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Current Concepts in Psychodermatology

  • Complex Medical-Psychiatric Issues (MB Riba, Section Editor)
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Abstract

Several diagnoses in the new DSM-5 chapter on ‘Obsessive-Compulsive and Related Disorders’ directly relate to psychodermatology. The new excoriation (skin-picking) disorder (SPD) and trichotillomania (TTM) both manifest as recurrent body-focused repetitive behaviors that have compulsive and dissociative features, the latter being more prevalent in TTM than SPD. The DSM-5 refers to SPD and TTM occurring without full awareness or preceding tension, however does not specifically mention the possible role of dissociation. This has important treatment implications, as patients with high dissociative symptoms are not likely to respond to the standard treatments for obsessive-compulsive disorder. Body dysmorphic disorder (BDD), which is frequently associated with cutaneous body image (CBI) dissatisfaction, is present in 9 %-15 % of dermatology patients. Treatment guidelines in dermatology are increasingly considering the psychosocial morbidity related to CBI in their treatment outcome measures. The presence of BDD, if unrecognized, may therefore directly affect the dermatologic treatment regimens offered to the patient.

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Conflict of Interest

Madhulika A. Gupta and Aditya K. Gupta declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, 585 Springbank Drive, Suite 101, London, Ontario, N6J 1H3, Canada

    Madhulika A. Gupta

  2. Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada

    Aditya K. Gupta

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  1. Madhulika A. Gupta
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  2. Aditya K. Gupta
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Correspondence to Madhulika A. Gupta.

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This article is part of the Topical Collection on Complex Medical-Psychiatric Issues

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Gupta, M.A., Gupta, A.K. Current Concepts in Psychodermatology. Curr Psychiatry Rep 16, 449 (2014). https://doi.org/10.1007/s11920-014-0449-9

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