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.
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)