Psychosomatic aspects of prurigo nodularis [Psychosomatische aspekte der prurigo nodularis]

摘要

Background/objectives. This article gives an overview of the theoretical background and the empirical research concerning psychosomatic aspects of prurigo nodularis (PN). Materials and methods. Literature research in PubMed with the search terms "prurigo nodularis", "nodular prurigo", "psych*"; clinical experience and research of the authors. Results. Although reviews on PN frequently mention psychosomatic aspects, there is little empirical research concerning the subject. Psychosomatic aspects of PN may play a role in (1) the etiology of the chronic pruritus; (2) scratching, which leads to the typical nodules of PN; (3) the consequences of the chronic pruritus, the scratching and the skin lesions; (4) comorbidity. There is evidence for higher psychic comorbidity and higher psychopathology (anxiety, depression) in PN patients than in healthy controls, but PN patients were comparable to patients with other pruritic dermatoses. Discussion. Increased levels of psychopathological problems and comorbidities also have been found in other dermatoses; they are not specific for PN. Because all of the research on this topic is cross-sectional, we cannot be sure whether these aspects are etiological factors or consequences of PN or independent comorbidities. Nevertheless, psychosomatic aspects should be considered in diagnosis and treatment of PN patients.