Sabine Dutray

European University of Brittany, Roazhon, Brittany, France

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Publications (9)4.69 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Psychogenic excoriations are also called neurotic excoriations, dermatillomania or skin picking syndrome. We proposed diagnostic criteria and then performed a study of the psychiatric profiles of outpatients with psychogenic excoriations and the circumstances around the creation of these excoriations. Although the results must be interpreted with caution because the study was performed with only 10 patients, interesting data is provided about the onset of psychogenic excoriations, the behaviour of picking, and comorbidity. Common or specific characteristics were identified according to type of case. The majority of patients associated first excoriations with personal problems. Four patients reported abuse in childhood or adolescence. This study confirms that skin picking is an impulsive reaction and does not belong to the obsessive-compulsive disorders: impulsivity is defined by ineffective or failing control resulting in uninhibited behaviour.
    Acta Dermato-Venereologica 03/2012; 92(4):416-8.
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    ABSTRACT: Atopic dermatitis is a chronic disease, which is a burden with putative major repercussions. Its management could be complex. The workshops of atopy gather therapeutic education psychological help. Such interventions are not possible for all patients. They are very useful and efficient since clinical controlled trials have demonstrated that Scorad, a score of severity for atopic dermatitis, was decreased whereas topical steroids were globally less used.
    Health Policy. 12/2011;
  • Sabine Dutray, Laurent Misery
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    ABSTRACT: Does the appearance of pruritus always necessitate psychological treatment? The answer to this question remains subordinate to the dermatologist’s clinical examination, including the psychological component (cf. Part II, Subchapter 4, Psychological Approach). The dermatologist’s entire observational and clinical sense is mobilized. ‘What is the patient telling me about his pruritus?’ ‘Is he psychically and physically overwhelmed by the itching?’ ‘Did this lead to changes in his daily life?’ ‘Is he only talking to me about his skin, or also about what it is to him as an individual?’ Taking into account the psychological functioning of the subject under medical treatment permits a global approach to the patient.
    12/2009: pages 316-323;
  • Sabine Dutray, Laurent Misery
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    ABSTRACT: I really scratched myself, and I can say here that whoever has not known uninterrupted itching knows very little about hell… Lorette Nobécourt, La démangeaison [Itching], Editions J’ai lu, Paris, 1999 Defined as “an unpleasant sensation that provokes the desire to scratch oneself”,1 pruritus is one of the main functional signs in dermatology, specific to this speciality.2 Lying on the skin and some mucosa, it disturbs the functions of these organs without creating a necessarily observable lesion on it. And in the end, it is always in the brain that the sensation is or is not perceived. As a conscious perception, it unites skin and brain - without “the brain, no itch.”3 Hence, there is a subjective side. The sign exists at the cerebral, physiological, psychological, and verbal levels. It is from this plurality that a link between soma and psyche can be formed. The use of the terms “displeasure” and “desire,” and notions with a dual interpretation (physical and mental), to define pruritus express this complexity well. It is why the skin can be the starting point for a somatic and psychological expression of the subject, as well as the destination, a dead end where it becomes impossible to exist outside the itching. As a result it becomes a vicious circle, a suffering that can hold such a central position that it affects social, professional, emotional, and mental life. The subject becomes the pruritus: “…at the edge of one’s self, on one’s skin, the subject acts out not only his identity, his connections to others and his relationship to time, but his humanity as well.”4
    12/2009: pages 217-221;
  • [Show abstract] [Hide abstract]
    ABSTRACT: It is widely accepted that episodes of seborrheic dermatitis are frequently induced by stress, as stated in all general reviews of the subject. However, there have been no studies to confirm this view. This prospective study was performed in two phases. An initial questionnaire collected information on patients' identity, somatic and psychiatric history and seborrheic dermatitis characteristics. Information on triggering episodes was sought by means of an open question and patients were then asked if they had experienced stress during the week or month prior to the active episode. A second questionnaire containing the same questions (except for history) was completed four months later. The two questionnaires contained psychopathological evaluation scales designed to detect symptoms of anxiety and depression among patients (HAD: Hospital Anxiety and Depression scale; Beck; STAI: State-Trait Anxiety Inventory) and determine their perceived stress (PSS: Perceived Stress Scale by Cohen and Williamson). Eighty-two patients (36 women and 46 men) were included in the study. 82% of patients presented involvement of scalp, 33% of the face, 19% of the chest and 13% of other sites (ears, skinfolds). Patients themselves identified stress as the main triggering factor, whether for episodes in general, for the first episode or for the current episode. A stressful event was in fact found in the majority of cases. The fact that stress was recognised as a triggering factor for episodes was not associated with a higher depression score (HAD or Beck) but was associated with a higher anxiety score (STAI). The psychological effects of the disease were pronounced in 11% of patients, moderate in 20%, mild in 35%, and nil in 25%, with 9% of patients stating no opinion. Patients with facial involvement were more depressed in terms of Beck Depression Index score. Two characteristics noted at inclusion were predictive for the onset of at least one further episode or persistence of an ongoing episode four months later: patients' designation of stress as the cause of the previous episode, and STAI score. This study confirms that seborrheic dermatitis is often preceded by a stressful event and that stress tends to suggest a poor prognosis. This is the first study to show a possible link between stressful life events and episodes of seborrheic dermatitis. It suggests the need to confirm these results through a study comparing patients with seborrheic dermatitis and subjects without the disease. It also shows that depression is more common among patients with facial involvement and that anxiety is an aggravating factor.
