Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Dermatology and Venereology, Syrian Arab Red Crescent Hospital, Ministry of Health, Damascus, Syria.
J Eur Acad Dermatol Venereol. 2022 Dec;36(12):2267-2278. doi: 10.1111/jdv.18478. Epub 2022 Aug 27.
The management of primary psychodermatologic disorders (PPDs) (i.e. psychiatric disorders with dermatologic presentation) is challenging. The scarceness of reported prevalence hinders the development of coordinated interventions to improve healthcare delivery. This review aimed to explore the global prevalence of PPDs. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Of the 4632 identified publications, 59 were included. Five PPDs were investigated from the included studies: delusional parasitosis (n = 9), skin picking disorder (n = 26), trichotillomania (n = 26), tanning dependence (n = 5) and repetitive nail biting (n = 6). Delusional parasitosis was rare in the general population (prevalence ranging from 0.0002% to 0.03%), with higher rates in psychiatric settings (outpatient = 0.5%; inpatient = 0.1%). Other pathologic or subclinical forms of PPDs had a minimum prevalence of 0.3% (median = 7.0%; mean = 17.0%). The distribution of the prevalence rates was highly skewed, with large differences based on the study setting (e.g. dermatologic settings, psychiatric settings, and general population). The most common condition was pathologic skin picking (prevalence, 1.2%-11.2%) in the general population. Its rates were higher in the psychiatric settings (obsessive-compulsive disorder, 38.5%; Tourette syndrome, 13.0%; body dysmorphic disorder, 26.8%-64.7%). The prevalence of trichotillomania in the general population ranged from 0.6% to 2.9%, while that of pathologic tanning and nail biting could not be ascertained as the studies were mainly in students (range; 12.0%-39.3% and 3.0%-10.1%, respectively). In conclusion, PPDs are common, especially in the dermatologic and psychiatric settings. Further population-based studies are needed to determine more accurate prevalence rates.
原发性精神皮肤病障碍（PPD）（即具有皮肤病表现的精神障碍）的管理具有挑战性。由于报告的患病率稀少，阻碍了协调干预措施的制定，以改善医疗保健服务。本综述旨在探讨 PPD 的全球患病率。综述按照系统评价和荟萃分析报告的首选项目进行。在确定的 4632 篇文献中，有 59 篇被纳入。从纳入的研究中调查了五种 PPD：妄想性寄生虫病（n=9）、皮肤搔抓障碍（n=26）、拔毛癖（n=26）、嗜晒癖（n=5）和重复性咬甲癖（n=6）。妄想性寄生虫病在普通人群中罕见（患病率在 0.0002%至 0.03%之间），在精神科环境中发病率更高（门诊患者为 0.5%；住院患者为 0.1%）。其他病理性或亚临床形式的 PPD 的最低患病率为 0.3%（中位数=7.0%；平均值=17.0%）。患病率的分布高度偏态，研究环境差异很大（例如皮肤科环境、精神科环境和普通人群）。最常见的疾病是普通人群中的病理性皮肤搔抓（患病率为 1.2%-11.2%）。在精神科环境中发病率更高（强迫症，38.5%；妥瑞氏症，13.0%；躯体变形障碍，26.8%-64.7%）。普通人群中拔毛癖的患病率为 0.6%至 2.9%，而病理性嗜晒和咬甲癖的患病率尚不确定，因为这些研究主要针对学生（范围分别为 12.0%-39.3%和 3.0%-10.1%）。总之，PPD 很常见，尤其是在皮肤科和精神科环境中。需要进一步进行基于人群的研究，以确定更准确的患病率。
