Turk Tarek, Dytoc Marlene, Youngson Erik, Abba-Aji Adam, Mathura Pamela, Fujiwara Esther
12357 Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.
3146 Department of Dermatology and Venereology, Syrian Arab Red Crescent Hospital, Ministry of Health, Damascus, Syria.
J Cutan Med Surg. 2021 Jan-Feb;25(1):30-37. doi: 10.1177/1203475420952424. Epub 2020 Sep 3.
Psychodermatologic disorders are difficult to identify and treat. Knowledge about the prevalence of these conditions in dermatological practice in Canada is scarce. This hampers our ability to address potential gaps and establish optimal care pathways.
To provide an estimate of the frequencies of psychodermatologic conditions in dermatological practice in Alberta, Canada.
Two administrative provincial databases were used to estimate the prevalence of potential psychodermatological conditions in Alberta from 2014 to 2018. Province-wide dermatology claims data were examined to extract relevant International Classification of Disease codes as available. Claims were linked with pharmacy dispensation data to identify patients who received at least 1 psychoactive medication within 90 days of the dermatology claim.
Of 243 963 patients identified, 28.6% had received at least 1 psychotropic medication (mean age: 47.9 years; 67.5% female). Rates of concurrent psychotropic medications were highest for pruritus and related conditions (46.7%), followed by urticaria (44.5%) and hyperhidrosis (32.8%). Among patients with psychotropic medications, rates of antidepressants were highest (56.3%), followed by anxiolytics (37.1%). Across billing codes, besides hyperhidrosis (71.2%), diseases of hair (61.4%) and psoriasis (59.1%) had the highest rates of antidepressant dispensations. Patients with atopic dermatitis had the highest rates for anxiolytic prescriptions (54.3%).
In a 5-year window, more than a quarter of the identified dermatology patients in Alberta received at least 1 psychotropic medication, pointing to high rates of potential psychodermatologic conditions and/or concurrent mental health issues in dermatology. Diagnostic and care pathways should include a multidisciplinary approach to better identify and treat these conditions.
精神皮肤疾病难以识别和治疗。在加拿大皮肤科临床实践中，关于这些疾病患病率的知识匮乏。这阻碍了我们解决潜在差距并建立最佳护理途径的能力。
估计加拿大艾伯塔省皮肤科临床实践中精神皮肤疾病的发生频率。
利用两个省级行政数据库来估计2014年至2018年艾伯塔省潜在精神皮肤疾病的患病率。对全省范围内的皮肤科索赔数据进行检查，以提取可用的相关国际疾病分类代码。将索赔数据与药房配药数据相链接，以识别在皮肤科索赔后90天内至少接受过1种精神活性药物治疗的患者。
在识别出的243963名患者中，28.6%的患者至少接受过1种精神药物治疗（平均年龄：47.9岁；女性占67.5%）。瘙痒症及相关病症同时使用精神药物的比例最高（46.7%），其次是荨麻疹（44.5%）和多汗症（32.8%）。在使用精神药物的患者中，抗抑郁药的使用率最高（56.3%），其次是抗焦虑药（37.1%）。在所有计费代码中，除了多汗症（71.2%）外，毛发疾病（61.4%）和银屑病（59.1%）的抗抑郁药配药率最高。特应性皮炎患者的抗焦虑药处方率最高（54.3%）。
在5年的时间范围内，艾伯塔省超过四分之一的皮肤科确诊患者至少接受过1种精神药物治疗，这表明皮肤科潜在精神皮肤疾病和/或并发心理健康问题的发生率很高。诊断和护理途径应包括多学科方法，以更好地识别和治疗这些病症。
