Psychiatric aspects of dermatitis artefacta

Abstract

Fifty patients with dermatitis artefacta were investigated psychiatrically over several years and twenty-six of these were seen independently by a clinical psychologist. The psychological investigations suggest a personality structure characterized by inward-looking self-centred attitudes leading to increasing isolation. The psychiatric investigations suggest a background of emotional disturbances during the formative years and in later life often resulting in feelings of isolation and insecurity. The onset of dermatitis artefacta is very frequently related to definable precipitating events which vary according to age and life situations. The visible skin lesions can be understood as an attempt at non-verbal communication subserving an appeal function. Therapeutic methods and prognosis are discussed in some detail.