The Effect of Rapport on Psychocutaneous Patients’ Referral to Psychiatry Department

Abstract

Background: The skin described as the mirror of the mind. In primary psychocutaneous diseases patients have no primary skin disease and all of the cutaneous findings are self-induced. Establishing rapport has great effect on patient compliance and considered the initial and the most important step in the successful management of psychocutaneous patients. Aims: To highlight the role of rapport on the compliance of patients with primary psychocutaneous diseases to visit psychiatry department. Study Design:  Descriptive study. Place and Duration of Study: Center of Dermatology/Medical City in Baghdad,between December 2017- June 2018. Methodology: A total 47 patients with primary psychocutaneous diseases were enrolled in the study. Detailed history was taken from each patient with special attention to establish rapport. Referral to psychiatry department was offered to the patients emphasizing on the relationship between mental health and dermatological diseases. Results: A total of 47 patients diagnosed with primary psychocutaneous disorders were assessed and enrolled in this study. 37 were females and 10 were males with female to male ratio: 3.7:1. Age of patients ranged from (11-63) years with mean and standard deviation of   (37.978±15.597) years. The enrolled diseases and their frequency were: Neurotic excoriations 34%, dermatitis artefacta 21%, lichen simplex chronicus 19%, Prurigo nodularis 10.6%, trichotillomania 10.6% and delusion of parasitosis 4%. In the present study 72.3% of the enrolled psychocutaneous patients eventually accepted psychiatric referral. Conclusion: Primary psychocutaneous diseases are found to affect patients with a mean age 38 years and female preponderance, neurotic excoriations was the most common of these diseases.  Rapport building is very important in dealing with psychocutaneous patients and has a major role in improving referral rate to psychiatry department.