Department of Psychosomatics and Psychotherapy, University Hospital Münster, DE-48149 Münster, Germany.
Acta Derm Venereol. 2020 Mar 12;100(6):adv00075. doi: 10.2340/00015555-3424.
While psychological factors are relevant in many patients with chronic pruritus, not all patients can be offered psychologic, psychosomatic or psychiatric consultation. The aim of this exploratory study was to identify criteria suggestive of psychological factors relevant for the etiology of chronic pruritus and of somatoform pruritus. Routine data from the database of the Center for Chronic Pruritus of the University Hospital Münster were used, including the Neuroderm Questionnaire, Dermatology Life Quality Index and Hospital Anxiety and Depression Scale. Chronic pruritus patients (n = 3,391) without a psychiatric diagnosis in their medical history were compared to the 331 chronic pruritus patients with diagnoses of "psychological factors associated with etiology and course of chronic pruritus" (ICD-10:F54) or "somatoform pruritus" (F45.8) confirmed by an expert. The latter reported more pruritus triggers, especially "strain" and "emotional tension" and used more emotional adjectives to describe their pruritus. They reported more often scratching leading to excoriations, higher levels of pruritus, impairment of quality of life, anxiety and depression. These aspects suggest the presence of psychological factors in the etiology of chronic pruritus and somatoform pruritus. Prospective validation, however, needs to be carried out.
虽然心理因素与许多慢性瘙痒患者有关，但并非所有患者都可以提供心理、身心或精神科咨询。本探索性研究的目的是确定与慢性瘙痒和躯体形式瘙痒的病因相关的心理因素的提示性标准。使用了明斯特大学医院慢性瘙痒中心数据库中的常规数据，包括神经皮炎问卷、皮肤病生活质量指数和医院焦虑抑郁量表。将无既往病史中精神科诊断的 3391 例慢性瘙痒患者与 331 例经专家确诊为“与慢性瘙痒病因和病程相关的心理因素”（ICD-10：F54）或“躯体形式瘙痒”（F45.8）的慢性瘙痒患者进行比较。后者报告了更多的瘙痒诱因，特别是“压力”和“情绪紧张”，并用更多的情感形容词来描述他们的瘙痒。他们报告说搔抓导致更多的抓痕、更高的瘙痒程度、生活质量受损、焦虑和抑郁。这些方面表明慢性瘙痒和躯体形式瘙痒的病因中存在心理因素。然而，需要进行前瞻性验证。
