Psychosomatic Burden and Childhood Trauma in Chronic Pruritus without Primary Dermatosis or Systemic Disease: A Case-control Study

Chronic pruritus without a primary dermatosis or systemic disease is a clinically challenging condition in which psychological factors may be relevant and substantial psychosomatic burden may be present. This case-control study examined childhood trauma, psychological symptoms and psychosomatic characteristics in this patient population. A total of 75 patients and 75 healthy controls aged 18-65 years were included. Childhood trauma, dissociation, depressive and anxiety symptoms, somatic symptom burden, alexithymia, health anxiety, somatosensory amplification and itch burden were assessed using validated self-report instruments. Group differences were analysed using multivariate analysis of covariance and follow-up ANCOVAs adjusted for age, sex and education. Patients showed higher somatic symptom burden, alexithymia, health anxiety, somatosensory amplification, anxiety and depressive symptoms than controls, whereas dissociative symptoms did not differ. Among childhood trauma dimensions, emotional abuse and physical abuse were higher in patients, while other trauma domains were not significantly different. Itch severity was correlated with depressive symptoms, anxiety symptoms and somatic symptom burden; in exploratory regression analyses, depressive symptoms emerged as the only independent predictor of itch severity. These findings suggest that patients with chronic pruritus without a primary dermatosis or systemic disease may have a broad psychosomatic burden extending beyond affective symptoms alone.