title: Psychosomatic factors in pruritus.
abstract: Pruritus and psyche are intricately and reciprocally related, with psychophysiological evidence and psychopathological explanations helping us to understand their complex association. Their interaction may be conceptualized and classified into 3 groups: pruritic diseases with psychiatric sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Management of chronic pruritus is directed at treating the underlying causes and adopting a multidisciplinary approach to address the dermatologic, somatosensory, cognitive, and emotional aspects. Pharmcotherapeutic agents that are useful for chronic pruritus with comorbid depression and/or anxiety comprise selective serotonin reuptake inhibitors, mirtazapine, tricyclic antidepressants (amitriptyline and doxepin), and anticonvulsants (gabapentin, pregabalin); the role of neurokinin receptor-1 antagonists awaits verification. Antipsychotics are required for treating itch and formication associated with schizophrenia and delusion of parasitosis (including Morgellons disease).
authors.affiliation: Department of Dermatology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA.
authors.forename: Hong Liang
authors.initials: HL
authors.lastname: Tey
authors.forename: Joanna
authors.initials: J
authors.lastname: Wallengren
authors.forename: Gil
authors.initials: G
authors.lastname: Yosipovitch
mesh_terms: D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D011537:Pruritus / Q000523:psychology*; D011602:Psychophysiologic Disorders / Q000150:complications*; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D012720:Severity of Illness Index