PS38 Minding your skin: a review of a newly established psychodermatology service in Ireland

Abstract

The intersection of dermatology and psychology is multifaceted. The benefits that a dedicated psychodermatology service have for patient outcomes and healthcare resource utilization are well documented in the literature. A new psychodermatology service was established in our tertiary centre in 2024, but was abruptly ceased following funding cuts after 9 months. We analysed referrals to a clinical psychologist and engagement of dermatology patients over a 9-month period (March to November 2024). A service evaluation and chart review were carried out of patients referred to the dermatology clinical psychologist. The inclusion criterion for referral was a mild-to-moderate level of distress related to their skin condition. Patients with a mental health condition as their main cause of distress were excluded. In total, 27 patients consented to referral; their mean age was 40 years and 63% were female. Five remain on the waiting list following abrupt service cessation. Of the 22 who received an appointment, the overall nonengagement rate was 27%; two completely declined, two disengaged following initial assessment and two disengaged following three psychology sessions. Twenty patients underwent psychologist assessment, and 90% engaged in interventions. The most common reason for referral was psychological burden of chronic disease (n = 14) for atopic dermatitis, psoriasis and hidradenitis suppurativa. Others included idiopathic pruritus (n = 3) and dermatitis artefacta (n = 2). Overall, 40% require ongoing psychological input and 40% were discharged with treatment complete. The mean number of clinical psychologist reviews per patient was 5.3, and interventions included cognitive behavioural therapy and habit reversal training. Improvement was noted in symptoms and Dermatology Life Quality Index scores, alongside qualitative evidence of patient satisfaction with the service. A review of our service underlines the benefits of psychological support in dermatological conditions, on both individual and societal levels. We plan to imminently re-establish a psychologist in our centre given the evidence of patient benefit from our pilot data and clear ongoing need.