Skin can 'warn' of a mental health crisis

Patients with psychiatric disorders who experience skin symptoms may be prone to a more severe course of illness, including a high risk of depression and suicidal behaviour.

The researchers said this at the European College of Neuropsychopharmacology (ECNP) conference held in Amsterdam.

The link between skin and psyche: study results

Researchers from the Gregorio Marañón Institute for Medical Research in Madrid observed 481 patients who had experienced their first episode of psychosis. This condition includes manifestations such as loss of connection with reality, hallucinations and delusions. The study showed that 14.5% of patients had dermatological symptoms at the time of starting therapy - rash, itching, increased sensitivity to light and others. These manifestations were more common in women (24%) than in men (9.8%).

All participants received antipsychotic treatment for four weeks, after which they underwent a second psychiatric assessment.

Study leader Dr Joaquin Galvan noted:

"After four weeks, patients with skin symptoms showed higher levels of depression and propensity for suicidal behaviour. Only 7 per cent of patients without skin symptoms had suicidal thoughts or attempts, compared with about 25 per cent of patients with skin manifestations."

Opportunity for early diagnosis and personalisation of therapy

The researchers believe that the presence of skin symptoms could be an indicator of the severe course of psychosis and help in the early identification of high-risk patients. This discovery could inform the development of personalised approaches to the treatment of mental illness.

Dr Galvan explained that skin and brain share a common origin - they develop from the same germ layer, the ectoderm. This led scientists to hypothesise a possible link between skin and mental symptoms.

Potential mechanisms for the link

Although the exact mechanism of the link has not yet been established, researchers speculate that it may be related to shared inflammatory pathways, as well as the fact that the skin and nervous system develop from the same source. Importantly, this is the first study to identify such a relationship specifically in patients with psychosis.

The study also opens up the possibility of exploring a similar link in other psychiatric disorders such as bipolar disorder, ADHD, anxiety disorders and depression.

Independent evaluation

Professor Erik Rue, a specialist in hard-to-treat depression from Radbaud University in the Netherlands, said:

"This is an interesting finding. Although confirmation of the results in other samples is required, it may indicate a new link between skin manifestations and psychopathology. This area deserves further investigation from both a diagnostic and biological point of view."