PS37 Bridging dermatology and psychosomatic medicine in patients with chronic pruritus: screening for psychosomatic burden in a bidisciplinary setting

Abstract

Chronic pruritus (CP), defined by a duration of ≥ 6 weeks, imposes a high psychological and somatic burden caused by various dermatological and nondermatological conditions. To address this multidimensional condition comprehensively, a specialized bidisciplinary pruritus clinic was established at the University Hospital of Basel, Switzerland, integrating dermatological and psychosomatic assessments and interventions. We describe the screening process for the somatic and psychological burden in patients with CP and present initial descriptive data from this cohort. Patients completed itch-related (Neuroderm, GerItchyQoL) and mental health-related [Patient Health Questionnaire (PHQ)-8, General Anxiety Disorder (GAD)-7, Somatic Symptom Scale (SSS)-8, Somatic Symptom Disorder (SSD)-12] questionnaires via tablet-­based software (Heartbeat Medical) at their first visit. Data were analysed using R (2022). In total 148 patients were included, with the following classifications based on the International Forum for the Study of Itch (IFSI). IFSI-I (CP on diseased skin), n = 37; IFSI-II (CP on nondiseased skin), n = 82; IFSI-III (CP with chronic scratching lesions), n = 29. The median worst itch intensity was 7.0 [interquartile range (IQR) 5.0–8.0]. Itch-related quality of life was markedly impaired (GerItchyQoL: median 58.0, IQR 46.8–70.0), with highest scores in patients with IFSI-III stage (median 70.0, IQR 56.0–87.0). Psychological screening indicated mild depressive (PHQ-8: median 5.0, IQR 3.0–9.0) and anxiety symptoms (GAD-7: median 4.0, IQR 2.0–8.0) overall. These were most pronounced in patients with IFSI-III stage (PHQ-8: median 8.0, IQR 4.0–14.0; GAD-7: media 6.0, IQR 2.0–12.0). Somatic symptom burden (SSS-8: median 8.0, IQR 4.0–13.0) and somatic symptom disorder severity (SSD-12: median 16.0, IQR 9.0–24.2) showed elevated scores across all groups. Significant differences between IFSI classes were found only for itch-related quality of life (P < 0.05). These findings demonstrate substantial psychosomatic burden in patients with CP, emphasizing the need for integrated dermatological–psychosomatic care. The bidisciplinary clinic model in Basel facilitates comprehensive assessment of somatic symptoms and provides accessible psychological support for patients with CP and comorbid mental health concerns.