Psychocutaneous Medicine Clinic: Wisconsin Experience.

Abstract

Psychocutaneous medicine, also known as psychodermatology, is a subspecialty of dermatology and psychiatry that explores the interactions between the skin and the brain. For many patients, skin disease affects their quality of life and mental well-being. For others, psychiatric problems exhibit skin signs. Little data are available from psychocutaneous clinics worldwide. The aim of our review is to advance clinical knowledge about psychocutaneous medicine and help bridge the current gap between dermatology and psychiatry. A total of 808 cases referred to our psychocutaneous clinic from 2002 to 2018 were reviewed. A specific code in the electronic health records allowed us to identify these patients. All the patients referred to the clinic were included in the study. The primary variable of interest was the patient's final diagnosis, as made by the psychiatrist. Patient demographics (age, sex, marital status), number of visits, and treatments were collected. Our data showed a high prevalence of skin picking disorder followed by depressive and anxiety disorders. Serious mental health disorders such as major depressive disorder and generalized anxiety disorder were common in our patients. Three-fourth of our patients were women. Skin picking was more prevalent in women, and alcohol dependence was more prevalent in men. No other significant gender differences in final diagnoses were found. 44.2% of patients needed one visit and were able to return to referring physicians for follow up. This is the largest collection of patients from a psychocutaneous clinic in the literature to date. Previous studies show that psychocutaneous clinics save health care dollars by decreasing the number of patient visits and improving the quality of life of patients with dermatologic problems. Introducing the results of this clinic could inform future integration of psychocutaneous clinics in dermatology practices and identify areas of need in training dermatology and psychiatry residents.