j.1468-3083.2010.03609.x - DOI:...

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ORIGINAL ARTICLE Skin disorders in chronic psychiatric illness EJ Mookhoek, , PCM van de Kerkhof, § JEJM Hovens, , JRBJ Brouwers, AJM Loonen , , ** , * Department of Pharmacy, Division of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands Delta Psychiatric Centre, Poortugaal, The Netherlands § Department of Dermatology, Radboud University, Nijmegen, The Netherlands Inst. Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands **GGZ Westelijk Noord-Brabant, Bergen op Zoom, The Netherlands *Correspondence: AJM Loonen. E-mail : a.j.m.loonen@rug.nl Abstract Background Chronic psychiatric patients are prone to develop skin diseases. However, epidemiological data are scarce. Objective To describe the prevalence of skin complaints and dermatological disorders in residential psychiatric patients. Methods Ninety-one randomly chosen patients of the residential wards of a general psychiatric hospital completed a short, structured interview concerning skin disease and underwent a physical examination of the skin. Results Of the examined patients, 69% reported symptoms of skin disease in the month prior to the interview and 77% had skin disorders at physical examination. In 34 (37%) patients, skin disorders were diagnosed, which were not mentioned in the interview. Patients with diabetes had infectious skin disease more often than their fellow patients [odds ratio (OR) 10.9; 95% conFdence interval (CI): 2.40–49.75]. Moreover, overweight patients had infectious skin disease more often (OR 7.4; 95% CI: 1.38–39.3). Women reported more skin complaints (OR 6.4: 95% CI: 1.67–24.2), and also had skin problems other than infection, tumours or dermatitis more frequently (OR 3.7; 95% CI: 1.34–10.14). Clozapine use was associated with benign neoplasms of the skin. The nature of this association remains unclear and merits further investigation. Conclusions Many chronic psychiatric patients have skin problems. Clinical examination of the skin is important to discover these problems. Patients with diabetes mellitus are particularly at risk for skin infections. Because of their relationship with overweight and diabetes mellitus, atypical antipsychotics may be partly responsible for these serious complications. Only a few other relationships between psychiatric medication and speciFc skin problems were found. Received: 14 August 2009; Accepted: 14 January 2010 Keywords comorbidity, dermatology, diabetes mellitus, mental disorders, prevalence, skin diseases Confict oF interest None declared. Introduction In comparison with the general population, chronic hospitalized psychiatric patients (mostly diagnosed with schizophrenia or other psychotic disorders) are known to suffer from far more somatic comorbid conditions. 1,2 This results in higher mortality rates from both disease and unnatural causes like suicide and accidents.
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This note was uploaded on 10/08/2010 for the course PSY 3001w taught by Professor Stellmack during the Fall '10 term at Minnesota.

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j.1468-3083.2010.03609.x - DOI:...

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