Chronic itching: "Is it really all in my head?"

The skin is one of the most common body organs involved in emotional disorders. There is now an entire field devoted to psychocutaneous disorders, which include both primary dermatologic disorders that are adversely affected by emotional distress and psychiatric illnesses that have symptoms focused on the skin as part of a delusion, hallucination, or disturbed thought process. Many skin conditions are chronic or recurring in nature, resulting in the need for ongoing coping skills to deal with symptom management, the need for treatment, physician visits, and the often embarrassing physical signs of skin disfigurement. Given the negative impact that chronic skin disease has on patients, physicians must be active in obtaining information about social, emotional, and mental health symptoms. In this Psychiatry Rounds column, Dr. Lantz discusses the importance of determining a possible relationship between psychological factors and skin disorders and provides resources for patients.