[Personality of patients with dermatologic artefacts]

35 female patients with dermatological artefacts being treated in the University Skin Clinic Basel have been investigated by a dermatologist, a psychiatrist, and a psychologist. The testpsychological examination with the Color Pyramid Test and the Rosenzweig Picture-Frustration Test yielded a striking uniform picture: The patients showed strong intrapsychic tension, severe depressivity, inhibition of aggression, affective inhibition, low frustration tolerance, weak ego-integration (with tendencies to break outs of impulses) and autoaggressive tendencies. These results point to a depressive and schizoid-narcissistic personality-structure. The manipulations at the skin have different functions: by causing pain to themselves the patients try to feel their body-boundaries and to avoid fragmentations in the body-self; on the tactile level emotional experiences of early childhood should be (re)-activated; the artefact should draw the attention of the surroundings to the emotional suffering of the patient. Concerning therapy, it is important that the doctor to whom the patients come first is ready to offer therapeutic talks. In these discussions the situation in which the artefact was done, with its psychodynamic background, should be explored and the therapist should help the patient to find other ways than artefacts to articulate his needs.