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Pruritus Diagnosis Tied to Psychopathology


 

SAN FRANCISCO — Patients with pruritus are twice as likely to have a comorbid psychiatric diagnosis as those with other dermatologic diagnoses, according to a large epidemiologic study.

This is driven largely by the strong association between pruritus and comorbid anxiety disorders, Dr. Madhulika A. Gupta reported at the annual meeting of the American Academy of Dermatology.

The link between pruritus and obsessive compulsive disorder (OCD) was particularly robust. In this analysis representing more than 33 million physician/patient encounters, patients with a diagnosis of pruritus were 11.3-fold more likely than all other dermatology patients to have a comorbid diagnosis of OCD, said Dr. Gupta, a psychiatrist at the University of Western Ontario, London.

She analyzed epidemiologic data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey for 1995–2003.

Patients diagnosed with pruritus were 4.6-fold more likely to have a comorbid anxiety disorder than were patients with other dermatologic diagnoses.

To Dr. Gupta's surprise, pruritus was not associated with a significantly increased likelihood of comorbid major depressive disorder. She suspects this was because there was a substantial prevalence of major depressive disorder among the comparison group comprised of patients with other dermatologic disorders.

However, pruritus may be associated with an increased likelihood of comorbid depression. Depression was 3.3 times more frequent when the patient in question had pruritus, Dr. Gupta added.

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