Primary Psychiatric Diseases

Mercan, Sibel

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Primary Psychiatric Diseases [Turkderm-Turk Arch Dermatol Venereol]

Turkderm-Turk Arch Dermatol Venereol. 2010; 44(1): 16-24 | DOI: 10.4274/turkderm.44.s16

Primary Psychiatric Diseases

Sibel Mercan

The etiology of these dermatological diseases is entirely psychiatric origin. These patients show overconcern to their skin or self inflicted dermatoses unconsciously instead of facing with their real problems. In this group, delusions, dermatitis artefacta, trichotillomania, body dysmorphic disorder can be seen. They use denial as defence mechanism to their real psychiatric problems and prefer to apply dermatology instead of psychiatry. Dermatologist should be very careful before asking psychiatric consultation. Denial mechanism help patients to overcome agressive impulses like suicide or prevent further psychiatric damage like psychosis. Dermatologist should see these patients with short and frequent intervals with a good empathic approach. This will help to progress a powerful patient doctor relationship which will lead to a psychiatric evaluation.

Keywords: Psychosis, delusional parasitosis, dermatitis artefacta, trichotillomania, body dysmorphic disorder

Primer Psikiyatrik Hastal�klar

Sibel Mercan
�i�li Etfal E�itim Ve Ara�t�rma Hastanesi, Psikiyatri Klini�i, �stanbul, T�rkiye

Salt dermatolojik hastal�kla gelen bu grup hastalarda altta yatan neden t�m�yle psikiyatriktir. Bu hastalar bilin� d�� savunmalarla var olan psikiyatrik sorunlar�yla y�zle�mek yerine derileri ile a��r� u�ra� geli�tirirler ya da derilerine zarar verirler. Bu grupta del�zyonlar, artefakt dermatiti, trikotillomani, beden dismorfik bozuklu�u say�labilir. Bu hastalar her zaman dermatologlara ba�vurmakta, eylemi inkar etmekte ve sorunun psikiyatrik olabilece�i ger�e�ini kabul etmemektedirler. Bu yak�nmayla gelen hastalarda ger�ek sorunun psikiyatrik olabilece�i ger�e�i ile y�zle�tirmek, hastan�n inkar�n� y�karak �ncelikle psikiyatrik de�erlendirmeye y�neltmek intihar e�ilimi ya da a��r psikiyatrik tablolar ortaya ��kma olas�l�� nedeniyle sak�ncal�d�r. Dermatologlar bu grup vakalarda k�sa ve s�k dermatoloji g�r��meleri yaparak g��l� bir empatik yakla��mla onlarla iyi bir hasta hekim ili�kisi geli�tirmeli ve bu ili�ki zemininde psikiyatrik yard�ma y�neltmelidir.

Anahtar Kelimeler: Psikoz, del�zyonel parazitoz, artefakt dermatiti, trikotillomani, beden dismorfik bozuklu�u

Sibel Mercan. Primary Psychiatric Diseases. Turkderm-Turk Arch Dermatol Venereol. 2010; 44(1): 16-24

Corresponding Author: Sibel Mercan, T�rkiye

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