A Prospective Cohort Study on Clinical Outcomes, Psychiatric Comorbidity Burden, and Treatment Response in Psychodermatological Disorders.
Keywords:
psychodermatology, psychocutaneous disorders, integrated care, psychiatric comorbidity, treatment outcomes, psoriasis, depression, anxiety, multidisciplinary care, skin-brain axisAbstract
Background: Psychodermatological disorders represent the intersection of psychiatry and dermatology, yet integrated care models remain underutilised and poorly evaluated. The prevalence of psychiatric comorbidity in dermatological populations is substantial, but prospective data on treatment outcomes in combined care settings are limited [4, 5].
Objective: To evaluate clinical outcomes, psychiatric comorbidity burden, and treatment response in patients managed through a combined psychiatry-dermatology clinic.
Methods: A prospective cohort study was conducted at a tertiary care combined clinic between January 2021 and December 2022. Consecutive adult patients (N = 150) underwent standardised dermatological (PASI, EASI, IGA) and psychiatric (MINI, HADS, GHQ-12) assessments at baseline, 6 months, and 12 months. Treatment comprised individualised dermatological therapy, psychotropic medications, and/or psychological interventions. The primary outcome was treatment response at 12 months (≥50% reduction in disease severity + ≥3-point HADS reduction). Logistic regression identified predictors of response.
Results: Psychiatric comorbidity was present in 72.0% of patients (depression: 44.7%; anxiety: 34.7%). At 12 months, 67.9% achieved the primary outcome. Significant improvements were observed in PASI (14.6 to 6.2, p < 0.001), EASI (18.2 to 7.8, p < 0.001), HADS (16.4 to 7.4, p < 0.001), and DLQI (14.2 to 7.8, p < 0.001). Treatment adherence (OR = 3.42, p < 0.001) and combined pharmacopsychological intervention (OR = 2.18, p = 0.007) predicted response.
Conclusions: Combined psychiatry-dermatology care produces substantial improvements in dermatological severity, psychiatric symptoms, and quality of life. These findings support wider implementation of integrated care models for psychocutaneous disorders..
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