Sat, Dec 01, 2012 - Page 11 News List

More than 80% of mentally ill unaware of skin disorders
逾八成精神病患 不知自己皮膚有狀況

Mentally ill patients rest in a room at a mental hospital on the eve of World Mental Health Day in Hyderabad, Pakistan on Oct. 9.
這張照片是十月九日世界精神衛生日前夕攝於巴基斯坦海得拉巴的精神病患者在精神院的一間房間裡休息。

Photo: EPA
照片:歐新社

The mentally ill typically exude an unspeakable sense of suffering. Apart from mental suffering, many of them are afflicted with numerous physical ailments, which are usually left unknown because of clothing covering them or because patients lack the ability to properly take care of themselves. After studying more than 300 patients with schizophrenia, Wu Pai-yao, an attending physician in the department of dermatology at Tri-Service General Hospital, discovered that as much as 96.6 percent of his patients had at least one type of skin disorder, but that less than 20 percent of them were actually aware of their skin condition.

Shen Cheng-nan, a geriatric psychiatrist, says that people with chronic mental illness usually lack insight — the ability to recognize one’s own illness — and display poor self-care. Shen also says that the mentally ill do not usually complain about being sick, so the only way they can get proper medical treatment is by regularly receiving health checkups, which should include thorough examinations of the mouth, scalp and body.

Wu, along with his brother — another psychiatrist — both discovered that their patients often had neglected skin problems, so they decided to conduct further research, the results of which were presented at a Taiwanese Dermatological Association conference on Nov. 25. Out of the 337 schizophrenic patients they studied, whom were all given meticulous head-to-toe examinations, more than 90 percent of them had at least one type of skin disorder, yet less than half of them were aware of this.

Wu found that 60 percent of the patients had mycoses, the most prevalent of which was onychomycosis — a fungal infection of the nail— which afflicted half of the patients, and was followed by eczema — a form of dermatitis. Eczema usually causes incessant itching in the average person, while people with mental illness typically feel the itching sensation significantly less. Wu also discovered a connection between obesity and mycoses, while bacterial infections, including folliculitis — an inflammation of one or more hair follicles — and cellulitis, were found to be linked with diabetes.

TODAY’S WORDS 今日單字

1. regularly adv.

定期地 (ding4 qi2 de5)

例: Do you get your blood pressure checked regularly?

(你有定期地去檢查血壓嗎?)

2. scalp n.

頭皮 (tou2 pi2)

例: Dandruff is the most common cause of itchy scalp.

(頭皮癢通常是因為有頭皮屑。)

3. humid adj.

潮濕的 (chao2 shi1 de5)

例: Deserts are typically arid, while rain forests are usually quite humid.

(沙漠通常乾燥,雨林通常潮濕。)


Wu says that the connection between obesity and mycoses can be explained by obese people sweating more, and having more skinfolds, and Taiwan being so humid. On the other hand, people with diabetes are immunocompromised and it usually takes longer for sores to heal, which means they have a higher risk of bacterial infection. Wu also discovered that doctors typically notice the rashes located on the hands and feet of people with severe mental illness, but says that they usually neglect infections and eczema because they are hidden under clothing.

(Liberty Times, Translated by Kyle Jeffcoat)

一般精神病患常給人一種有苦難言的感覺,其實他們除了心裡的苦,還有許多身體的不適,也因為衣物的遮蔽、自我照顧能力的低落,而經常不為人所知。三軍總醫院皮膚科主治醫師吳百堯研究三百多位精神分裂病患,發現高達百分之九十六點六具有一種以上皮膚疾患,但只有不到兩成的病人知道自己的皮膚有狀況。

老年精神科醫師沈政男表示,慢性精神病患較缺乏病識感,自我照顧能力也較弱,就算生病也不會抱怨,因此定期健檢應包括口腔、頭皮、身體的徹底檢視,才能使病人獲得妥善治療。

三總醫師吳百堯自己的哥哥就是精神科醫師,他們發現精神病患的皮膚問題經常被忽視,因此進行研究,十一月二十五日於台灣皮膚科醫學會發表結果。他們為三百三十七位精神分裂患者,從頭到腳仔細檢視,發現有九成以上病人有一種以上的皮膚疾患,卻只有不到五成的病人有病識感。

吳百堯發現,這些病人以黴菌感染占六成最多,近半數病人都有灰指甲,其次是濕疹,一般人得了濕疹會因奇癢無比而非常困擾,但精神病患對於癢的感覺似乎較遲鈍。吳百堯也發現,肥胖和黴菌的感染有關,而細菌感染的皮膚病,例如毛囊炎、蜂窩性組織炎,則與糖尿病有關。

吳百堯表示,肥胖患者較容易流汗,皮膚皺摺也較多,台灣氣候又潮濕,可能與黴菌感染有關。而糖尿病患的傷口癒合能力、免疫力較低,確實也有較高的細菌感染風險。吳百堯也發現,精神病嚴重度較高的病人,其手腳上的皮膚疹比較會被醫師發現,但覆蓋在衣物下面的感染或濕疹,則大多被忽略。

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