Shah Bushra, Levenson James L
Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Clin Dermatol. 2018 Nov-Dec;36(6):748-755. doi: 10.1016/j.clindermatol.2018.08.012. Epub 2018 Aug 16.
Dermatologists often find themselves treating patients with psychiatric disorders, most commonly anxiety and depression, in the context of skin disease. The psychiatric condition may either be present before the skin condition developed and exacerbate it or, in some cases, even create it (eg, delusions of parasitosis). Alternatively, the psychiatric condition may occur subsequent to the development of the dermatologic condition. The treatment of psychodermatogic disorders requires collaboration between psychiatrists and dermatologists. Dermatologists should be able to recognize primary psychiatric disorders and refer patients to psychiatrists for appropriate treatment; however, the patient may encounter delays in accessing psychiatric care, and dermatologists should be familiar with the basic use of psychotropic drugs. This review describes common psychiatric disorders encountered in a dermatology practice and their treatment with psychotropic drugs. For each commonly used drug, dose range, side effects, and how to initiate and terminate treatment are described. Although psychotherapy is an important part of the treatment of most psychiatric disorders, we have limited our focus to psychotropic drugs in this review.
皮肤科医生常常发现自己在皮肤病的背景下治疗患有精神疾病的患者，最常见的是焦虑症和抑郁症。精神状况可能在皮肤病发展之前就已存在并使其恶化，或者在某些情况下，甚至引发皮肤病（例如，寄生虫妄想症）。另外，精神状况可能在皮肤病发展之后出现。精神皮肤病疾病的治疗需要精神科医生和皮肤科医生之间的合作。皮肤科医生应该能够识别原发性精神疾病，并将患者转介给精神科医生进行适当治疗；然而，患者在获得精神科护理方面可能会遇到延误，皮肤科医生应该熟悉精神药物的基本用法。这篇综述描述了皮肤科实践中遇到的常见精神疾病及其用精神药物的治疗方法。对于每种常用药物，都描述了剂量范围、副作用以及如何开始和终止治疗。虽然心理治疗是大多数精神疾病治疗的重要组成部分，但在本综述中我们将重点局限于精神药物。
