People treated for psychosis who experienced skin conditions were more likely to have suicidal thoughts or attempts, a new study has revealed.
The research team say its findings show that skin problems could be a “marker of illness severity” in the early stages of psychosis and could be used to identify higher risk patients who may benefit from personalised treatment.
The brain and skin develop from the same embryonic layer – the ectoderm – prompting researchers to investigate how the two could be linked.
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The study involved 481 people in a first episode of psychosis, which is when an individual experiences delusions, hallucinations or loses touch with reality. Of this group, 14.5% presented with skin symptoms which included rashes, itching or light sensitivity.
Following four weeks of antipsychotic treatment, the researchers looked closely at several different markers of mental health in the study group.
They found that just 7% of those without skin complaints experienced suicidal thoughts or attempts, a significantly lower number than the 25% of people with skin symptoms who reported having suicidal thoughts or attempts.
Skin issues were also associated with more severe depression and poorer well-being.
Lead researcher Dr Joaquín Galvañ, from Instituto de Investigación Sanitaria Gregorio Marañón in Madrid, said: “This discovery suggests that the presence of skin conditions indicates that these patients are more at risk for worse outcomes than patients who do not have skin conditions after a first episode of psychosis.
“It was already known that between 30% and 60% of people with skin conditions show psychiatric symptoms. What we have done is look at things from the opposite direction; do people with mental health problems have skin conditions, and if so, can this tell us anything useful?
“The reason for the connection is still unclear, but our working hypothesis is that this may be due to the skin and neurological systems having common developmental origins and inflammatory pathways; but this needs to be confirmed.
“As far as we know this is the first study to show this link in patients with psychosis, so we need follow-up studies to confirm the finding. We also need to understand if this link applies also to a range of other psychiatric conditions, such as bipolar disorder, ADHD, anxiety or depression.”
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Commenting on the findings, Professor Eric Ruhe, Professor of Difficult-to-Treat Depression at Radboud University in the Netherlands, who was not involved in the study, said: “This is an interesting association between skin problems and a first episode of psychosis. These results need replication in different cohorts but might indeed show a new link between skin and psychopathology.
“As the skin and the brain derive from the same embryonic origin, this would worth pursuing further, both diagnostically and mechanistically, which may be more interesting. For example, this association might be used to culture skin cells to begin to understand which treatment is appropriate.”
The findings were presented at the recent European College of Neuropsychopharmacology meeting in Amsterdam.
