Non-delusional hypochondriasis in the skin sphere

Background. Hypochondriasis, including that with an affinity for the skin, remains a serious diagnostic and treatment challenge. As the outer boundary of the body, the skin is involved in the formation of psychopathological perception disorders. With its obvious ability to quickly heal itself and its accessibility, unlike internal organs, the skin can often become the target of self-harm in a number of selfdestructive disorders (neurotic excoriations, artificial dermatitis, etc.). As an integral component of appearance, the skin becomes part of the clinical manifestations of mental disorders related to body image pathology.The publication provides an analysis of both theoretical and practical aspects of the problem based on a model of non-delusional hypochondriasis with presentations of somatoform and obsessive itch, skin health anxiety, and cutaneous autonomic dysfunction ("skin organ neurosis").

Materials and methods. Analysis of the main scientific concepts of non-delusional hypochondriasis, related to skin; description of a clinical case, i.e. a patient with "skin organ neurosis"; evaluation of the results of therapy with Alimemazine supplemented by a psychotherapeutic intervention.

Results. The ambiguity of the clinical qualification of non-delusional hypochondriasis in relation to disorders in dermatology is shown; a dimensional model of non-delusional hypochondriasis extending previous concepts is proposed; the model includs the intersection of several psychopathological axes; the provisions of the proposed model are illustrated by the clinical case; the high effectiveness of alimemazine in relation to symptoms derived from various psychopathological dimensions is demonstrated.

Conclusions. The set of clinical phenomena labeled in the literature by the term "non-delusional hypochondriasis" is a multidisciplinary construct that includes associated coenesthetic, personality and ideatory (anxious and obsessive) hypochondriac phenomena characterized by a differentiated response to psychopharmacologic intervention and psychotherapy.

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