Researchers have discovered that individuals experiencing their first episode of psychosis who also have skin issues face higher risks of depression and suicidal thoughts. The finding, presented at the ECNP meeting in Amsterdam, suggests dermatological symptoms could serve as early warning signs for poorer mental health outcomes. This connection may stem from shared developmental origins between the skin and brain.
A study involving 481 people with their first episode of psychosis—characterized by symptoms like delusions, hallucinations, or loss of touch with reality—revealed that 14.5% had skin conditions, including rashes, itching, or light sensitivity. This rate was higher among females at 24% compared to 9.8% in males. All participants underwent four weeks of antipsychotic treatment, after which mental health indicators were evaluated.
Lead researcher Dr. Joaquín Galvañ from the Instituto de Investigación Sanitaria Gregorio Marañón in Madrid explained the results: "After 4 weeks of follow-up, patients with a first episode of psychosis presenting with skin conditions experienced higher levels of depression and risk of suicide. We found that just 7% of the patients without the initial skin conditions had suicidal thoughts or attempts, in contrast, around 25% of the patients with initial skin conditions had suicidal thoughts or attempts. Initial skin conditions are also linked to greater depression and poorer well-being at follow-up."
Dr. Galvañ noted that while 30% to 60% of people with skin conditions exhibit psychiatric symptoms, this research reverses the perspective: "What we have done is look at things from the opposite direction; do people with mental health problems have skin conditions, and if so, can this tell us anything useful? Our findings suggest that dermatological symptoms may represent a marker of illness severity and poor short-term outcomes in the early stages of psychosis."
The scientists hypothesize that the link arises from the skin and brain both originating from the ectoderm embryonic layer and sharing inflammatory pathways, though this requires confirmation. As the first study to identify this association in psychosis patients, further research is needed to validate it and explore applicability to conditions like bipolar disorder, ADHD, anxiety, or depression.
Professor Eric Ruhe, an expert in difficult-to-treat depression at Radboud University in the Netherlands who was not involved, offered an independent view: "This is an interesting association between skin problems and a first episode of psychosis. These results need replication in different cohorts but might indeed show a new link between skin and psychopathology. As the skin and the brain derive from the same embryonic origin, this would be worth pursuing further, both diagnostically and mechanistically."