S43.02 - Psychodermatology - yesterday, today, and tomorrow

Abstract

The main requirement of diagnostics is the improvement of communication in daily practice on the one hand and the clinical relevance of diagnostic entities with respect to treatment and prognosis on the other hand. A main problem of the classical psychodermatological classifications is that the assignment to classes is based on more or less unproven assumptions and postulations concerning pathogenesis and nosology. This unsatisfactory diagnostic situation was the incentive to develop the Vienna Diagnoses Schedule for Psychodermatological Disorders, which was created on the basis of clinical experience in psychodermatological treatment units and includes four main diagnostic categories: 1. mental disorders without dermatological symptoms; 2. Mental disorders combined with dermatological disorders, e.g.classical psychosomatic disorders and stress-related disorders, secondary dermatological disorders due to mental disorders, secondary mental disorders due to primary dermatological disorders, mental disorders due to dermatological treatment, dermatological disorders due to psychiatric treatment, dermatological disorders often associated with mental disorders, and dermatological and mental disorders occurring simultaneously but independently from each other; 3. Dermatological disorders without mental disorders (troublesome patients, misdiagnosed patients, etc.); and 4. dermatological and/or mental problems not reaching the level of a disorder. Such a categorical classification has to be enlarged in clinical practice by a dimensional diagnostic approach, including not only deficiencies but also the resources of the patient in order to provide effective treatment strategies focusing not only on the disorder itself but on the suffering human being in its entirety.