Erkrankungen der Haut bei primär psychischen Störungen

 

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Zusammenfassung

Somatische Erkrankungen sind bei psychischen Störungen in der klinischen Praxis häufig. Zahlreiche internationale Untersuchungen zeigen, dass Patienten mit einer psychischen Störung ein im Vergleich zur Allgemeinbevölkerung deutlich höheres Risiko aufweisen, z. T. schwere somatische Komorbiditäten zu entwickeln. Während das Wissen zu kardiovaskulären Komorbiditäten enorm gewachsen ist, sind die Zusammenhänge zwischen psychischen Störungen und Hauterkrankungen weniger bekannt, zumal bis heute nur wenige Untersuchungen dazu vorhanden sind und es zudem an Kenntnissen über entsprechende bedingende neurobiologische und immunologische Mechanismen fehlt. Dabei können Veränderungen und Erkrankungen der Haut oftmals ein (frühes) Zeichen für eine psychische Störung sein. Und andersherum sind bei psychiatrischen Patienten im Sinne einer guten somatischen Versorgung Hauterkrankungen frühzeitig und gut zu behandeln. Diese Übersicht thematisiert diejenigen dermatologischen Diagnosen, die im Zusammenhang mit primären psychiatrischen Erkrankungen wie psychotische Störungen, affektive Störungen oder Abhängigkeitserkrankungen stehen, und benennt die wichtigsten Aspekte bzgl. Epidemiologie, Symptomatik und möglicher Pathophysiologie.

Abstract

Somatic diseases in psychiatric disorders are frequently seen in clinical practice. Several international studies have shown that patients with a primary psychiatric disorder are at increased risk for developing severe somatic comorbidities in comparison to the normal population. Whereas there has been accumulation of knowledge on cardiovascular comorbidities, the relationship between skin and psychiatric disorders is less understood. There are only a few systematic studies on this subject and, in addition, there is lack of knowledge about underlying neurobiological and immunological mechanisms. Impairments and disorders of the skin are often an (early) sign of a psychiatric disorder. Somatic treatment of skin diseases should be initiated as early as possible in patients with psychiatric disorders. This review article focuses on dermatological diagnoses that are related to primary psychiatric disorders such as psychotic and affective disorders as well as addiction disorders, and presents the most important aspects of epidemiology, symptomatology and possible pathophysiology.

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