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Kuryłło M, Mojs E. Do Atopic Dermatitis and Psoriasis Have an Impact on Cognitive Decline-Latest Research Review. Healthcare (Basel) 2024; 12:1170. [PMID: 38921285 PMCID: PMC11203898 DOI: 10.3390/healthcare12121170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Atopic dermatitis and psoriasis are chronic skin diseases that affect the mental health of patients. The relationship between AD and psoriasis and cognitive processes in patients remains unclear. The aim of the review was to answer the question of whether AD and psoriasis have an impact on cognitive decline in patients. METHOD A systematic literature search was conducted on PubMed and EBSCO to identify case-control, cross-sectional, or cohort studies that evaluated the association between atopic dermatitis and psoriasis and cognitive impairment. RESULTS Most of the studies included in the review confirmed cognitive decline in patients with atopic dermatitis and psoriasis. CONCLUSIONS It seems that atopic dermatitis and psoriasis may negatively affect cognitive processes such as working memory, concentration, attention, and speed of motor reactions. Psychological interventions targeting distorted cognitive processing could improve the quality of life of patients with atopic dermatitis and psoriasis.
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Affiliation(s)
- Marcin Kuryłło
- Department of Clinical Psychology, Poznan University of Medical Sciences, 60-812 Poznań, Poland;
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Nicoloro-SantaBarbara J, Majd M, Burdick KE, Dixon V, Giannetti MP. Cognitive Impairment and Depression in Mastocytosis: A Synthesis of the Literature. Curr Allergy Asthma Rep 2024; 24:53-62. [PMID: 38294589 DOI: 10.1007/s11882-024-01127-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE OF REVIEW Symptoms of depression and cognitive dysfunction are commonly reported in mastocytosis. The aims of this review paper are to summarize the current literature on cognitive dysfunction and depressive symptoms, elucidate some of the mechanistic pathways underlying depressive symptoms in mastocytosis, identify gaps in the literature, and offer guidance for future research in this area. RECENT FINDINGS The study of cognition and depression in mastocytosis is in its infancy and the methodological flaws of the current literature limit interpretability. There is preliminary evidence that some individuals with mastocytosis might experience mild deficits in memory. On average, depression symptom scores fell within the mild to moderate or sub-syndromal range. Regrettably, only one study utilized a standardized diagnostic instrument to assess major depressive disorder. The authors' tendency to inaccurately equate depressive symptoms with a diagnosis of major depressive disorder presents a notable issue. The prevalence of cognitive deficits and depression appears to be similar to other chronic illnesses. Future work needs to better characterize cognition and characterize "depression" in this population.
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Affiliation(s)
- Jennifer Nicoloro-SantaBarbara
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Marzieh Majd
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Katherine E Burdick
- Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Victoria Dixon
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Matthew P Giannetti
- Harvard Medical School, Boston, MA, USA
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, MA, USA
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3
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Iocca F, Burlando M, Angelo NL, Ragucci F, Pugi D, Parodi A, Dèttore D, Pozza A. Sexual functioning in patients with psoriasis: the role of body dissatisfaction and cognitive biases toward sexuality. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:439-455. [PMID: 38288968 DOI: 10.1080/0092623x.2024.2302959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Psoriasis is a chronic disease, involving skin and joints, characterized by inflamed lesions. Psoriasis negatively impacts the patients' quality of life due to the physical, emotional, and social burden that accompanies this condition. Also, psoriasis is associated with a number of psychiatric comorbidities, including sexual dysfunctions. The present study investigates the variables associated with sexual functioning in psoriasis patients. One-hundred-three psoriasis patients and 101 matched control subjects took part in the present study. Each participant completed five self-report measures investigating the presence of depression, anxiety and stress symptoms, body image, quality of life, and sexual experience. Our results show that differences in sexual activity, but not in sexual functioning, emerged between groups. In men with psoriasis, more sexual difficulties were associated with more negative automatic thoughts about sexuality. In women, more sexual difficulties were associated with more negative automatic thoughts; anxiety, depression, and stress; severity of symptoms; comorbid disease; age; quality of life. Our findings expand the current knowledge about sexual functioning in psoriasis and shed light on specific cognitive, psychological, and demographic variables associated with sexual impairment in men and women with psoriasis.
