Objective: Itching or pruritus is an uncomfortable sensation leading to the urge to scratch. Chronic pruritus may be seen in many skin and systemic diseases as well as in psychiatric disorders. The aim of the present study was to assess the sociodemographic characteristics of patients with chronic pruritus due to reasons other than primary skin diseases or systemic diseases that may cause itching, and to investigate itching features, psychiatric disorders and depressive symptoms.
Method: One hundred twenty six patients with chronic pruritus were included in the study. Sociodemographic data and disease-related features were recorded on a form. Psychiatric diagnoses were established based on the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR) criteria by using the Structured Clinical Interview for DSM-IV, Clinical Version (SCID-I/CV). The Beck Depression Inventory (BDI) was applied.
Results: Of chronic pruritus patients, 70.6% had psychiatric disorders ranging 1-3. The most common psychiatric disorders were depressive disorders with a rate of 34.1%. The rate of female patients was higher among chronic pruritus patients both with and without a psychiatric diagnosis. The generalized itching and BDI scores were significantly higher in patients with a psychiatric diagnosis as compared to those without (p<0.05). Among all chronic pruritus patients, 62% had depressive symptoms, ranging mild to severe. Among patients with a psychiatric disorder, 57.3% had no skin lesion, while 42.7% had skin lesions secondary to itching such as excoriation, lichen simplex chronicus and prurigo nodularis.
Conclusions: The high rate of psychiatric disorders and particularly the presence of concomitant depressive symptoms in patients with chronic pruritus without a primary skin or systemic disease indicate the importance of psychiatric evaluation in such patients.