理皮肤病护理。需要开展研究来评估这些多学科护理模式对患者结局和医疗保健成本的影响。