A survey assessment of the recognition and treatment of psychocutaneous disorders in the outpatient dermatology setting: how prepared are we?

Authors:
Nancy Keuthen
Nancy Keuthen
Massachusetts General Hospital
United States
Daniela Kroshinsky
Daniela Kroshinsky
Massachusetts General Hospital
United States
Alexa Boer Kimball
Alexa Boer Kimball
Harvard Medical School

J Am Acad Dermatol 2013 Jan 3;68(1):47-52. Epub 2012 Sep 3.

Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.

Background: Dermatologists provide the bulk of psychocutaneous care; however, recent studies suggest that dermatologists believe they are largely underprepared to treat most psychocutaneous conditions.

Objective: We sought to identify gaps in psychodermatologic knowledge among practicing dermatologists in two academic institutions.

Methods: An online survey was sent to 59 dermatologists at the Massachusetts General Hospital (Boston, MA) and Brigham and Women's Hospital (Boston, MA) from July 2010 through October 2011.

Results: The response rate was 40 of 59 (68%). More than 50% of dermatologists were comfortable making diagnoses for 8 of 10 psychocutaneous disorders. In all, 57% were comfortable making a diagnosis of depression. A total of 11% were comfortable starting antidepressants; 3%, antipsychotics; and 66%, medications for neuropathic pain. In all, 72%, 68%, and 21% of dermatologists never prescribe antidepressants, antipsychotics, or medications for neuropathic pain, respectively. Only 38% believed they were successful treating compulsive skin picking; 15%, body dysmorphic disorder; 27%, delusions of parasitosis; and 24%, depression.

Limitations: Limitations include small sample size, data extraction from an academic setting, self-reporting of outcome measures, and response bias.

Conclusion: Although the majority of the physicians surveyed believed they were capable of diagnosing psychocutaneous disease, very few were comfortable starting psychotropics or thought they were successful treating such conditions.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jaad.2012.04.007DOI Listing
January 2013
10 Reads

Publication Analysis

Top Keywords

antidepressants antipsychotics
8
neuropathic pain
8
medications neuropathic
8
psychocutaneous disorders
8
comfortable making
8
hospital boston
8
successful treating
8
comfortable starting
8
dermatologists
6
psychocutaneous
5
dermatologists comfortable
4
diagnoses psychocutaneous
4
extraction academic
4
making diagnoses
4
57% comfortable
4
diagnosis depression
4
depression total
4
size data
4
making diagnosis
4
disorders 57%
4

Similar Publications

The knowledge, awareness, and practice patterns of dermatologists toward psychocutaneous disorders: results of a survey study.

Int J Dermatol 2010 Jul;49(7):784-9

Department of Psychiatry & Behavioral Sciences, Division of Child & Adolescent Psychiatry, University of Washington School of Medicine, Seattle, WA, USA.

Background: To assess the level of training in, and awareness and attitude about, psychocutaneous disorders among dermatologists.

Methods: A mail-in survey was sent to all members of Washington State Dermatology Society, who were requested to provide information on demographic variables; level of training, skills, and degree of comfort in managing psychodermatologic disorders; referral patterns, knowledge of patient and family resources on psychodermatology; and interest in continuing medical education on psychocutaneous disorders.

Results: Of 237 mailed surveys, 102 were returned for analysis. Read More

View Article
July 2010

Use of psychotropic drugs in dermatology: unique perspectives of a dermatologist and a psychiatrist.

Clin Dermatol 2013 Jan-Feb;31(1):92-100

Department of Dermatology, University of California School of Medicine, San Francisco, 515 Spruce St, San Francisco, CA 94118, USA.

Psychocutaneous morbidity is commonly found in dermatologic practice. Patients generally refuse referral to psychiatry, and dermatologists cannot always provide psychotherapeutic support. By establishing an alliance with these patients and with working knowledge of the common psychotherapeutic agents used in dermatology, these patients can be managed comfortably by the clinician. Read More

View Article
June 2013

Psychocutaneous disorders: a survey study of psychiatrists' awareness and treatment patterns.

South Med J 2010 Dec;103(12):1199-203

Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Children's Hospital and Regional Medical Center, University of Washington School of Medicine, Seattle, WA, USA.

Objective: To assess the level of training, awareness and attitude about psychocutaneous disorders among psychiatrists.

Methods: A mail-in survey was sent to all members of the Washington State Psychiatric Association and the Washington State Council on Child and Adolescent Psychiatry. Survey respondents were asked about demographic variables, level of training, skills, and degree of comfort in managing psychodermatological disorders, referral patterns, knowledge of patient and family resources on psychodermatology, and interest in continuing medical education on psychocutaneous disorders. Read More

View Article
December 2010

Psychocutaneous drug therapy.

Semin Cutan Med Surg 2003 Sep;22(3):222-33

Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.

Many patients with skin disorders have psychosocial issues associated with their chief complaints. New psychotropic agents with superior side effect profiles have become available to allow nonpsychiatric physicians to manage psychiatric patients safely with psychotropic agents that are effective, simple to administer, and well tolerated. Dermatologists who wish to help their patients with psychodermatologic conditions can greatly enhance their therapeutic armamentarium by becoming familiar with the use of a few selected psychotropic agents. Read More

View Article
September 2003