Needs assessment survey of psychocutaneous medicine

Abstract

Psychocutaneous medicine studies the boundaries between skin and mind, and takes the unique approach of examining the patients in their biopsychosocial context. It can help patients with chronic skin problems cope with anxiety and the social stigma of their disease. Decreased psychologic stress can contribute to better treatment outcomes and be an important key to patient care. In addition, some primary psychiatric disorders may be expressed in the skin, such as delusions of parasitosis. A psychocutaneous specialist is well placed to treat these disorders. To assess the need for psychocutaneous medicine in dermatology, eighty-five attendees of the Wisconsin Dermatological Society (WDS) meeting were asked to complete a needs assessment survey. Forty-two percent of respondents felt that 30% of their patients would benefit from psychiatric interventions. In addition, 43% of respondents did not routinely inquire about mental health issues. When they did recognize psychiatric needs in a patient, 83% of responders did not feel comfortable prescribing psychotropic medications. Our data showed that about one-half of the members of WDS attending the meeting believed that a high percentage of their patients would benefit from psychocutaneous intervention. Moreover, it was found that the training during medical school and dermatology residency was insufficient for professionals to confidently prescribe psychotropic medications. Considering the fact that studies have shown psychiatric comorbidity in 30% of dermatologic diseases, and that many of the respondents who felt that their patients would not benefit from psychocutaneous intervention did not inquire about psychologic effects of skin disease in their patients, we conclude that psychocutaneous medicine is an under-recognized field in dermatology. Further evaluation of the demand for psychocutaneous clinics and their integration into daily dermatologic practices and residency training programs is needed.