What Is the Relationship Between Psychiatric Disorders and Skin Disease?

Researchers found depression is frequently associated with psoriasis and atopic dermatitis, according to a descriptive-explorative and retrospective study published in Psychiatry Investigation.

More than 17,000 patients with primary psychiatric disorders were examined to determine if they exhibited dermatological comorbidities. Of the 1.24% (n = 212) of patients with primary mental disorders and an additional dermatological disease, psoriasis accounted for 35.4% of all dermatological disease, and atopic dermatitis was exhibited by 22.6% of patients.

In addition, researchers found infectious-parasitic skin diseases present in 13.2% of comorbid patients, and 42.5% of patients (n = 90) had a depressive illness, the most prevalent mental disorder in the study.

The second largest group (19.3%, n=41) consisted of patients with neurotic, stress-related and somatoform disorders, while 11.8% (n=25) of the comorbid patients had a disease from the spectrum of schizophrenia, schizotypal and delusional disorders.

There has been limited research conducted on the connection between psychiatric conditions and skin diseases. According to the researchers, “The complexity of the structure and the meticulous functions of both the skin and the central nervous system (CNS), but also the multiple interactions between them, complicate the investigation of pathological reactions and phenomena.”

In the current study, more than half of the patients who suffered depression had a recurrent depressive disorder (63.54%), and the majority of comorbid patients (66%) had an overall work impairment due to unemployment or retirement.

Along with psychiatric and dermatological diseases, 30% of patients in the comorbid cohort had cardiovascular disease, including arterial hypertension, and they exhibited diabetic metabolic states. The researchers found their results consistent with other studies, as “psoriasis, atopic dermatitis, and depressive disorders are among the most common chronic/chronic-recurrent skin and mental illnesses.”

The researchers note that due to small case numbers of individual subgroups, their results are not generalizable and cannot stand for the whole population of patients undrgoing psychiatric care. However, the results do “indicate a link between stress-related dermatoses and mental illness, especially with regard to the clarification of further predisposing factors that contribute to the development of comorbidities in some of the patients.”

Future studies could provide more insight into underlying pathogenic mechanisms of the relationship and may lead to relevant therapies.

Reference

Mavrogiorgou P, Mersmann C, Gerlach G, et al. Skin diseases in primary psychiatric disorders. Psychiatry Investig. 2020;17(2). doi: 10.30773/pi.2019.0193.