Idiopathic pruritus in psychiatric inpatients: an explorative study

Pruritus is an annoying physical symptom, frequently related to mental states. Dermatologic treatment commonly includes psychotropic medications.

This study aimed to investigate idiopathic pruritus (IP) in psychiatric patients, its demographic characteristics and its relationship to psychiatric diagnoses, psychosocial stress, medication use, drug use and psychological characteristics.

The study population included 100 psychiatric inpatients. Study data were acquired by means of structured patient interview using standardized questionnaires.

IP was experienced by 42% of the subjects, 34% of the men and 58% of the women (P=.03). The presence of IP was found to be related to psychosocial stress with a prevalence of 48.5% among those without adequate social support and 29.5% among those with adequate social support (P=.02) and with a prevalence of 48.5% of those without regular employment and 16.7% among subjects who were employed (P=.01). A trend of reduced prevalence of IP (14%) was found among patients treated with tricyclic antidepressants compared with 48% of those treated with other antidepressants (P=.09). No significant correlation was found with other medications or psychiatric diagnoses. IP was found in 76% of regular users of opioids. IP was more frequent in patients with higher scores on the anger-trait measure (P=.02) and on the angry temperament measure (P=.02) and ruminative catastrophization (P=.04).

The high incidence of itching among psychiatric inpatients necessitates awareness of the treating psychiatrist to this potential discomfort. Examination, diagnosis and treatment when needed can relieve the physical symptoms, which may also have an emotional effect on the patient.