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Psychodermatology: Challenges, Prevalence and Therapeutic Options
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- Author / Creator
- Turk, Tarek
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Psychodermatology is specialized field of medicine that encompasses the skin-mind interaction and the conditions associated with it. Psychodermatology poses ongoing challenges for healthcare practitioners. There are notable gaps in knowledge that impede clinicians' ability to provide comprehensive treatment within this niche area. These include the inadequacy of specialized services mainly stemming from the scarcity of prevalence data, the lack of clinical trials and guidelines discerning treatment options, and referral system complications. To address these gaps, this thesis aimed to enhance our comprehension of the prevalence and treatment of psychodermatologic conditions and identify the challenges faced by dermatologists in their management.
The research objectives encompassed four distinct studies. Firstly, the thesis sought to estimate the frequency of psychodermatologic conditions in Alberta, Canada. To achieve this, a chart review was conducted on administrative health data to determine the prevalence of these conditions in dermatology clinics. The findings revealed that 28.6% of patients visiting dermatology clinics were concurrently dispensed psychotropic medications, indicating a potential presence of psychodermatologic conditions. This study provided a valuable estimation of the prevalence of these conditions in the region, shedding light on the potential burden they place on both the healthcare system and the population.
The second study, conducted through a systematic review, aimed to explore the global prevalence of primary psychodermatologic conditions (PPDs). The scarcity of existing data in this area necessitated a comprehensive analysis to gather and evaluate the available literature. The study highlighted that the pathologic and subclinical forms of primary psychodermatologic conditions had a minimum prevalence of 0.3%, and the most common condition in the general population was pathologic skin picking, with a prevalence range of 1.2% to 11.2%. These findings underscored the wide-ranging prevalence of psychodermatologic conditions and emphasized the need for further research to better understand their true burden on populations worldwide.
The third study aimed to investigate the efficacy of pharmacologic interventions in managing PPDs. Through a comprehensive analysis of existing literature and clinical trials, the study aimed to discern the effectiveness of various therapeutic options available to healthcare practitioners. The study mapped out seven distinct classes of pharmacologic interventions and evaluated their effectiveness across five psychodermatologic conditions. This investigation provided valuable insights into which medications showed more promising effectiveness for specific conditions, facilitating more informed treatment decisions for clinicians. The study also highlighted the existing gaps in evidence/
Finally, to gain a deeper understanding of the challenges faced by dermatologists when treating psychodermatologic conditions, the fourth study involved surveying Canadian dermatologists' perceptions, practice patterns, and difficulties encountered in their clinical practice. The results indicated that most dermatologists had less than optimal comfort levels in managing these conditions and initiating psychopharmacological therapy. A majority of dermatologists advocated for a multidisciplinary approach. The study also emphasized the importance of more training opportunities for residents and specialists to better equip healthcare providers in managing psychodermatologic conditions effectively. The research outcomes from the four studies led to the establishment of a multidisciplinary psychodermatology clinic at Kaye Edmonton Clinic in Alberta, Canada, the Skin Health Clinic (Psychodermatology). Preliminary findings from the clinic's first year of operation (2021-2022) revealed valuable insights into patient demographics, diagnoses, and treatment modalities.
In conclusion, this thesis presents a comprehensive exploration of psychodermatology, shedding light on the prevalence, treatment options, and challenges faced by healthcare practitioners. The findings highlight the potential benefits of a multidisciplinary approach to improve patient care. Through continued research and integration of mental health support, the field of psychodermatology can further advance and enhance the overall well-being and outcomes of patients with psychodermatologic conditions. -
- Graduation date
- Spring 2024
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- Type of Item
- Thesis
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- Degree
- Doctor of Philosophy
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- License
- This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.