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Affiliation(s)
- Francesco Iocca
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Martina Burlando
- Department of Dermatology, Dipartimento di Scienze della Salute- DISSAL, University of Genoa, Genova, Italy
- UO Clinica Dermatologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Nicole Loren Angelo
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Federica Ragucci
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Daniele Pugi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Aurora Parodi
- Department of Dermatology, Dipartimento di Scienze della Salute- DISSAL, University of Genoa, Genova, Italy
- UO Clinica Dermatologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Andrea Pozza
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- Psychology Unit, Department of Mental Health, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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4
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Meneo D, Martoni M, Giannandrea A, Tengattini V, Baglioni C. Mindfulness and self-compassion in dermatological conditions: a systematic narrative review. Psychol Health 2024; 39:268-300. [PMID: 35522563 DOI: 10.1080/08870446.2022.2070619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE People affected by chronic skin conditions suffer from elevated levels of psychological distress. There is a need for evidence-based treatments that integrate medical care. Mindfulness and Self-compassion programs (MCBPs) have proven effective in chronic diseases. This systematic review aims to narratively synthesize the literature on mindfulness and self-compassion as traits and interventions in chronic skin conditions. DESIGN We searched four electronic databases for mindfulness and self-compassion trials and correlational studies in chronic skin conditions. We narratively synthetized results regarding the effects of mindfulness and self-compassion, both as traits and as interventions, on psychological and disease outcomes. RESULTS Thirteen studies were included in our review. Evidence from cross-sectional studies suggest that mindfulness and self-compassion are linked to lower psychological distress and better adjustment to the disease. MCBPs appear feasible for this population and can lower psychological distress, reduce disease severity and improve quality of life. Methodological issues limit conclusions on MCBP efficacy. Based on our analysis, we propose possible mechanisms that future research could explore. CONCLUSIONS The integration of MCBPs in the care process of chronic skin conditions appears promising. Definitive conclusions cannot be drawn due to a lack of strong evidence. Further studies with high methodological standards are needed.
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Affiliation(s)
- D Meneo
- Human Sciences Department, University of Rome Guglielmo, Marconi, Rome, Italy
| | - M Martoni
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - A Giannandrea
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - V Tengattini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - C Baglioni
- Human Sciences Department, University of Rome Guglielmo, Marconi, Rome, Italy
- Department of Clinical Psychology and Psychophysiology/Sleep, Medicine, Centre for Mental Disorders, University Medical Centre, Freiburg, Germany
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5
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Hewitt RM, Urmston D, Mcateer H, Schofield J, Bundy C. A UK online survey exploring patient perspectives of remote consultations for managing psoriasis and psoriatic arthritis during the SARS-CoV-2 pandemic. PSYCHOL HEALTH MED 2023; 28:3163-3176. [PMID: 35941815 DOI: 10.1080/13548506.2022.2104883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 07/18/2022] [Indexed: 10/15/2022]
Abstract
The use of remote consultations via telephone or video can contribute to the management of people with psoriasis and has allowed continuity of patient care throughout the SARS-CoV-2 pandemic, though little is known about the patient experience. The present study aimed to provide insights into the views and experiences of people with psoriasis and psoriatic arthritis on their remote consultations during the SARS-CoV-2 pandemic and develop guidance for patients and healthcare professionals on how to optimise future remote consultations. We conducted a cross-sectional, on-line survey of people with psoriasis and psoriatic arthritis. Data were analysed using descriptive statistics and Thematic Analysis. Overall, 126 people reported experiences of telephone (92%) or video (8%) consultations. Most participants were satisfied with (78%), and were happy for, remote consultations to continue (21%); few were not (5%). Others did not always want remote consultations (39%) and preferred alternating with face-to-face consultations (18%). Some wanted remote care during the pandemic only (17%). Five themes were identified: (1) Advantages of Remote Consultations; (2) Disadvantages of Remote Consultations plus sub-themes (2.1) Practical Issues and (2.2) the Absence of Non-Verbal Cues and Emotions; (3) Serving a Purpose; and (4) A 'Good' Remote Consultation; and (5) Advice to Other Patients. Remote consultations form an important part of psoriatic disease management, mainly for routine follow-up appointments in patients with stable disease, and in addition to face-to-face consultations. Additional skills training for clinicians could improve the quality of remote consultations.
