Systematic Review of Psychodermatologic Assessment Tools: Diagnostic Accuracy and Clinical Utility

Area of Science:

• Dermatology
• Psychiatry
• Psychometrics

Background:

• Primary psychodermatologic disorders present diagnostic challenges due to complex symptoms.
• Reliable screening tools are crucial for diagnosis and management but lack consensus.
• Existing tools often fail to capture the full symptom spectrum, including social impairment.

Purpose of the Study:

• To systematically review and assess the diagnostic accuracy and psychometric properties of screening tools for primary psychodermatologic disorders.
• To identify the most effective tools for conditions like body dysmorphic disorder, trichotillomania, and excoriation disorder.
• To highlight the need for standardized, multidimensional assessment instruments.

Main Methods:

• Systematic review of 81 studies utilizing 45 psychodermatologic tools.
• Assessment of psychometric properties: sensitivity, specificity, reliability, and validity.
• Empirical data on diagnostic accuracy was available from 13 studies.

Main Results:

• The Body Dysmorphic Disorder Questionnaire (BDDQ) demonstrated high accuracy (sensitivity 0.97, specificity 0.91).
• The Skin Picking Scale-Revised showed high accuracy for excoriation disorder (sensitivity 0.89, specificity 0.95).
• The Massachusetts General Hospital Hairpulling Scale for trichotillomania exhibited strong properties (sensitivity 0.90, specificity 0.72).

Conclusions:

• Several tools, including BDDQ, Skin Picking Scale-Revised, and MGH Hairpulling Scale, show promising diagnostic accuracy.
• Many current tools lack comprehensive assessment of social impairment and behavioral nuances.
• Development of standardized, multidimensional, and practical tools is essential for routine dermatology settings.