People with mental health conditions who have skin conditions may be at higher risk for worse outcomes, including suicidality and depression, according to new research presented at the European College of Neuropsychopharmacology (ECNP) Congress in Amsterdam, the Netherlands.
For the study, the researchers looked at 481 patients with a first episode of psychosis. On testing, 14.5% were found to have dermatological symptoms (24% female, 9.8% male) such as rash, itching, photosensitivity, etc. All patients were given four weeks’ treatment with an antipsychotic and then checked for a range of mental health parameters.
After four weeks of follow-up, patients with a first episode of psychosis presenting with skin conditions experienced higher levels of depression and risk of suicide. Specifically, 7% of the patients without the initial skin conditions had suicidal thoughts or attempts. In contrast, around 25% of the patients with initial skin conditions had suicidal thoughts or attempts. Initial skin conditions were also linked to greater depression and poorer well-being at follow-up, the study showed.
The researchers note that, if confirmed, this finding has the potential to act as an advance marker for mental health risk, similar to the way a blood test might indicate a greater risk of cancer or heart disease.
“It was already known that between 30% and 60% of people with skin conditions show psychiatric symptoms. What we have done is look at things from the opposite direction; do people with mental health problems have skin conditions, and if so, can this tell us anything useful?” says study author Joaquín Galvañ of the Instituto de Investigación Sanitaria Gregorio Marañón in Madrid, Spain, in a news release.
“Our findings suggest that dermatological symptoms may represent a marker of illness severity and poor short-term outcomes in the early stages of psychosis, potentially identifying a subgroup of patients with a poorer clinical prognosis who may benefit from early tailored interventions. The reason for the connection is still unclear, but our working hypothesis is that this may be due to the skin and neurological systems having common developmental origins and inflammatory pathways; but this needs to be confirmed.
“As far as we know, this is the first study to show this link in patients with psychosis, so we need follow-up studies to confirm the finding. We also need to understand if this link applies also to a range of other psychiatric conditions, such as bipolar disorder, ADHD, anxiety or depression.”
Professor Eric Ruhe of Radboud University in the Netherlands) adds, “This is an interesting association between skin problems and a first episode of psychosis. These results need replication in different cohorts but might indeed show a new link between skin and psychopathology. As the skin and the brain derive from the same embryonic origin, this would be worth pursuing further, both diagnostically and mechanistically (which may be more interesting). For example, this association might be used to culture skin cells to begin to understand which treatment is appropriate.”
Professor Ruhe has no ties to the new research.
