INTRODUCTION

Owing to the same ectodermal embryonic origin, Skin and Nervous System share many similar connections throughout the life [1]. Prurigo nodularis (PN) is one of the common skin conditions which due to its chronicity and difficulty to respond to plethora of treatments available, poses a significant implications in the psychological aspect of living [2]. Emotional instabilities with chances in inflammatory markers like cytokines, neuropeptides etc can trigger or perpetuate the course of PN [3]. Although there are some evidences in the literature of having increased psychiatric morbidities like depression and anxiety among patients with Prurigo Nodularis, there is limited literature among Indian population [4–6]. This study was conducted to assess psychiatric comorbidities among patients of PN which helps for the comprehensive management including expertise from both the departments of psychiatry and dermatology.

MATERIAL AND METHODS

A cross sectional study was conducted in the department of dermatology in a tertiary care hospital, south India after the approval of ethical committee. All diagnosed patients of PN aged between 18-60 years, who visited dermatology outpatient department, irrespective of their gender were included in the study. This study was conducted during May 2021 to April 2022. Patients with significant medical illness or intellectually retarded are excluded from the study. Socio demographic details were entered in a semi structured format. Psychiatric morbidities were assessed using Mini international neuropsychiatric interview (MINI): It is a brief, validated and reliable structured diagnostic interview to assess psychiatric morbidities [7]. Data were analysed using Statistical Package for Social Sciences software, version 18.0 (SPSS) [8].

RESULTS

A total of 150 patients were included in the study. Out of which majority of 83 were males and rest 67 were females. Mean age for males was 32.2years. Mean years of education among males were 14±2 and for females were 9±3. A total of 67 males and 45 females were from joint family background and majority of 80 males and 60 females were married during the time of our study. 59 males and 57 females were from rural area of living and the rest from urban background (Table 1).

Table 1: Demographic features of study sample.

Social phobia was found to be higher in males (16.8%) and generalised anxiety disorder among females (16.4%) in our study sample. Major Depressive Disorder was found in 8.4% males and 7.4% in females. Whereas 2 of the males had somatisation disorder and majority of (61%) in both males and females didn’t had any psychiatric symptoms (Table 2).

Table 2: Psychiatric morbidities among patients with Prurigo Nodularis.

DISCUSSION

Psychiatric morbidities were found to be significantly higher in many patients of PN compared to general population. Similar findings were found in many of the studies in the literature [9–15]. Mean age in our study sample was 29.9 years. In many of the studies the mean age was found 10±2 years [12]. Generalised anxiety disorders were found among 27.2% in our study group and MDD in 15.8% which are in line with studies conducted. Hypochondriasis was found in 2.4% of PN patients in our study. Similarly in another study they found higher prevalence of alexithymia, hypochondriasis, anxiety and depression in patients of Prurigo Nodularis [12–16]. Smaller sample size and single centre study were one of the limitations in our study. As significant psychiatric morbidities were found in many patients of Prurigo Nodularis the importance of cross consultation is highlighted here in our study.

REFERENCES