Your skin can warn of hidden mental health issues

The study included 481 people experiencing their first episode of psychosis (the first time a person experienced symptoms such as delusions, hallucinations, or loss of contact with reality). Among them, 14.5% showed signs of skin problems (24% of females and 9.8% of males), including rash, itching or sensitivity to light. All participants received four weeks of antipsychotic treatment, after which researchers assessed various mental health indicators.

Lead researcher Dr. Joaquín Galvani (Gregorio Marañon Health Research Institute, Madrid) explained:

“After 4 weeks of follow-up, patients with a first episode of psychosis who had skin conditions had higher levels of depression and suicide risk. We found that only 7% of patients without a primary skin condition had suicidal thoughts or attempts. In contrast, about 25% of patients with a primary skin condition had suicidal thoughts or attempts. Primary skin conditions also increased depression and poor health at follow-up.

“This finding suggests that the presence of skin disease suggests that these patients are more at risk for worse outcomes than patients without skin disease after their first episode of psychosis.”

The team noted that if more research supports these findings, skin symptoms could serve as an early warning sign of elevated mental health risks, much like the way blood tests can indicate the possibility of cancer or heart disease.

Because the brain and skin develop from the same embryonic layer called the ectoderm, scientists set out to explore how these two systems are related.

Dr. Cole added:

“It was already known that between 30% and 60% of people with skin conditions had psychological symptoms. What we did was 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 skin symptoms may represent a marker of illness severity and poor short-term outcome in the early stages of psychosis, potentially identifying a subgroup of patients with a poor clinical prognosis who may benefit from early tailored interventions. The reason for the association remains unclear, but our working hypothesis is that this may be because the skin and nervous system have common developmental origins and inflammatory pathways. But this needs to be confirmed. To our knowledge, this is the first study to show this association in patients with psychosis, so we need follow-up studies to confirm the results. We also need to understand whether this association also applies to a range of other psychiatric conditions, such as bipolar disorder, ADHD, anxiety or depression.

Providing an independent perspective, Professor Eric Ruhe (Professor of Difficult-to-Treat Depression at Radboud University, Netherlands) commented:

“This is an interesting association between skin problems and a first episode of psychosis. These findings need to be replicated in different populations but may actually show a new link between skin and psychopathology.”

Since skin and brain derive from the same embryonic origin, this is worth pursuing further, both diagnostically and mechanistically (which would be more interesting). “For example, this connection could be used to culture skin cells to begin to understand the appropriate treatment.”

This is an independent comment, and Professor Roh was not involved in this work.