Dear Editor,
Advancing medical knowledge partly depends on exchanging ideas and publications in peer-reviewed journals. Journals’ impact factors play an important role in the process.
Psychocutaneous medicine/psychodermatology is one of the oldest subspecialties of dermatology1. Despite this, psychodermatology is not consistently represented in dermatology practices.
We hypothesized that there is a deficit of Psychodermatology publications in high-impact dermatology journals.
We compared publications of Psychocutaneous articles with publications on Psoriasis and Biologics/Biological treatments between 2011 and 2021.
On 2/18/2022 we conducted a Scopus (largest peer-reviewed medical database) search, with the following search words:
TITLE-ABS-KEY (psoriasis) AND (limit to publication year) AND (Limit-to (SRCTYPE, “j”))
TITLE-ABS-KEY(Psychocutan* OR psychoderm* OR “psycho-cutan*” OR “psycho-derm*”)
TITLE-ABS-KEY(biologic OR biologics OR “biological treatment*” OR “biological therapy” OR “biological therapies”).
Dermatology journals were identified by analyzing the source list in the Dermatology subject area. Scopus’s CiteScroe percentile/ranking and SJR impact factors were used to select six journals from this group as the highest impact in this study.
Statistical analyses were conducted using SAS software (SAS Institute Inc., Cary NC), version 9.4. All reported p-values are two-sided and p<0.05 was used to define statistical significance. Descriptive statistics, such as count and frequency, were generated, and Fisher’s exact was used for publication comparisons between Psychocutaneous vs. Biologics and Psoriasis articles. A binomial test was used to compute the proportion and confidence limits of Psychocutaneous, and Biologics articles published within Psoriasis articles.
Table 1 shows the number of articles in all journals compared to the 231 journals identified as “dermatology journals” by Scopus, as well as the number of publications in the 6 highest impact dermatology journals.
Table 1:
Statistics of publication of the three main subjects in all versus 6 highest impact dermatology journals
| Scopus Search on 2/18/2022 | Biologics | Psychocutaneous | Psoriasis | P(Psy v. Bio) | P (Psy v. Psoriasis) |
|---|---|---|---|---|---|
| All journals | 59806 | 493 | 35704 | ||
| 231 Dermatology journals | 3432 (5.74%) | 328 (66.53%) | 15834 (44.35%) | <.0001* | <.0001* |
| 6 highest impact dermatology journals | 970 (28.26%) | 38 (11.59%) | 4656 (29.41%) | <.0001* | <.0001* |
| British journal of dermatology | 281 (8.19%) | 9 (2.74%) | 1429 (9.02%) | 0.0001* | <.0001* |
| Jama and archives dermatology | 55 (1.60%) | 5 (1.52%) | 315 (1.99%) | 1.0000 | 0.6903 |
| American Journal of Clinical dermatology | 80 (2.33%) | 3 (0.91%) | 178 (1.12%) | 0.1138 | 1.0000 |
| Journal of Investigative dermatology | 69 (2.01%) | 1 (0.30%) | 657 (4.15%) | 0.0288* | <.0001* |
| Journal of the European Academy of Dermatology and Venereology | 213 (6.21%) | 6 (1.83%) | 1148 (7.25%) | 0.0005* | <.0001* |
| Journal of the American Academy of dermatology | 272 (7.93%) | 14 (4.72%) | 929 (5.87%) | 0.0160* | 0.2824 |
Statistical significance
Abbreviations; JAMA: The Journal of the American Medical Association; Psy: Psychocutaneous; Bio: Biologics
Table 2 compares the presence of “Psoriasis AND Biologics” in the same article, with that of “Psoriasis AND Psychocutaneous”.
Table 2:
Probabilities of Psoriasis articles mentioning Biologics versus Psychocutaneous
| Combination search with psoriasis | Proportion | LCL | UCL |
|---|---|---|---|
| Biologics | 12.96% | 12.62% | 13.32% |
| Psychocutaneous | 0.28% | 0.23% | 0.34% |
LCL: lower confidence level
UCL: upper confidence level
Results show that a statistically higher percentage of Psychocutaneous articles are published in dermatology journals, but the rate of publications in high-impact journals is significantly lower than the rate of publications for Psoriasis or Biological treatments. There is also a very low chance that a Psoriasis article mentions Psychocutaneous/Psychodermatology compared to Biologics/Biological.
In 2018, Shen et al. published an article in Nature arguing that publication in distinguished journals advances careers, and being under-published in those journals has negatively affected the careers of thousands of female scientists2. Therefore, we propose that high-impact journals under-publishing Psychocutaneous articles could affect the advancement of this subspecialty.
It is well known that 30–40% of patients with chronic skin disorders have psychological impacts due to their skin disease3. Investigating the reasons for the absence of Psychocutaneous publications in high-impact dermatology journals may be one of the avenues in promoting mental health awareness in dermatology. This will save health care dollars by decreasing the number of unnecessary visits by patients4, and decrease spending on expensive treatments by reducing stress in skin diseases that are triggered or exacerbated by stress5,6.
The limitation of our present literature search is that mental health issues could be mentioned under other search words. We used Psychocutaneous or Psychodermatology since they are common keywords that Psychocutaneous researchers use to find related articles. We also do not have the number of papers that were submitted but not accepted.
In promoting Psychodermatology we do need to have a set of guidelines. Publishers and journals with a high impact on dermatologists should consider their responsibility in this matter to create a fair field to spread the knowledge.
Acknowledgments:
The project was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR002373 The content is solely the responsibility of the author and does not necessarily represent the official views of the NIH. The author would like to acknowledge valuable contributions by: Leslie Christensen, MA-LIS, and Qianqian Zhao, MS
Footnotes
Conflicts of Interest: None declared.
Data Availability:
The data used in the manuscript will be available upon request from the author.
References:
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Data Availability Statement
The data used in the manuscript will be available upon request from the author.