Psychosomatic factors in pruritus.

Abstract

Pruritus and psyche are intricately and reciprocally related, with psychophysiological evidence and psychopathological explanations helping us to understand their complex association. Their interaction may be conceptualized and classified into 3 groups: pruritic diseases with psychiatric sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Management of chronic pruritus is directed at treating the underlying causes and adopting a multidisciplinary approach to address the dermatologic, somatosensory, cognitive, and emotional aspects. Pharmcotherapeutic agents that are useful for chronic pruritus with comorbid depression and/or anxiety comprise selective serotonin reuptake inhibitors, mirtazapine, tricyclic antidepressants (amitriptyline and doxepin), and anticonvulsants (gabapentin, pregabalin); the role of neurokinin receptor-1 antagonists awaits verification. Antipsychotics are required for treating itch and formication associated with schizophrenia and delusion of parasitosis (including Morgellons disease).

• Authors: Hong Liang Tey, Joanna Wallengren, Gil Yosipovitch
• Journal: Clinics in dermatology (Clin Dermatol) 2013 Jan-Feb Vol. 31 Issue 1 Pg. 31-40 ISSN: 1879-1131 [Electronic] United States
• PMID: 23245971 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Adult
• Child
• Diagnosis, Differential
• Humans
• Pruritus (psychology)
• Psychophysiologic Disorders (complications)
• Psychotherapy (methods)
• Quality of Life
• Severity of Illness Index