Obsessive Compulsive Spectrum in Cosmetic dermatological patients and impact on their quality of life
Skin has a special place in psychiatry with its responsiveness to emotional stimuli and ability to express emotions such as anger, fear, shame and frustration and by providing self-esteem, the skin plays an important role in the socialization process, which continues from childhood to adulthood. Psycho-dermatology or Psycho-cutaneous medicine describes an interaction between dermatology and psychiatry.1 This domain of dermatology is not new, but has often received limited attention. A survey done to assess the awareness and attitude about this condition among dermatologists revealed a clear understanding of psycho-dermatology in only 18% of…show more content… It has been recorded that patients with depression suffer more from physical illness and patients with chronic illness suffer more often from major depressive illness, suggesting that the state of mind has a marked bearing not only on how an illness is perceived but also on its severity and content.4
Although there is no single universally accepted classification system of psycho-cutaneous disorders and many of the conditions are overlapped into different categories, the most widely accepted system is that devised by Koo and Lee. 5
Psychodermatology is divided into three categories according to the relationship between skin diseases and mental disorders (Fig.1)
I- Psychophysiologic (psychosomatic) disorders: caused by skin diseases triggering different emotional states (stress), but not directly combined with mental disorders (psoriasis, eczema).
II. Primary psychiatric disorders responsible for self-induced skin disorders (trichotillomania).
III. Secondary psychiatric disorders caused by disfiguring skin (Psoriasis, Vitiligo), which can lead to states of fear, depression or suicidal thoughts…show more content… Patients with psychiatric symptoms were further assessed by MINI for diagnosis of psychiatric disorders.
Generalized anxiety disorder (GAD) was the most prevalent 25 (24.8%) patients among the studied sample followed by OCD in 19 (18.8%) patients and other disorders distribution is as follow; past depressive episode 8 (7.9%), Substance use disorder 5 (6%), current depressive episode and panic each in 2 (3%) patients and lastly Bulimia was found in only 1 (2%) patient and suicidal risk as well 1 (2%).
Furthermore, the 19 OCD patients were further subjected to YBOCS table (4); the most common obsessions were contamination in 11 (57.9%), followed by somatic and aggression obsession each 5 (26.3%) patients and lastly sexual obsession in only 2 (10.5%). No religion or symmetry obsessions were detected among Group (I). The most common compulsions were cleaning in 9 (47.4%) patients, both checking and hoarding each detected in 7 (36.8%) patients and lastly each of collecting and arranging was in only 1 (5.3%) patient.
Table (4) YBOCS symptoms detection in Group I
Obsessions Compulsions
Type Number % Type Number