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Affiliation(s)
- Rachael M Hewitt
- School of Healthcare Sciences, College of Biomedical & Lifesciences, Cardiff University, Cardiff, UK
| | | | - Helen Mcateer
- The Psoriasis Association, Northampton, England, UKb
| | - Julia Schofield
- The Psoriasis Association, Northampton, England, UKb
- Postgraduate Medicine, University of Hertfordshire, College Lane, Hatfield, England
| | - Chris Bundy
- School of Healthcare Sciences, College of Biomedical & Lifesciences, Cardiff University, Cardiff, UK
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Zhang XJ, Lin J, Feng L, Ou M, Gong FQ. Non-pharmacological interventions for patients with psoriasis: a scoping review. BMJ Open 2023; 13:e074752. [PMID: 38000814 PMCID: PMC10679995 DOI: 10.1136/bmjopen-2023-074752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES Healthcare ultimately aims to eradicate diseases and restore normality to people's lives. However, until this is achieved for every person, there is a need to support and assist patients with psoriasis using non-pharmacological interventions. These 'adjuvant' approaches have received little attention, whereas dermatologists and researchers strive for better pharmacological therapy. Here, we aimed to perform a scoping review to identify and catalogue non-pharmacological interventions for patients with psoriasis. DESIGN A scoping review. SETTING All healthcare settings. SEARCH STRATEGY EMBASE, PubMed, CINAHL, PsycINFO and Scopus databases were searched from their inception to June 2022. Irrespective of the study type, the studies included non-pharmacological interventions for patients with psoriasis. This theme was extracted from the included articles. Two reviewers independently screened and analysed the data. RESULTS From 1322 initial records, 71 studies were identified and analysed. Non-pharmacological interventions for patients with psoriasis include two levels: organisational and individual. The organisational non-pharmacological interventions included the nationwide healthcare model (PsPSP, ProvenCare, German PsoHealth and Psoriasis Network, IMPROVE model and PsoWell clinic), innovative teledermatology models (mHealth app, electronic Targeted Intervention for Psoriasis study and therapist-guided internet-based cognitive and behavioural treatments) and multidisciplinary interventions. The individual non-pharmacological interventions included educational interventions (therapeutic patient education, psychoeducational intervention and self-management education), psychosocial interventions (cognitive and behavioural treatments, self-help and peer-to-peer support programmes) and others (happify and motivational interviewing-based training). CONCLUSIONS Based on previous literature, a nationwide healthcare model protocol was constructed for patients with psoriasis. This provided the direction for developing a new psoriasis healthcare model and a basis for summarising the non-pharmacological interventions for patients with psoriasis, which helps them adjust to changes in the skin disease.
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Affiliation(s)
- Xiu-Jie Zhang
- School of Public Health, China Medical University, Shenyang, Liaoning, China
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, Dalian, China
| | - Jingrong Lin
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, Dalian, China
| | - Li Feng
- Department of Dermatology, Dalian Dermatology Hospital, Dalian, China
| | - Minxing Ou
- Department of Dermatology, First Affiliated Hospital of Dalian Medical University, Dalian, Dalian, China
| | - Fu-Qing Gong
- School of Public Health, China Medical University, Shenyang, Liaoning, China
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Langenbruch A, Mohr N, Andrees V, Kessens I, Reich A, Czarnecka-Operacz M, Puig L, Dauden E, Iversen L, Augustin M. PsoBarrier EU study: a Multicentre, Cross-sectional Survey Investigating the Quality of Psoriasis Care in Four European Countries. Acta Derm Venereol 2023; 103:adv6532. [PMID: 37649411 PMCID: PMC10496845 DOI: 10.2340/actadv.v103.6532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
Enhanced treatment options for psoriasis and growing use of guidelines increased the potential to better quality of psoriasis care in Europe. The aim of the PsoBarrier EU study is to compare the quality and processes of psoriasis care in four European countries with different healthcare systems, based on validated quality indicators. This cross-sectional survey was conducted in dermatology centres in Denmark, Germany, Poland and Spain on 1,304 patients, using standardized patient and physician questionnaires. Measured by quality of psoriasis care indicators, patients in Poland had the most critical outcomes, such as the highest disease severity (Psoriasis Area and Severity Index; PASI) and lowest health-related quality of life (Dermatology Life Quality Index; DLQI). This indicates differences in psoriasis care, with Polish participants experiencing more severe psoriasis and its consequences. Differences in the healthcare systems, which create barriers to accessing treatments, could explain variations in quality of care.
