David Tordeurs

Psychosomatics and Dermatology: Comparison between Objective Data and Subjective Impressions Given by Patients and Dermatologists

The authors wanted to assess the psychological part in the etiology of different skin diseases in adult outpatients in a dermatological university clinic. The other aim of this study was to explore the dermatologist’s perception of a psychological involvement in the etiology of some skin diseases. This was compared with the patients’ perception of it and with objective data obtained by self-rating questionnaires. 554 outpatients consulting for psoriasis, alopecia areata, eczema, and benign tumors were studied with multiple comparison statistics about family functioning, depression, tendency to complain, perceived stress, life events, and coping skills. When based on the dermatologist’s impression of a psychosomatic involvement, significant mean differences do exist about tendency to complain, depression, life events before the onset of the disease, and coping with the treatment. When comparing psoriasis, alopecia areata and eczema patients with patients consulting for benign tumor, significant differences are quite the same. According to the patients, life events with an impact on the onset of the disease happened during the last year for psoriasis and during the years before for alopecia areata. Only about 35% of patients with difficulties in family relationships and 48% of patients with depression are correctly recognized by dermatologists. They seem to be influenced by the patients’ assumptions and by the dermatological diagnosis. This suggests that patients who are not aware of a psychological influence in the etiology of their disease could not be recognized by the dermatologist and could thus not be treated optimally. The authors point out the necessity of better tools in order to recognize the psychological part in the etiology of skin diseases.

La dimension familiale du processus suicidaire, une étude empirique

A retrospective study was carried out on 44 patients with major depression to study familial characteristics and to determine whether this patient population could be prospectively characterized. Two groups were differentiated: the first consisted of suicidal depressive patients, and the second consisted of non-suicidal depressive patients. A discriminant analysis was then made on two variables: health locus of control for the depressive patient, and the adaptability and cohesion factors for the existing couple, the original family and the nuclear family. This analysis provided a psychological profile of the suicidal patient and his family based on the individuals health locus of control, and indicated certain psychological and familial predisposing factors. The results showed that the family has a considerable influence on the health of a suicidal depressive subject compared to that of a non-suicidal depressive individual. The capacity for adaptability is less and the attitudes are more rigid in the former subjects family than in the latter individuals family. These results have been discussed