[Diagnosis of psychological aspects in chronic pruritus]

Abstract

Background: Pruritus is a frequent symptom in the general population and in clinics.

Objective: This article gives an overview on psychological and psychosomatic aspects of chronic pruritus and tools for their diagnosis.

Materials and methods: This is a review.

Results: Chronic pruritus can lead to psychological impairment and psychic diseases, e.g., adjustment disorder, depression. Psychological factors can also be important factors in the etiology and course of chronic pruritus, either in combination with somatic aspects or, in the absence of these, as somatoform pruritus or pruritus in coenasthetic schizophrenia. Self-induced scratch lesions with or without pruritus can be symptoms of impulse control disorders, obsessive-compulsive disease or artificial disorders. Furthermore, independent comorbidity with other psychic disorders can influence the management of chronic pruritus. We provide hints/tools for their diagnosis.

Conclusions: The diagnosis of psychological aspects in chronic pruritus is complex. The main diagnostic tool is the thorough taking of the patient history, including psychological aspects. It can be supplemented by standardized questionnaires, but these can not be substitutes.

Keywords: Diagnosis; Medical history taking; Psychic disorders; Psychosomatic aspects; Somatoform pruritus.