Psychogenic pruritus in women with a history of sexual abuse: A cross-sectional study

Abstract

Abstract Background: Psychogenic pruritus, a chronic itch without dermatological cause, is increasingly linked to psychological trauma, particularly sexual abuse in women. Its prevalence, severity, and trauma correlation are underexplored. Objective: To estimate the proportion and severity of psychogenic pruritus among women with a history of sexual abuse compared to women without such a history and to examine its association with trauma symptom severity. Materials and Methods: This cross-sectional analytical study was conducted at a tertiary care institute in North India (January 2023–June 2024). A sample of 150 women aged 18–65 years (75 with documented sexual abuse history and 75 without) were selected. Trauma was assessed using the Trauma Symptom Inventory-2 (TSI-2), pruritus severity with the Visual Analog Scale (VAS), and organic causes excluded via dermatological evaluation. Psychogenic pruritus was diagnosed by dermatologists, defined as chronic itch (>6 weeks) without primary skin lesions or systemic/neurological causes. Sexual abuse was confirmed via medical records or clinical interviews using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Statistical analyses included Chi-square tests, t -tests, Pearson’s correlation, and multivariate regression. Results: The prevalence of psychogenic pruritus was 61.3% in cases and 22.7% in controls (χ 2 = 22.91, P < 0.001). The mean VAS scores were 6.8 ± 1.9 (cases) and 3.4 ± 1.5 (controls) ( t = 11.43, P < 0.001). TSI-2 scores correlated moderately with VAS scores ( r = 0.52, 95% confidence interval: 0.36–0.65, P < 0.001). Subgroup analysis demonstrated that higher trauma burden, particularly intrusive experiences and somatic preoccupation subscales of TSI-2, showed stronger correlations with pruritus severity. TSI-2 total score predicted pruritus severity (β = 0.47, P < 0.001). Only 12% of cases sought psychological counseling. Limitations: The cross-sectional design limits causality inference, and self-reported data may introduce recall bias. The study was restricted to women at a single center, limiting generalizability. Conclusion: Women with sexual abuse histories show higher psychogenic pruritus prevalence and severity, correlated with trauma intensity. Integrated dermatological–psychological care is essential.