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Anxiety, Depression, and OCD: Understanding Common Psychiatric Conditions in the Dermatological Patient

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Stress and Skin Disorders

Abstract

This chapter will focus on the psychiatric disorders most often seen in dermatological clinics which may complicate the assessment and treatment of dermatological conditions. Dermatologists are often the initial point of contact for psychocutaneous patients and, as such, the overarching aim for this chapter is to provide a practical overview on how to recognize and talk to patients with depressive, anxiety, and obsessive-compulsive disorders. The sections in this chapter are divided by DSM-based diagnoses. In each section, we first provide an overview of depressive, anxiety, and obsessive-compulsive and related disorders, respectively. We then focus on reviewing the changes introduced in the American Psychiatric Association’s DSM-5 as a means of clarifying how to identify and diagnose these disorders. We also provide a simple guide for the initial treatment of these disorders.

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References

  1. Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJ, Vos T, Whiteford HA. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med. 2013;10(11):e1001547.

    Article  PubMed  PubMed Central  Google Scholar 

  2. WHO | Depression. In: WHO. http://www.who.int/mediacentre/factsheets/fs369/en/. Accessed 6 Jan 2016.

  3. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095–105.

    Article  PubMed  Google Scholar 

  4. Pedersen CB, Mors O, Bertelsen A, Waltoft BL, Agerbo E, McGrath JJ, Mortensen PB, Eaton WW. A comprehensive nationwide study of the incidence rate and lifetime risk for treated mental disorders. JAMA Psychiatry. 2014;71:573–81.

    Article  PubMed  Google Scholar 

  5. Picardi A, Abeni D, Melchi CF, Puddu P, Pasquini P. Psychiatric morbidity in dermatological outpatients: an issue to be recognized. Br J Dermatol. 2000;143:983–91.

    Article  CAS  PubMed  Google Scholar 

  6. Hughes JE, Barraclough BM, Hamblin LG, White JE. Psychiatric symptoms in dermatology patients. Br J Psychiatry. 1983;143:51–4.

    Article  CAS  PubMed  Google Scholar 

  7. Fava M, Kendler KS. Major depressive disorder. Neuron. 2000;28:335–41.

    Article  CAS  PubMed  Google Scholar 

  8. Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatry. 2000;157(10):1552–62.

    Google Scholar 

  9. American Psychiatric Association, American Psychiatric Association, editors. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association; 2013.

    Google Scholar 

  10. Association AP, Association AP, et al. Highlights of changes from DSM-IV-TR to DSM-5. Arlingt. VA Am Psychiatr Assoc. 2013:1–19. http://www.dsm5.org/documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf

  11. Cuijpers P, Dekker JJM, Hollon SD, Andersson G, et al. Adding psychotherapy to pharmacotherapy in the treatment of depressive disorders in adults: a meta-analysis. J Clin Psychiatry. 2009;70(9):1219–29.

    Google Scholar 

  12. Cuijpers P, van Straten A, Warmerdam L, Andersson G. Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta-analysis. Depress Anxiety. 2009;26:279–88.

    Article  PubMed  Google Scholar 

  13. Schatzberg AF, Nemeroff CB. The American Psychiatric Publishing textbook of psychopharmacology. Washington, DC: American Psychiatric Pub; 2009.

    Book  Google Scholar 

  14. Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, Üstün TB, Wang PS. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc. 2009;18:23–33.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602.

    Article  PubMed  Google Scholar 

  16. Grant BF, Hasin DS, Stinson FS, Dawson DA, June Ruan W, Goldstein RB, Smith SM, Saha TD, Huang B. Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychol Med. 2005;35:1747–59.

    Article  PubMed  Google Scholar 

  17. Wittchen H-U, Zhao S, Kessler RC, Eaton WW. DSM-III-R generalized anxiety disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:355–64.

    Article  CAS  PubMed  Google Scholar 

  18. Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, Pickering RP, Kaplan K. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders. Alcohol Res Health. 2006;29:107–20.

    Google Scholar 

  19. Schatzberg AF, DeBattista C. Manual of clinical psychopharmacology. Washington, DC: American Psychiatric Publishing, a division of American Psychiatric Association; 2009.

    Google Scholar 

  20. Bystritsky A, Hovav S, Sherbourne C, Stein MB, Rose RD, Campbell-Sills L, Golinelli D, Sullivan G, Craske MG, Roy-Byrne PP. Use of complementary and alternative medicine in a large sample of anxiety patients. Psychosomatics. 2012;53:266–72.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Cases N. Fatal fulminant hepatic failure induced by a natural therapy containing kava. Med J Aust. 2003;178:442–3.

