A descriptive study of clinical profile of psychiatric referrals from dermatology unit in a tertiary care center in north India

Abstract

Background: Psychological stress has been known to play an important role in initiation and maintenance of many dermatological illnesses, however there is lack of awareness among dermatologists regarding this. Aim: To study the pattern and prevalence of psychiatric referrals from dermatology OPD. Methods: The study was carried out jointly in dermatology and psychiatry department of D.M.C.H., Darbhanga, Bihar, North India. Sample was drawn from confirmed dermatology cases attending the dermatology OPD. Those patients who gave consent to participate in the study and scored above the desired cut off (>3) on GHQ-12 were sent for psychiatric evaluation. Socio-demographic data were collected and based on clinical interview and mental state examination, psychiatric diagnosis was made. Findings: As per ICD-10 criteria 24.5% of dermatology patients had a diagnosable psychiatric illness. Depressive disorder was the most common diagnosis seen in 27.8% patients (n=92), followed by anxiety disorder in 15.7% patients (n=52). Other diagnoses were; OCD (7.5%, n=25), adjustment disorder (6.9%, n=23), somatoform (8.7%, n=29), substance abuse (4.2%, n=14), psychosis (2.7%, n=9). No psychiatric diagnosis could be made in 26 patients (7.8%).Amongst the dermatological diagnosis, Psoriasis (19.3%) was the most common followed by Urticaria (13.3%). Conclusion: Patients with dermatological illnesses have a high prevalence of psychiatric morbidity. Awareness programmes would help in removing stigma towards psychiatric illness and would lead to holistic management of such patients.