    Annales de Dermatologie et de Vénéréologie 12/2007; 134(11):833-7. · 0.60 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 06/2007; 134(5 Pt 1):481-2. · 0.60 Impact Factor
  • Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2007; 134(5):481-482.
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    ABSTRACT: Background It is widely accepted that episodes of seborrheic dermatitis are frequently induced by stress, as stated in all general reviews of the subject. However, there have been no studies to confirm this view. Patients and methods This prospective study was performed in two phases. An initial questionnaire collected information on patients’ identity, somatic and psychiatric history and seborrheic dermatitis characteristics. Information on triggering episodes was sought by means of an open question and patients were then asked if they had experienced stress during the week or month prior to the active episode. A second questionnaire containing the same questions (except for history) was completed four months later. The two questionnaires contained psychopathological evaluation scales designed to detect symptoms of anxiety and depression among patients (HAD: Hospital Anxiety and Depression scale; Beck; STAI: State-Trait Anxiety Inventory) and determine their perceived stress (PSS: Perceived Stress Scale by Cohen and Williamson). Results Eighty-two patients (36 women and 46 men) were included in the study. 82% of patients presented involvement of scalp, 33% of the face, 19% of the chest and 13% of other sites (ears, skinfolds). Patients themselves identified stress as the main triggering factor, whether for episodes in general, for the first episode or for the current episode. A stressful event was in fact found in the majority of cases. The fact that stress was recognised as a triggering factor for episodes was not associated with a higher depression score (HAD or Beck) but was associated with a higher anxiety score (STAI). The psychological effects of the disease were pronounced in 11% of patients, moderate in 20%, mild in 35%, and nil in 25%, with 9% of patients stating no opinion. Patients with facial involvement were more depressed in terms of Beck Depression Index score. Two characteristics noted at inclusion were predicteive for the onset of at least one further episode or persistence of an ongoing episode four months later: patients’ designation of stress as the cause of the previous episode, and STAI score. Discussion This study confirms that seborrheic dermatitis is often preceded by a stressful event and that stress tends to suggest a poor prognosis. This is the first study to show a possible link between stressful life events and episodes of seborrheic dermatitis. It suggests the need to confirm these results through a study comparing patients with seborrheic dermatitis and subjects without the disease. It also shows that depression is more common among patients with facial involvement and that anxiety is an aggravating factor.
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2007; 134(11):833-837.
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    ABSTRACT: Functional itch disorder or psychogenic pruritus is a poorly defined diagnosis. This paper sets out the proposed diagnostic criteria of the French Psychodermatology Group (FPDG). There are three compulsory criteria: localized or generalized pruritus sine materia, chronic pruritus (>6 weeks) and the absence of a somatic cause. Three additional criteria from the following seven items should also be present: a chronological relationship of pruritus with one or several life events that could have psychological repercussions; variations in intensity associated with stress; nocturnal variations; predominance during rest or inaction; associated psychological disorders; pruritus that could be improved by psychotropic drugs; and pruritus that could be improved by psychotherapies.
    Acta Dermato Venereologica 01/2007; 87(4):341-4. · 3.49 Impact Factor