European Journal of Dermatology

, Volume 28, Issue 3, pp 326–331 | Cite as

A screening programme for dermatologists as a guide to request psychological consultation in routine clinical practice

  • Annarita Panebianco
  • Francesca Sampogna
  • Maria Luisa Iemboli
  • Luciano Sobrino
  • Elisabetta Andreoli
  • Valeria Antinone
  • Cinzia Mazzanti
  • Damiano AbeniEmail author
Clinical Report



The psychosocial impact of skin conditions is usually evaluated in research settings.


To define predictors that can be used by dermatologists to refer patients for psychological consultation or psychotherapy using a simple screening instrument.

Materials & Methods

A questionnaire to evaluate possible anxiety and depression (12-item General Health Questionnaire [GHQ-12]) was routinely used over a period of two months in an Italian dermatological reference centre.


Of 651 patients, 508 (78%) completed the GHQ-12. Of the total sample, 35.2% scored 4 or more (psychological consultation suggested), and 15.7% scored 7 or more (psychological consultation recommended). Probable depression or anxiety was more frequent in women than in men, in patients born in foreign countries, and in patients with leg ulcers, pemphigoid, and psoriasis.


Our results indicate that a simple instrument may be useful for dermatologists to detect patients at risk of psychological problems and subsequently refer them for psychological consultation.

Key words

anxiety daily practice depression dermatology GHQ-12 psychology 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dalgard FJ, Gieler U, Tomas–Aragones L, et al. The psychological burden of skin diseases:a cross–sectional multicenter study among dermatological out–patients in 13 European countries. J Invest Dermatol 2015; 135: 984–91.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Picardi A, Amerio P, Baliva G, et al. Recognition of depressive and anxiety disorders in dermatological outpatients. Acta Derm Venereol 2004; 84: 213–7.CrossRefPubMedGoogle Scholar
  3. 3.
    APPGS. The psychological and social impact of skin diseases on people’s lives. London:HMSO, 2013.Google Scholar
  4. 4.
    Picardi A, Lega I, Tarolla E. Suicide risk in skin disorders. Clin Dermatol 2013; 31: 47–56.CrossRefPubMedGoogle Scholar
  5. 5.
    Goldberg D. The detection of psychiatric illness by questionnaire. London: Oxford University Press, 1972.Google Scholar
  6. 6.
    Picardi A, Abeni D, Pasquini P. Assessing psychological distress in patients with skin diseases:reliability, validity and factor structure of the GHQ–12. J Eur Acad Dermatol Venereol 2001; 15: 410–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Picardi A, Abeni D, Mazzotti E, et al. Screening for psychiatric disorders in patients with skin diseases:a performance study of the 12–item General Health Questionnaire (GHQ–12). J Psychosom Res 2004; 57: 219–23.CrossRefPubMedGoogle Scholar
  8. 8.
    Picardi A, Adler DA, Abeni D, et al. Screening for depressive disorders in patients with skin diseases:a comparison of three screeners. Acta Derm Venereol 2005; 85: 414–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Nijsten TE, Sampogna F, Chren MM, Abeni DD. Testing and reducing skindex–29 using Rasch analysis:Skindex–17. J Invest Dermatol 2006; 126: 1244–50.CrossRefPubMedGoogle Scholar
  10. 10.
    Mayer S, Teufel M, Schaeffeler N, et al. The need for psychooncological support for melanoma patients:central role of patients’ self–evaluation. Medicine (Baltimore) 2017;96(37):e7987.CrossRefGoogle Scholar
  11. 11.
    Hughes JE, Barraclough BM, Hamblin LG, White JE. Psychiatric symptoms in dermatology patients. Br J Psychiatry 1983; 143: 51–4.CrossRefPubMedGoogle Scholar
  12. 12.
    Kent G, Al’Abadie M. Psychologic effects of vitiligo:a critical incident analysis. J Am Acad Dermatol 1996; 35: 895–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Barth JH, Catalan J, Cherry CA, Day A. Psychological morbidity in women referred for treatment of hirsutism. J Psychosom Res 1993; 37: 615–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Buchhold B, Arnold A, Lutze S, et al. Psychosocial distress and desire for support among inpatients with skin cancer. J Dtsch Dermatol Ges 2017; 15: 791–9.PubMedGoogle Scholar
  15. 15.
    Cotterill JA, Cunliffe WJ. Suicide in dermatological patients. Br J Dermatol 1997; 137: 246–50.CrossRefPubMedGoogle Scholar
  16. 16.
    Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol 1998; 139: 846–50.CrossRefPubMedGoogle Scholar
  17. 17.
    Shah R, Bewley A. The importance of integrated psychological interventions and dedicated psychologists in dermatology. Clin Exp Dermatol 2014; 39: 428–30.CrossRefPubMedGoogle Scholar
  18. 18.
    Koblenzer CS. Psychotherapy for intractable inflammatory dermatoses. J Am Acad Dermatol 1995; 32: 609–12.CrossRefPubMedGoogle Scholar
  19. 19.
    Woodruff PW, Higgins EM, du Vivier AW, Wessely S. Psychiatric illness in patients referred to a dermatology–psychiatry clinic. Gen Hosp Psychiatry 1997; 19: 29–35.CrossRefPubMedGoogle Scholar
  20. 20.
    Fordham B, Griffiths CE, Bundy C. A pilot study examining mindfulness–based cognitive therapy in psoriasis. Psychol Health Med 2015; 20: 121–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Ehlers A, Stangier U, Gieler U. Treatment of atopic dermatitis:a comparison of psychological and dermatological approaches to relapse prevention. J Consult Clin Psychol 1995; 63: 624–35.CrossRefPubMedGoogle Scholar
  22. 22.
    Chen Y, Xin T, Cheng AS. Evaluating the effectiveness of psychological and/or educational interventions in psoriasis:a narrative review. J Dermatol 2014; 41: 775–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Renzi C, Abeni D, Picardi A, et al. Factors associated with patient satisfaction with care among dermatological outpatients. Br J Dermatol 2001; 145: 617–23.CrossRefPubMedGoogle Scholar
  24. 24.
    Lavda AC, Webb TL, Thompson AR. A meta–analysis of the effectiveness of psychological interventions for adults with skin conditions. Br J Dermatol 2012; 167: 970–9.CrossRefPubMedGoogle Scholar

Copyright information

© John Libbey Eurotext 2018

Authors and Affiliations

  • Annarita Panebianco
    • 1
  • Francesca Sampogna
    • 2
  • Maria Luisa Iemboli
    • 2
  • Luciano Sobrino
    • 3
  • Elisabetta Andreoli
    • 4
  • Valeria Antinone
    • 4
  • Cinzia Mazzanti
    • 5
  • Damiano Abeni
    • 2
    Email author
  1. 1.Health DirectorFondazione Luigi Maria Monti (IDI-IRCCS, FLMM)RomeItaly
  2. 2.Clinical Epidemiology UnitFondazione Luigi Maria Monti (IDI-IRCCS, FLMM)RomeItaly
  3. 3.Hospital Information SystemFondazione Luigi Maria Monti (IDI-IRCCS, FLMM)RomeItaly
  4. 4.Clinical Psychology UnitFondazione Luigi Maria Monti (IDI-IRCCS, FLMM)RomeItaly
  5. 5.1st Dermatological Clinic, Istituto Dermopatico dell’Immacolata - Istituto di Ricovero e Cura a Carattere ScientificoFondazione Luigi Maria Monti (IDI-IRCCS, FLMM)RomeItaly

Personalised recommendations