Knowledge, Attitude, and Practice Patterns on Psychodermatology among Filipino Dermatologists: A Cross-sectional Study.

Abstract

Background: Psychodermatology is a field that focuses on the interaction of the skin and the mind. Psychodermatology patients are often challenging to manage because they often lack insight and are not amenable to psychiatric treatment or referral. Therefore, it is important that dermatologists become aware of the psychosocial impact of cutaneous disease and be knowledgeable in the fundamentals of psychodermatologic diagnosis and therapy. However, studies done in several countries report a general lack of perceived knowledge, awareness, and confidence in the management of psychodermatology disorders among dermatologists.

Objective: This study aims to determine the knowledge, attitudes, and practices of Filipino dermatologists towards psychodermatology using a self-administered questionnaire.

Methods: This is a mixed methods study using qualitative and quantitative measures. A self-administered questionnaire was validated and disseminated among the dermatologists in the country. Descriptive analysis was done.

Results: Of the 153 participating dermatologists, majority (70.59%) reported psychodermatologic patients comprised <10% of their practice. While more than half (56.2%) have a clear understanding of psychodermatology and are comfortable (57.52%) in approaching patients with these conditions, only 58 (37.91%) participants are able to demonstrate adequate knowledge on psychodermatology. Patients with primary psychiatric disorders are less frequently encountered than dermatologic disorders with psychiatric component or secondary psychiatric disorders. Most commonly prescribed medications are anti-histamines. Other psychotropic medications are rarely or never prescribed by the participants. All participants agree that psychodermatology is important in the practice of dermatology; 127 (62.1%) have attended at least one Continuing Medical Education (CME) on psychodermatology and 114 (74.51%) expressed willingness to attend CME training in psychodermatology. One hundred nine (71.24%) participants think that the best practice approach is a multidisciplinary approach to psychodermatology. The top recommendations for better healthcare delivery in psychodermatology were better access to mental health specialists (86.27%), more training opportunities and better training during residency (75.16%), and increase collaboration with psychiatrists (71.9%). The knowledge score was found to be associated with the duration of dermatology practice and attendance in CME proceedings but was not associated with the perceived adequacy of knowledge gained during training. Longer duration of practice may be associated with the knowledge score owing to the greater exposure to cases and more access to training opportunities.

Conclusions: There are many challenges to providing psychodermatologic care in the Philippines but the positive attitude towards psychodermatology, coupled with increased access to education and training opportunities, and the multidisciplinary approach to these cases may improve the quality of dermatologic care that we provide.