Obsessive-compulsive disorder in dermatology

Psychopathological symptoms in dermatology: A basic approach toward psychocutaneous disorders

Dermatological conditions impact not only an individual's physical body but also their psychological health. Similar to how cutaneous conditions can affect one's psychological health, worsening psychological conditions can exacerbate or even induce dermatological conditions. There are four common psychiatric pathologies typically found in dermatology practices: depressive symptoms, anxiety symptoms, obsessive-compulsive disorder behaviors, and psychosis. Common cutaneous disorders associated with these psychopathological symptoms include, but are not limited to, psoriasis, acne vulgaris, atopic dermatitis, urticaria, trichotillomania, excoriation disorder, and delusions of parasitosis. The goal of this review is to examine the relationship between these four psychopathological symptoms with common psychodermatological conditions and to help providers better diagnose and implement appropriate psychological support to treat their patients.

Understanding the experiences of anger in the onset and progression of psoriasis: A thematic analysis

Psoriasis is a chronic inflammatory skin condition, which can be affected by stress. Living with psoriasis can trigger negative emotions, which may influence quality of life. The present study explored the lived experiences of people with psoriasis with attention to the potential role of anger in the onset and progression of the chronic skin condition. Semi-structured qualitative interviews were conducted with 12 participants (n = 5 females, n = 7 males) recruited from an advert on a patient charity social media platform. Data were transcribed and analysed using thematic analysis. Four key themes were identified: (1) anger at the self and others, (2) the impact of anger on psoriasis: angry skin, (3) shared experiences of distress and (4) moving past anger to affirmation. Findings suggest that anger can have a perceived impact on psoriasis through contributing to sensory symptoms and unhelpful coping cycles, and points to a need for enhanced treatment with more psychological support. The findings also highlight the continued stigma which exists for those living with visible skin conditions and how this may sustain anger for those individuals. Future research could usefully focus on developing targeted psychosocial interventions to promote healthy emotional coping.

The Importance of Exploring the Role of Anger in People With Psoriasis

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When self-harm is about preventing harm: emergency management of obsessive-compulsive disorder and associated self-harm

Mental health staff may have limited exposure to emergencies associated with obsessive-compulsive disorder (OCD) during postgraduate training. The first time they encounter a person in the midst of severe obsessions, or one who has compulsively self-harmed in response to such obsessions, might be when working on call covering the emergency department. This educational article presents the lived experience of one of the authors as a clinical scenario. The scenario is then used to illustrate the severity of disability and the rates of self-harm and suicide-related mortality caused by OCD. The recognition and assessment of OCD is described, along with what helps in emergency situations. Written informed consent was obtained for the publication of clinical details.

Skin Picking Successfully Treated With Atomoxetine in Comorbid Skin Picking and Attention-Deficit/Hyperactivity Disorder: A Case Report

"Skin picking disorder" (SPD: also known as neurotic excoriation, psychogenic excoriation, or dermatillomania) is classified in the "obsessive-compulsive and related disorders" category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and characterized by unintentional, repetitive skin picking behaviors. Atomoxetine is a selective noradrenaline reuptake inhibitor used in the treatment of attention-deficit/hyperactivity disorder (ADHD). In this case report, we present a 9-year-old girl with the comorbid diagnosis of ADHD and SPD treated successfully with atomoxetine. To our knowledge, this is the first report of skin picking treated with atomoxetine in a patient with ADHD. We discussed possible explanations of mechanisms. Further studies are required on the effectiveness of atomoxetine for the treatment of SPD in the presence and absence of comorbid ADHD.

Atomoxetine Induced Skin Picking: A Case Report

"Skin picking disorder," also known as "dermatillomania" or "psychogenic excoriation," is classified in the "Obsessive Compulsive and Related Disorders" category in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and characterized by repetitive skin picking behaviors resulting in skin lesions. Atomoxetine (ATX) is a selective norepinephrine (noradrenaline) reuptake inhibitor commonly used in the management of attention-deficit/hyperactivity disorder. Atomoxetine is considered to increase levels of noradrenaline and dopamine by inhibiting norepinephrine transporters. In this case report, we present an 8-year-old male attention-deficit/hyperactivity disorder patient with skin picking behavior due to ATX treatment. We discussed possible explanations of skin picking behavior with ATX in the light of the current literature. To our knowledge, this is the first report of skin picking due to ATX in literature, and further studies are needed to investigate the frequency and mechanisms of skin picking with ATX.

Newly Developed Skin Picking After Methylphenidate Treatment in Attention Deficit Hyperactivity Disorder: Possible Mechanisms

Dermatillomania is characterized by excessive and repeated skin picking sufficient to damage cutaneous tissue, but with no underlying dermatological disease. The condition appears as an independent diagnosis in the Obsessive-Compulsive and Related Disorders category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A psychiatric pathology is generally reported to accompany this symptom. Attention deficit hyperactivity disorder (ADHD) is a potentially lifelong condition involving inattentiveness, hyperactivity, and impulsiveness. Attention deficit hyperactivity disorder is one of the most common childhood psychiatric disorders. Treatment includes medication, psychotherapy, and psychosocial therapies. Psychostimulants constitute the basis of treatment of children with ADHD worldwide. We describe a case of skin picking developing after methylphenidate therapy for ADHD. Possible explanations of methylphenidate and skin picking are reviewed in the light of the current literature.