Why should dermatologists worry about psychological assessment tools in their practice? Pamela Schell Werschler, Psy.D., MSN, ARNP, DNC, answers.
Why should dermatologists worry about psychological assessment tools in their practice? Pamela Schell Werschler, Psy.D., MSN, ARNP, DNC, answered this question in her presentation, “Survey of Assessment Tools in Dermatologic Practice,” at the recent inaugural Aesthetic + Medical Dermatology Symposia, held in Coeur d’Alene, Idaho, in May.
According to Dr. Werschler, a psychologist and nurse practitioner specializing in dermatology at Werschler Aesthetics, Spokane, Wash., “Dermatological diseases often co-exist along with conditions such as major depressive disorder, obsessive-compulsive disorder, body dysmorphic disorder and a plethora of other psychiatric illnesses.”
She notes that a recent study of 114 people with dermatological disorders showed that 39 - nearly 35% - reported depression. By comparison, only about 7% of adults in the U.S. general population report depression, according to National Institute of Mental Health statistics.
“This isn’t surprising,” Dr. Werschler says. “How do acne, alopecia areata, eczema, HSV breakouts, hyperhidrosis, lupus, melasma, nail fungus, pruritis, psoriasis, rosacea, scarring, skin cancer, sexually transmitted diseases, urticaria, warts and don’t forget age-related changes - how do they make any of us feel?”
She says there’s an extensive list of psychiatric diagnoses dermatologists are likely see in combination with their patients’ dermatological condition. These disorders include obsessive-compulsive, body dysmorphic, trichotillomania (hair-pulling), excoriation (picking at the skin), substance/medication-induced obsessive-compulsive behavior, avoidant/restrictive food intake, anorexia nervosa, bulimia, binge eating, gender dysphoria, generalized anxiety, post-traumatic stress disorder - the list goes on and on.
The Assessment Tools
The crux of the presentation was Dr. Werschler’s discussion of the most useful psychological assessment tools. For patients with depressive symptoms, she recommends:
Dr. Werschler also recommends these dermatologic- and cosmetic-procedure-specific assessment tools:
“It’s important to treat the patient in a holistic manner, including how they may feel about their diagnosis,” Dr. Werschler says in summary. “And a crucial part of doing this is to employ appropriate psychological assessment tools.”