[Disorders of sweating in psychiatry]

During the past few years psychiatric research has focused its interest on the disorders of sweating: hyperidrosis and hypoidrosis/anhidrosis. Hyperhydrosis is the most commonly encountered in practice. In this situation, the total amount of sweat produced is greater than needed for thermoregulation. The disorders of sweating receive the research attention of many medical specialties. This trend is attributed to their high prevalence, their relation with many psychiatric disorders, their effects on the quality of life of patients, but also of the new therapeutic approaches that have been developed (the use of botulinum toxin, surgical methods, etc). Balancing among different suggestions for the treatment of hyperhidrosis, the psychiatrist must be thoughtful for the therapeutic approach. The cases of hypohidrosis and anhidrosis are less frequently mentioned, for which patients hardly ever complain. They are characterized by reduced sweating below the amount needed to cool down an elevated body temperature, or even absent sweating. They may constitute an urgent medical situation leading to hyperthermia and death. Overall, disorders in sweating may be caused by pharmaceutical or hormonal causes. Many pharmaceutical and psychotherapeutic methods have been used for treatment. Therefore, we believe it is useful for the clinical psychiatrist to keep in mind the psychiatric and psychological aspects of the disorders of sweating, and their impact on patient diagnosis, course and treatment.