Psychocutaneous disorders: a survey study of psychiatrists' awareness and treatment patterns

To assess the level of training, awareness and attitude about psychocutaneous disorders among psychiatrists.

A mail-in survey was sent to all members of the Washington State Psychiatric Association and the Washington State Council on Child and Adolescent Psychiatry. Survey respondents were asked about demographic variables, level of training, skills, and degree of comfort in managing psychodermatological disorders, referral patterns, knowledge of patient and family resources on psychodermatology, and interest in continuing medical education on psychocutaneous disorders.

A total of 632 surveys were mailed and 223 were returned for analysis. Only 21% of psychiatrists reported a clear understanding of psychodermatology in terms of the interface between skin and the psyche. Twenty-two percent of the respondents reported being very comfortable in diagnosing and treating psychocutaneous disorders. Self-inflicted cutaneous lesions were reported as the most common psychiatric condition associated with a dermatologic component. Medication-related cutaneous rash was the most common diagnosis necessitating referral to dermatologists. About 90% of survey respondents were not aware of any patient or family resources on psychodermatology. Eighty-five percent of psychiatrists expressed interest in attending continuing medical education activities.

Results of this survey suggest that knowledge about the diagnosis, treatment and/or appropriate referrals of psychocutaneous disorders is lacking. Significant information gaps were also identified about the knowledge of patient or family resources on psychodermatological disorders. Incorporating formal training and didactics on psychodermatology in psychiatry residency programs and regularly occurring CME events are recommended. Psychiatry-dermatology liaison services will prove helpful in the management of these patients.