Integrating dermatology and psychiatry: Clinical impact of dermatoses in hospitalized patients with mental illness

Background: Psychodermatology highlights the bidirectional interactions between psychiatric disorders and cutaneous diseases. Patients with severe mental illness are at increased risk of dermatological conditions due to neuro-immunological dysregulation, behavioral disturbances, inadequate hygiene, and psychotropic-related skin reactions.

Objectives: To assess the prevalence, types, and clinical correlates of dermatoses in patients followed in a hospital-based psychiatric service, and to identify determinants associated with these conditions.

Methods: A six-month prospective descriptive study was conducted in 2018 at the Psychiatry Department of the Military Hospital Moulay El Hassan, Guelmim. Fifty-six male patients with a confirmed DSM-5 psychiatric diagnosis and a dermatologist-validated dermatosis were included. Sociodemographic data, psychiatric diagnoses, dermatological characteristics, and medication profiles were recorded. Descriptive analyses and psychiatric–dermatological cross-tabulations were performed.

Results: All 56 participants were male, with a mean age of 35 years. In 83.4% of cases, the dermatological condition appeared after the onset of the psychiatric disorder. The most frequent psychiatric diagnoses were schizophrenia (38.9%), bipolar disorder (22.2%), anxiety disorders (22.3%), and major depression (16.6%). Infectious dermatoses predominated (47.2%), followed by inflammatory/immuno-allergic dermatoses (44.4%). One case of carbamazepine-induced drug eruption and one pressure ulcer were documented. Infectious dermatoses were markedly more frequent among psychotic patients, particularly those exhibiting poor hygiene, disorganized behavior, and low insight.

Conclusion: Dermatological comorbidities are highly prevalent in psychiatric patients, especially infectious and inflammatory conditions. An integrated dermatology–psychiatry model is essential for early detection, prevention, treatment optimization, and reduction of avoidable complications.