Citation

Gupta MA, Pur DR, Vujcic B, Gupta AK. Clin. Dermatol. 2017; 35(3): 302-311.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.clindermatol.2017.01.006

PMID

unavailable

Abstract

An assessment of suicidal behaviors in the dermatology patient may be necessary in several situations: (i) presence of psychiatric comorbidity (major depressive disorder, body dysmorphic disorder, substance use disorder, posttraumatic stress disorder) encountered in upto 30% of dermatology patients; (ii) when dermatologic symptoms ('dysmorphophobia', dermatitis artefacta) represent psychiatric pathology; (iii) when psychosocial stressors (bereavement, interpersonal violence) increase the risk of suicidal behavior and also exacerbate stress-reactive dermatoses (psoriasis, acne); (iv) in the presence of high disease burden (chronicity, increased disease severity); (v) in instances of significant pruritus or chronic sleep disruption; (vi) presence of facial lesions and/or facial scarring; (vii) when social exclusion and/or feelings of alienation arise secondary to the skin disorder; (viii) use of medications (retinoids, biologics) where suicidal behavior has been implicated as a possible side-effect; (ix) when treating psychiatric patients experiencing a serious reaction to psychotropic medications (eg.,Stevens-Johnson syndrome and anticonvulsants). Suicide risk must be assessed within a demographic context, as suicide rates rise rapidly in adolescents and young adults, among whom the prevalence of skin disorders associated with suicidal behaviors (acne, psoriasis, atopic dermatitis) is also high, and suicide rates are increasing among white men, who tend to be over-represented in dermatology clinical trials.

Language: en