Background: Empirical investigations examining the psychosocial distress and need for care of dermatology patients are rare. Little is known about the use of psychotherapeutic interventions in routine care. Objective: To evaluate the psychosocial distress of dermatological inpatients, the need for psychotherapeutic interventions and their realization in the framework of a psychosomatic liaison service. Methods: 86 patients from one unit at the University Dermatology Clinic in Freiburg underwent psychodiagnostic interviews and completed self-rating instruments, elucidating mental disorders, psychosocial distress, coping methods, quality of life, treatment motivation and psychotherapeutic interventions. Results: Using ICD-10 criteria, mental and behavioral disorders were diagnosed in 46%; most frequent were mood and anxiety disorders. Professional assessment indicated a need for psychotherapeutic treatment in 51%, while 28% of the patients wished for psychotherapy; actual intervention occurred in 38%. Conclusions: The need for psychotherapeutic treatment can only be handled within the framework of a liaison service in close collaboration with care givers.

Keywords:
Psychosocial distress, Consultation liaison service, Psychotherapeutic interventions
1.
Gupta MA, Gupta AK: Psychodermatology: An update. J Am Acad Dermatol 1996;34:1030–1046.
2.
Gupta MA: Dermatology; in Stoudemire A, Fogel B (ed): Psychiatric Care of the Medical Patient. Oxford, Oxford Press, 1993, pp 681–690.
3.
Koblenzer CS: Psychiatric syndromes of interest to dermatologists. Int J Dermatol 1993;32:82–88.
4.
Panconesi E, Hautmann G: Psychophysiology of stress in dermatology: The psychobiologic pattern of psychosomatics. Dermatol Clin 1996;14:399–421.
5.
Van Moffaert M: Psychodermatology: An overview. Psychother Psychosom 1992;58:125–136.
6.
Attah Johnson JF, Mostaghimi H: Co-morbidity between dermatologic diseases and psychiatric disorders in Papua New Guinea. Int J Dermatol 1995;34:244–248.
7.
Hughes JE, Barraclough BM, Hamblin LG, White JE: Psychiatric symptoms in dermatology patients. Br J Psychiatry 1983;143:51–54.
8.
Wessely SC, Lewis GH: The classification of psychiatric morbidity in attenders at a dermatology clinic. Br J Psychiatry 1989;155:686–691.
9.
Windemuth D, Stucker M, Hoffmann K, Altmeyer P: Prävalenz psychischer Auffälligkeiten bei dermatologischen Patienten in einer Akutklinik. Hautarzt 1999;50:338–343.
10.
White A, Horne DJ, Varigos GA: Psychological profile of the atopic eczema patient. Australas J Dermatol 1990;31:13–16.
11.
Faulstich ME, Williamson DA: An overview of atopic dermatitis: Toward a bio-behavioral integration. J Psychosom Res 1985;29:415–417.
12.
Al-Ahmar HF, Kurban AK: Psychological profile of patients with atopic dermatitis. Br J Dermatol 1976;95:373–377.
13.
Gupta MA, Gupta AK, Haberman HF: Psoriasis and psychiatry: An update. Gen Hosp Psychiatry 1987;9:157–166.
14.
Morse RM, Perry HO, Hurt RD: Alcoholism and psoriasis. Alcohol Clin Exp Res 1985;9:396–399.
15.
Söllner W, Zschocke I, Augustin M: Melanompatienten: Psychosozialer Stress, Krankheitsverarbeitung und soziale Unterstützung: Eine systematische Übersicht. Psychother Psychosom Med Psychol 1998;48:338–348.
16.
Tilkorn M, Mawick R, Sommerfeld S, Strittmatter G: Lebensqualität von Patienten mit malignen Gesichts- und Hauttumoren – Entwicklung eines Fragebogens und erste Ergebnisse einer Studie. Rehabilitation 1990;29:134–139.
17.
Augustin M, Zschocke I: Bedarf und Motivation zu psychosozialen Interventionen bei Patienten mit malignen Hauttumoren. Z Hautkr 1997;72:333–338.
18.
Söllner W, Mairinger G, Zingg-Schir M, Fritzsch P: Krankheitsprognose, psychosoziale Belastung und Einstellung von Melanompatienten zu unterstützenden psychotherapeutischen Massnahmen. Hautarzt 1996;47:200–205.
19.
Schaller CM, Alberti L, Pott G, Ruzicka T, Tress W: Psychosomatische Störungen in der Dermatologie – Häufigkeiten und psychosomatischer Mitbehandlungsbedarf. Hautarzt 1998;49:276–279.
20.
Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–370.
21.
Rief W, Hiller W, Heuser J: SOMS, das Screening für somatoforme Störungen: Manual zum Fragebogen. Bern, Huber, 1997.
22.
Muthny FA: FKV, Freiburger Fragebogen zur Krankheitsverarbeitung. Weinheim, Beltz, 1989.
23.
Bullinger M, Kirchberger I, von Steinbüchel N: Der Fragebogen Alltagsleben – ein Verfahren zur Erfassung der gesundheitsbezogenen Lebensqualität Alltagsleben. Z Med Psychol 1993;2:121–131.
24.
Margraf J: Mini-Dips – diagnostisches Kurz-Interview bei psychischen Störungen. Berlin, Springer, 1994.
25.
Malt UF, Huyse FJ, Herzog T, Lobo A. Rijssenbeek AJ: The ECLW Collaborative Study. III. Training and reliability of ICD-10 psychiatric diagnoses in the general hospital setting – An investigation of 220 consultants from 14 European countries. European Consultation Liaison Workgroup. J Psychosom Res 1996;41:451–463.
26.
Cooper B: Probleme der Falldefinition und der Fallfindung. Nervenarzt 1978;49:437–444.
27.
Snaith RP, Ahmed SN, Mehta S, Hamilton M: Assessment of the severity of primary depressive illness. Psychol Med 1971;1:143–149.
28.
Fava GA, Pilowsky I, Pierfederici A, Bernardi M, Pathak D: Depression and illness behavior in a general hospital: A prevalence study. Psychother Psychosom 1982;38:141–153.
29.
Stangier U, Gieler U: Somatoforme Störungen in der Dermatologie. Psychotherapie 1997;2:91–101.
30.
Levitan SJ, Kornfeld DS: Clinical and cost benefits of liaison psychiatry. Am J Psychiatry 1981;138:790–793.
31.
Lupke U, Ehlert U, Hellhammer D: Effekte psychologischer Behandlung im Allgemeinkrankenhaus: Verlaufsuntersuchung an Patienten mit Somatisierungsverhalten. Psychother Psychosom Med Psychol 1995;45:358–365.
32.
Strain JJ, Lyons JS, Hammer JS, Fahs M, Lebovits A, Paddison PL, Snyder S, Strauss E, Burton R, Nuber G, et al: Cost offset from a psychiatric consultation-liaison intervention with elderly hip fracture patients. Am J Psychiatry 1991;148:1044–1049.
© 2001 S. Karger AG, Basel
2001
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.