Prevalence and Burden of Somatic Symptom Disorder in Atopic Dermatitis and Chronic Pruritus—The Persistent Somatic Symptoms Across Diseases: Pruritus (SOMA.PRU) Study

ABSTRACT Background Somatic symptom disorder (SSD) is a relatively “novel” psychiatric diagnosis defined as excessive thoughts, feelings, or behaviors related to persistent somatic symptoms such as chronic pruritus (CP) and could be important in this population. Objectives To compare pruritus intensity, psychological distress, quality of life (QoL) and clinical characteristics in CP patients with and without SSD. Methods Patients with CP of inflammatory (atopic dermatitis) or noninflammatory (CP on non‐lesional skin) origin were recruited at two university dermatology departments in Germany as part of the SOMA.PRU study. Presence of SSD was determined by a structured clinical interview. A range of both clinician‐ and patient‐reported measures were gathered and analyzed cross‐sectionally. Results Ninety‐five CP patients (59 female, mean age 53.4 ± 22.3 years) participated. Prevalence of SSD was 14.7% (95% CI [7.5%, 22.0%]) independent of presence/absence of inflammatory skin lesions. Patients with SSD reported higher pruritus intensity, psychological distress and worse QoL. SSD was not associated with scratch lesion severity or cutaneous nerve fiber density. Conclusions SSD is an important comorbidity in CP in atopic dermatitis and CP on non‐lesional skin and may be associated with worsening of CP‐associated burden.