Scientists have found that people receiving treatment for mental health conditions who also have skin problems may face a higher risk of severe outcomes, including depression and suicidal thoughts. The research, which could help doctors better identify vulnerable patients and tailor psychiatric care, was presented at the ECNP meeting in Amsterdam.
The study involved 481 individuals experiencing their first episode of psychosis (the first time a person has symptoms such as delusions, hallucinations, or losing touch with reality). Among them, 14.5% showed signs of skin issues (24% of females and 9.8% of males), including rashes, itching, or sensitivity to light. All participants received four weeks of antipsychotic treatment, after which researchers assessed various mental health indicators.
Lead researcher Dr. Joaquín Galvañ (Instituto de Investigación Sanitaria Gregorio Marañón, Madrid) explained:
“After 4 weeks of follow-up, patients with a first episode of psychosis presenting with skin conditions experienced higher levels of depression and risk of suicide. We found that just 7% of the patients without the initial skin conditions had suicidal thoughts or attempts, in contrast, around 25% of the patients with initial skin conditions had suicidal thoughts or attempts. Initial skin conditions are also linked to greater depression and poorer well-being at follow-up.
“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.”
The team noted that, if further research supports these results, skin symptoms could serve as an early warning sign for elevated mental health risks, much like how blood tests can signal the likelihood of cancer or heart disease.
Because both the brain and skin develop from the same embryonic layer called the ectoderm, the scientists set out to explore how these two systems might be connected.
Dr. Galvañ added:
“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?
Our findings suggest that dermatological symptoms may represent a marker of illness severity and poor short-term outcomes in the early stages of psychosis, potentially identifying a subgroup of patients with a poorer clinical prognosis who may benefit from early tailored interventions. 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.”
Offering an independent perspective, Professor Eric Ruhe (Professor of Difficult-to-Treat Depression at Radboud University, the Netherlands) commented:
“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.”
This is an independent comment, Professor Ruhe was not involved in this work.