    Google Scholar 

  22. Kraft M, Spahn TW, Menzel J, Senninger N, Dietl KH, Herbst H, Domschke W, Lerch MM. [Fulminant liver failure after administration of the herbal antidepressant Kava-Kava]. Dtsch Med Wochenschr. 2001;126:970–2.

    Article  CAS  PubMed  Google Scholar 

  23. Clouatre DL. Kava kava: examining new reports of toxicity. Toxicol Lett. 2004;150:85–96.

    Article  CAS  PubMed  Google Scholar 

  24. Mannel M. Drug interactions with St John’s wort. Drug Saf. 2004;27:773–97.

    Article  CAS  PubMed  Google Scholar 

  25. Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessivecompulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15:53–63.

    Article  CAS  PubMed  Google Scholar 

  26. Huppert JD, Simpson HB, Nissenson KJ, Liebowitz MR, Foa EB. Quality of life and functional impairment in obsessive–compulsive disorder: a comparison of patients with and without comorbidity, patients in remission, and healthy controls. Depress Anxiety. 2009;26:39–45.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Fineberg NA, O’Doherty C, Rajagopal S, Reddy K, Banks A, Gale TM. How common is obsessive-compulsive disorder in a dermatology outpatient clinic? J Clin Psychiatry. 2003;64:152–5.

    Article  PubMed  Google Scholar 

  28. Demet MM, Deveci A, Taskin EO, Ermertcan AT, Yurtsever F, Deniz F, Bayraktar D, Ozturkcan S. Obsessive–compulsive disorder in a dermatology outpatient clinic. Gen Hosp Psychiatry. 2005;27:426–30.

    Article  PubMed  Google Scholar 

  29. Bloch MH, McGuire J, Landeros-Weisenberger A, Leckman JF, Pittenger C. Meta-analysis of the dose-response relationship of SSRI in obsessivecompulsive disorder. Mol Psychiatry. 2010;15:850–5.

    Article  CAS  PubMed  Google Scholar 

  30. Gava I, Barbui C, Aguglia E, Carlino D, Churchill R, De Vanna M, McGuire HF. Psychological treatments versus treatment as usual for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev. 2007;(2):CD005333.

    Google Scholar 

  31. OMIM PGS. Estimated lifetime prevalence of trichotillomania in college students. J Clin Psychiatry. 1993;54:72–3.

    Google Scholar 

  32. Woods DW, Flessner CA, Franklin ME, Keuthen NJ, Goodwin RD, Stein DJ, Walther MR. The Trichotillomania Impact Project (TIP): exploring phenomenology, functional impairment, and treatment utilization. J Clin Psychiatry. 2006;67:1877.

    Article  PubMed  Google Scholar 

  33. Sah DE, Koo J, Price VH. Trichotillomania. Dermatol Ther. 2008;21:13–21.

    Article  PubMed  Google Scholar 

  34. Keuthen NJ, Koran LM, Aboujaoude E, Large MD, Serpe RT. The prevalence of pathologic skin picking in US adults. Compr Psychiatry. 2010;51:183–6.

    Article  PubMed  Google Scholar 

  35. Odlaug BL, Grant JE. Clinical characteristics and medical complications of pathologic skin picking. Gen Hosp Psychiatry. 2008;30:61–6.

    Article  PubMed  Google Scholar 

  36. Wilhelm S, Keuthen NJ, Deckersbach T, Engelhard IM, Forker AE, Baer L, O’Sullivan RL, Jenike MA. Self-injurious skin picking: clinical characteristics and comorbidity. J Clin Psychiatry. 1999;60:454–9.

    Article  CAS  PubMed  Google Scholar 

  37. Koo J, Lebwohl A. Psycho dermatology: the mind and skin connection. Am Fam Physician. 2001;64:1873–8.

    CAS  PubMed  Google Scholar 

  38. McGuire JF, Ung D, Selles RR, Rahman O, Lewin AB, Murphy TK, Storch EA. Treating trichotillomania: a meta-analysis of treatment effects and moderators for behavior therapy and serotonin reuptake inhibitors. J Psychiatr Res. 2014;58:76–83.

    Article  PubMed  Google Scholar 

  39. Rothbart R, Amos T, Siegfried N, Ipser JC, Fineberg N, Chamberlain SR, Stein DJ. Pharmacotherapy for trichotillomania. Cochrane Database Syst Rev. 2013;(11):CD007662.

    Google Scholar 

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Correspondence to Josie Howard MD .

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Howard, J., Serrano, W.C. (2017). Anxiety, Depression, and OCD: Understanding Common Psychiatric Conditions in the Dermatological Patient. In: França, K., Jafferany, M. (eds) Stress and Skin Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-46352-0_3

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  • DOI: https://doi.org/10.1007/978-3-319-46352-0_3

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