Management of the Psychological Comorbidities of Dermatological Conditions: Practitioners' Guidelines

The document from April 1, 2017, provides comprehensive guidelines for dermatologists on the management of psychological comorbidities in patients with skin conditions. It underscores the high prevalence of psychiatric disorders in these patients and their significant impact on quality of life. Dermatologists are encouraged to use screening tools like the Beck Depression Inventory-II, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 to identify psychological distress. The Dermatology Life Quality Index is recommended to assess the impact of skin diseases on patients' lives. The guidelines suggest that dermatologists can manage some psychiatric issues due to their frequent lack of access to psychiatrists, by learning basic management strategies and having open discussions with patients. Pharmacological treatments for anxiety include benzodiazepines for short-term use, buspirone for generalized anxiety disorder, and SSRIs. For depression, doxepin, SSRIs, SNRIs, and St. John's wort are discussed. Atypical antipsychotics are recommended for Delusional Infestation, with a focus on minimizing side effects and careful patient monitoring. Motivational interviewing is suggested to encourage medication adherence, and N-acetylcysteine is mentioned as a treatment for trichotillomania. The document emphasizes the need for integrated care and the role of dermatologists in addressing the psychological aspects of skin conditions to improve patient outcomes.