title: Psychosomatic assessment of skin diseases in clinical practice.
abstract: BACKGROUND
  Psychiatric disorders are frequent in dermatology patients, and many studies pointed out complex, mutual relationships between psyche and skin. Our aim was to provide a systematic psychosocial evaluation of a large and heterogeneous population of patients with skin diseases, including assessments of quality of life, psychiatric status according to the DSM-IV and psychological conditions with psychosomatic relevance according to established criteria (Diagnostic Criteria for Psychosomatic Research, DCPR).
  
  
  METHODS
  We studied 545 dermatological inpatients aged 18-65 years, free from dementia and cognitive impairment. They completed the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12) and were administered the SCID-I and the Structured Interview for Psychological Conditions of Psychosomatic Relevance by a trained mental health professional blinded to questionnaire scores.
  
  
  RESULTS
  Overall, 38% of patients received a DSM-IV diagnosis. The most common diagnoses were mood (20%) and anxiety disorders (16%); 48% of patients also received a DCPR diagnosis. The most common were demoralisation, irritable mood, type A behaviour and various forms of abnormal illness behaviour. Adjusting for gender, age, and education, the presence of DSM-IV or DCPR diagnoses was significantly associated with high scores on the GHQ-12 and on the Functioning and Emotions scales of the Skindex-29. Also, DCPR diagnoses were significantly associated with high scores on the Symptoms scale of the Skindex-29.
  
  
  CONCLUSIONS
  These findings highlight the high frequency of psychosocial problems in patients with skin disease and suggest that the joint use of DSM-IV and DCPR criteria may help identify those patients in whom psychiatric issues are worthy of increased clinical attention.
authors.affiliation: Dermatological Institute IDI-IRCCS, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.forename: Paolo
authors.initials: P
authors.lastname: Pasquini
authors.forename: Damiano
authors.initials: D
authors.lastname: Abeni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fassone
authors.forename: Eva
authors.initials: E
authors.lastname: Mazzotti
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Fava
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D003710:Demography; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011602:Psychophysiologic Disorders / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012871:Skin Diseases / Q000175:diagnosis* / Q000209:etiology*