ABSTRACT
Psychogenic itch can be defined as "an itch disorder where itch is at the center of the symptomatology and where psychological factors play an evident role in the triggering, intensity, aggravation, or persistence of the pruritus." The disorder is poorly known by both psychiatrists and dermatologists and this review summarizes data on psychogenic itch. Because differential diagnosis is difficult, the frequency is poorly known. The burden is huge for people suffering from this disorder but a management associating psychological and pharmacological approach could be very helpful. Classification, psychopathology, and physiopathology are still debating. New data from brain imaging could be very helpful. Psychological factors are known to modulate itch in all patients, but there is a specific diagnosis of psychogenic itch that must be proposed cautiously. Neurophysiological and psychological theories are not mutually exclusive and can be used to better understand this disorder. Itch can be mentally induced. Opioids and other neurotransmitters, such as acetylcholine and dopamine, are probably involved in this phenomenon.
Subject(s)
Pruritus , Psychophysiologic Disorders , Somatoform Disorders , Humans , Pruritus/classification , Pruritus/diagnosis , Pruritus/physiopathology , Pruritus/therapy , Psychophysiologic Disorders/classification , Psychophysiologic Disorders/diagnosis , Psychophysiologic Disorders/physiopathology , Psychophysiologic Disorders/therapy , Somatoform Disorders/classification , Somatoform Disorders/diagnosis , Somatoform Disorders/physiopathology , Somatoform Disorders/therapyABSTRACT
Psychogenic excoriations are also called neurotic excoriations, dermatillomania or skin picking syndrome. We proposed diagnostic criteria and then performed a study of the psychiatric profiles of outpatients with psychogenic excoriations and the circumstances around the creation of these excoriations. Although the results must be interpreted with caution because the study was performed with only 10 patients, interesting data is provided about the onset of psychogenic excoriations, the behaviour of picking, and comorbidity. Common or specific characteristics were identified according to type of case. The majority of patients associated first excoriations with personal problems. Four patients reported abuse in childhood or adolescence. This study confirms that skin picking is an impulsive reaction and does not belong to the obsessive-compulsive disorders: impulsivity is defined by ineffective or failing control resulting in uninhibited behaviour.
Subject(s)
Neurotic Disorders/diagnosis , Psychiatric Status Rating Scales , Self-Injurious Behavior/diagnosis , Skin Diseases/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child Abuse/psychology , Comorbidity , Female , France , Humans , Impulsive Behavior/diagnosis , Impulsive Behavior/psychology , Inhibition, Psychological , Male , Middle Aged , Neurotic Disorders/epidemiology , Neurotic Disorders/psychology , Predictive Value of Tests , Self-Injurious Behavior/epidemiology , Self-Injurious Behavior/psychology , Skin Diseases/epidemiology , Skin Diseases/psychology , Surveys and QuestionnairesABSTRACT
Functional itch disorder or psychogenic pruritus is a poorly defined diagnosis. This paper sets out the proposed diagnostic criteria of the French Psychodermatology Group (FPDG). There are three compulsory criteria: localized or generalized pruritus sine materia, chronic pruritus (>6 weeks) and the absence of a somatic cause. Three additional criteria from the following seven items should also be present: a chronological relationship of pruritus with one or several life events that could have psychological repercussions; variations in intensity associated with stress; nocturnal variations; predominance during rest or inaction; associated psychological disorders; pruritus that could be improved by psychotropic drugs; and pruritus that could be improved by psychotherapies.