Honorary Associate/fellow of Letter &Science/Integrative Biology UW Madison, Professor Emerita of the University of Wisconsin Madison, Madison, WI; Wisconsin Psychocutaneous Clinic, Middleton, WI.
J Acad Consult Liaison Psychiatry. 2021 Sep-Oct;62(5):522-527. doi: 10.1016/j.jaclp.2021.04.008. Epub 2021 May 8.
Psychocutaneous medicine, also known as psychodermatology, is a subspecialty of dermatology and psychiatry that explores the interactions between the skin and the brain. For many patients, skin disease affects their quality of life and mental well-being. For others, psychiatric problems exhibit skin signs.
Little data are available from psychocutaneous clinics worldwide. The aim of our review is to advance clinical knowledge about psychocutaneous medicine and help bridge the current gap between dermatology and psychiatry.
A total of 808 cases referred to our psychocutaneous clinic from 2002 to 2018 were reviewed. A specific code in the electronic health records allowed us to identify these patients. All the patients referred to the clinic were included in the study. The primary variable of interest was the patient's final diagnosis, as made by the psychiatrist. Patient demographics (age, sex, marital status), number of visits, and treatments were collected.
Our data showed a high prevalence of skin picking disorder followed by depressive and anxiety disorders. Serious mental health disorders such as major depressive disorder and generalized anxiety disorder were common in our patients. Three-fourth of our patients were women. Skin picking was more prevalent in women, and alcohol dependence was more prevalent in men. No other significant gender differences in final diagnoses were found. 44.2% of patients needed one visit and were able to return to referring physicians for follow up.
This is the largest collection of patients from a psychocutaneous clinic in the literature to date. Previous studies show that psychocutaneous clinics save health care dollars by decreasing the number of patient visits and improving the quality of life of patients with dermatologic problems. Introducing the results of this clinic could inform future integration of psychocutaneous clinics in dermatology practices and identify areas of need in training dermatology and psychiatry residents.
心理皮肤病学，也称为精神皮肤病学，是皮肤科和精神病学的一个分支，探索皮肤和大脑之间的相互作用。对于许多患者来说，皮肤病会影响他们的生活质量和心理健康。对于其他患者来说，精神问题则表现为皮肤症状。
全世界的心理皮肤科诊所的数据很少。我们的综述旨在增进对心理皮肤病学的临床认识，并帮助弥合皮肤科和精神病学之间目前的差距。
回顾了 2002 年至 2018 年期间我们的心理皮肤科诊所收治的 808 例患者。电子健康记录中的一个特定代码允许我们识别这些患者。所有被转诊到诊所的患者都包括在研究中。主要的感兴趣变量是精神科医生做出的患者最终诊断。收集了患者的人口统计学数据（年龄、性别、婚姻状况）、就诊次数和治疗方法。
我们的数据显示，皮肤搔抓障碍的患病率较高，其次是抑郁和焦虑障碍。严重的精神健康障碍，如重度抑郁症和广泛性焦虑症，在我们的患者中很常见。我们的患者中有四分之三是女性。女性中皮肤搔抓更为常见，而男性中酒精依赖更为常见。没有发现其他显著的性别差异在最终诊断。44.2%的患者只需就诊一次，就可以返回给转介医生进行后续治疗。
这是迄今为止文献中最大的一组心理皮肤科诊所患者。先前的研究表明，心理皮肤科诊所通过减少患者就诊次数和提高皮肤科问题患者的生活质量来节省医疗保健费用。介绍该诊所的结果可以为未来皮肤科实践中引入心理皮肤科诊所提供信息，并确定皮肤科和精神病学住院医师培训的需求领域。
