Psychosomatic aspects of psoriasis (review)

The review reflects the increased scientific interest in the psychosomatic aspects of psoriasis in the world literature in recent years. The studied material of the articles is structured according to the principles of the modern clinical psychosomatic approach. The introduction substantiates the relevance of studying this topic. The article considers the stress manifestations/examinations of psoriasis under the influence of psychosocial acute and chronic stress, including under the action of the COVID-19 pandemic; the quality of life and stigmatization of patients with psoriasis. The driving factors leading to the formation of nosogenic psychosomatic disorders are identified: common disfiguring rashes, itching, recurrent course, the threat of disability, social restrictions, constitutional premorbid features of patients. The description of comorbid mental disorders of the anxiety and affective range with a discussion of suicidal risk is presented. A separate section of the review is devoted to itching, as one of the most discussed aspects of psoriasis in the modern literature. Different points of view on the psycho-biological structure of itching in psoriasis are presented. Various factors related to the intensity, objective and subjective perception of itching are considered. Among them are the clinical form and severity of psoriasis, the localization and prevalence of rashes, gender, age, level of education, marital status of patients, concomitant somatic and mental diseases.

Delusional disorder and schizophrenia: a comparative study across multiple domains

BackgroundDelusional disorder (DD) is an under-researched condition and its relationship to schizophrenia (SZ) controversial. This study aimed to further characterize DD and to examine multi-domain evidence for the distinction between DD and SZ.MethodUsing univariate analyses we examined 146 subjects with DD, 114 subjects with paranoid SZ and 244 subjects with non-paranoid SZ on 52 characteristics from several domains including demographics, risk factors, premorbid features, illness characteristics, index episode features, delusional-related features, response to treatment and outcome. In a further step, we searched for independent associations of the examined characteristics with DD v. SZ.ResultsUnivariate analyses showed that DD differed from either form of SZ in 40 characteristics, the pattern of findings indicated that paranoid SZ was much more similar to non-paranoid SZ than DD. Relative to subjects with SZ, those with DD were more likely to have drug abuse before illness onset, better premorbid sexual adjustment, later age at illness onset, higher levels of affective symptoms and lack of insight, poorer response to antipsychotic medication, better functioning in the domains of personal care, paid work and social functioning; last, subjects with DD had fewer but more severe delusions and higher ratings of conviction of delusional experience than those with SZ. Predominance of jealousy and somatic delusions was confined to subjects with DD.ConclusionsDD and SZ represent two distinct classes of disorders, the differential features of DD being of nosological, aetiological and therapeutic relevance.

Distinctions of bipolar disorder symptoms in adolescence

Bipolar disorder in adolescents is a serious mental illness with problematic diagnosis that adversely affects social, academic, emotional, and family functioning. The objective of this study was to analyze features of premorbid and clinical symptoms, comorbidity, and course of bipolar disorder in adolescence. Data for analysis were collected from all case histories (N=6) of 14–18-year-old patients, hospitalized with diagnosis of bipolar disorder in theUnit of Children’s and Adolescents’ Psychiatry, Department of Psychiatry, Hospital of Kaunas University of Medicine, during the period from 2000 to 2005. Analysis of bipolar disorder course showed that five patients previously had been diagnosed with an episode of depression. The most frequent symptoms typical to bipolar disorder were disobedience and impulsive behavior, rapid changes of mood. The most common premorbid features were frequent changes of mood, being active in communication, hyperactive behavior. Adolescence-onset bipolar disorder was frequently comorbid with emotionally instable personality disorder, borderline type. Findings of the study confirm the notion that oppositional or impulsive behavior, rapid changes of mood without any reason, dysphoric mood and euphoric mood episodes with increased energy were cardinal symptoms of bipolar disorder with mania in adolescents. Most frequent premorbid features of these patients were quite similar to attention-deficit/hyperactivity disorder making differential diagnosis problematic.