Screening for Psychiatric Disorders in Dermatological Settings: A Review of Clinically Useful Assessment Tools

The possibility of coexistence of dermatological diseases and psychiatric disorders has been proposed through a number of previous studies since considerable commonality in underlying pathophysiology including alteration in immune function, hormonal dysfunction, vulnerability to stress, patient-specific personality traits, genetic factors, and environmental factors, while the two clinical conditions share few similarities in phenomenology. From a diagnostic aspect, many dermatological disorders are frequently questioned to have comorbid psychiatric disorders, and dermatological delusions/preoccupations are even officially recognized among formal psychiatric disorders diagnosis criteria. Interestingly, academic terms such as "psychodermatology" and "psychocutaneous disease" are also commonly utilized in clinical practice. When comorbid psychiatric disorders are present but not recognized, patients may not receive timely and proper psychiatric intervention or psychosocial support, inadequate treatment and poor compliance to therapy may lead to failure of optimal treatment outcomes. Hence, proactive screening for comorbid or underlying psychiatric conditions can substantially enhance both treatment benefit and prognosis of dermatological diseases in routine clinical practice. However, it is very challenging for dermatologists without psychiatric training backgrounds to efficiently screen and diagnose psychiatric disorders in busy clinical settings. Thus, this review tries to provide dermatologists with simple, valid, and useful psychiatric rating scales for their routine practice.