Neurotic excoriations. A controlled psychiatric examination.

The investigation covers 68 patients with the primary form of neurotic excoriations (n.ex.) who within a 5 year period, 1974-78 had contact with the dermatology department, Odense University Hospital. The diagnosis was ascertained clinically - anamnestically, and by various laboratory examinations. The first 25 typical patients were matched with neurotic control patients (control group) who were homogeneous with regard to sex, age, level of intelligence, main personality traits (self-esteem, orderliness in a broad sense, hysterical traits), and level of invalidity. The primary psychiatric investigation contained a semistructured biographic interview lasting about 3 hours. N.ex. patients were on an average 42 years old at the time of reference to the dermatology department and most frequently in their 20s, 30s, and 40s. About 90% were women and only about 1/2 were married. Occupationally pensioners and workers dominated. Childhood seems on many levels to have been more discordant for n.ex. patients than for the control patients. Father and steady partners tended to have a lower social status in the n.ex. group than in the control group. A predominance of n.ex. patients lacked self-confidence (though possibly managed to mask it), were hypersensitive, meticulous or perfectionistic, suffered from sexual dysfunction. They were more reserved in contact situations than patients in the control group and often revealed no manifest need of psychiatric treatment. Significantly more in the n.ex. group than in the control group had a high level of energy and activity. There was a dominant tendency to depressive/dysphoric moods in the n.ex. group. Management of aggression was seldom without problems in both the n.ex. group and in the control group but aggressive explosions occurred with significantly greater frequency in the n.ex. group. A number of the patients in the n.ex. group described how their spouse's phlegmatism could violently irritate them. The same frequency for suicidal behaviour was found for both groups. The onset of the skin disease occurred at the average age of 30 years approximately; for 40% the outbreak could be described as "fresh" on approach to the dermatology department. Distressing factors preceding onset or recidivation after healing that were of significance for the patient were registered for about 90%.(ABSTRACT TRUNCATED AT 400 WORDS)