Co-morbidity between dermatologic diseases and psychiatric disorders in Papua New Guinea.
BACKGROUND
Neurodermatitis (now subdivided into lichen simplex chronicus and atopic dermatitis) was included among the psychosomatic disorders. Psychologic causes have been suggested for many skin conditions, such as urticaria, lichen simplex chronicus, atopic dermatitis, psoriasis, alopecia areata, and pruritus. The evidence for psychologic causation is neither strong nor convincing; however, psychiatric disorders are common among people with established skin diseases. Recent investigators have published data reporting co-morbidity between certain psychiatric disorders and skin diseases. The objective of the research was a prospective clinical study of 132 consecutive patients, who attended the dermatologic outpatient clinic of the Port Moresby General Hospital during 1992.


METHODS
The instrument for the study is the "Harding Self-Rating Questionnaire (SRQ) that has been demonstrated to work well as a gross screening instrument in the Urban Primary Health Care Clinic setting. The questionnaire was administered to 132 outpatients by one of the investigators (HM). Those patients who scored above the cut-off point of seven were referred to the second investigator (FYAJ) for examination of their mental state.


RESULTS
The results of the study showed all 132 patients were adults, aged between 16 and 75 years. There were 67/132 (50.75%) men and 65/132 (49.24%) women patients. The psychiatric diagnoses for the women patients were: normal variation 17/65, anxiety neurosis 11/65, and neurotic depression 37/65. For the men patients, the psychiatric diagnoses were: normal variation 21/67, anxiety neurosis 15/67, and neurotic depression 30/67. One man with psoriasis also presented with clinical features of schizophrenic psychosis.


CONCLUSIONS
The results of the study support the hypothesis, that there is a co-morbidity between some psychiatric disorders and some skin diseases.
Attah Johnson
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Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Boroko Papua.
Mostaghimi
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D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009450:Neurodermatitis / Q000453:epidemiology; D010219:Papua New Guinea / Q000453:epidemiology; D011446:Prospective Studies; D011565:Psoriasis / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D011602:Psychophysiologic Disorders; D012532:Scabies / Q000453:epidemiology; D012871:Skin Diseases / Q000453:epidemiology* / Q000523:psychology; D014504:Urban Health