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Affiliation(s)
- Anna Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany.
| | - Nicole Mohr
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany
| | - Valerie Andrees
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany
| | - Ihno Kessens
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | | | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Esteban Dauden
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany
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Bozsányi S, Czurkó N, Becske M, Kasek R, Lázár BK, Boostani M, Meznerics FA, Farkas K, Varga NN, Gulyás L, Bánvölgyi A, Fehér BÁ, Fejes E, Lőrincz K, Kovács A, Gergely H, Takács S, Holló P, Kiss N, Wikonkál N, Lázár I. Assessment of Frontal Hemispherical Lateralization in Plaque Psoriasis and Atopic Dermatitis. J Clin Med 2023; 12:4194. [PMID: 37445231 DOI: 10.3390/jcm12134194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/09/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Each brain hemisphere plays a specialized role in cognitive and behavioral processes, known as hemispheric lateralization. In chronic skin diseases, such as plaque psoriasis (Pso) and atopic dermatitis (AD), the degree of lateralization between the frontal hemispheres may provide insight into specific connections between skin diseases and the psyche. This study aims to analyze the hemispherical lateralization, neurovegetative responses, and psychometric characteristics of patients with Pso and AD. METHODS The study included 46 patients with Pso, 56 patients with AD, and 29 healthy control (Ctrl) subjects. The participants underwent frontal electroencephalogram (EEG) measurement, heart rate variability (HRV) assessment, and psychological tests. Statistical analyses were performed using ANOVA, with Bonferroni correction applied for multiple comparisons. RESULTS This study shows a significant right-lateralized prefrontal activity in both AD patients (p < 0.001) and Pso patients (p = 0.045) compared with Ctrl, with no significant difference between the AD and Pso groups (p = 0.633). AD patients with right-hemispheric dominant prefrontal activation exhibited increased inhibition and avoidance markers, while Pso patients showed elevated sympathetic nervous system activity. CONCLUSION Psychophysiological and psychometric data suggest a shared prevalence of right-hemispheric dominance in both AD and Pso patient groups. However, the findings indicate distinct psychodermatological mechanisms in AD and Pso.
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Affiliation(s)
- Szabolcs Bozsányi
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Natália Czurkó
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Melinda Becske
- Institute of Behavioral Sciences, Semmelweis University, 1089 Budapest, Hungary
- Selye János Doctoral College for Advanced Studies, 1085 Budapest, Hungary
| | - Roland Kasek
- Institute of Behavioral Sciences, Semmelweis University, 1089 Budapest, Hungary
- Selye János Doctoral College for Advanced Studies, 1085 Budapest, Hungary
| | - Botond Keve Lázár
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Mehdi Boostani
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Klára Farkas
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Noémi Nóra Varga
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Lili Gulyás
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Bence Ágoston Fehér
- Institute of Behavioral Sciences, Semmelweis University, 1089 Budapest, Hungary
| | - Emese Fejes
- Selye János Doctoral College for Advanced Studies, 1085 Budapest, Hungary
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Anikó Kovács
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Hunor Gergely
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Szabolcs Takács
- Institute of Psychology, Faculty of Humanities, Károli Gáspár University of the Reformed Church in Hungary, 1042 Budapest, Hungary
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
- Central Hospital of Northern Pest-Military Hospital, 1139 Budapest, Hungary
| | - Imre Lázár
- Institute of Behavioral Sciences, Semmelweis University, 1089 Budapest, Hungary
- Institute of Social and Communication Sciences, Faculty of Humanities and Social Sciences, Károli Gáspár University of the Reformed Church in Hungary, 1091 Budapest, Hungary
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Tkachenko E, Okhovat JP, Manjaly P, Huang KP, Senna MM, Mostaghimi A. Complementary and alternative medicine for alopecia areata: A systematic review. J Am Acad Dermatol 2023; 88:131-143. [PMID: 31870916 DOI: 10.1016/j.jaad.2019.12.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/22/2019] [Accepted: 12/08/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite high use of complementary and alternative medicine (CAM) for alopecia areata (AA), efficacy and safety remain unclear. OBJECTIVE To identify all CAM therapies studied for treatment of AA. Outcomes of interest included disease course and psychologic well-being. METHODS PubMed and Embase were searched to identify English articles containing original data investigating CAM in individuals with AA from 1950-2018. Quality was assessed with Oxford Centre for Evidence Based Medicine criteria. RESULTS Of 1015 initial citations, 16 articles met inclusion criteria: 5 randomized controlled trials, 5 prospective controlled cohorts, 4 prospective noncontrolled cohorts, 1 retrospective cohort, and 1 case series. CAM therapies with best evidence and efficacy for hair growth in AA include essential oil aromatherapy, topical garlic, and oral glucosides of peony with compound glycyrrhizin. Hypnosis and mindfulness psychotherapy represent low-quality evidence for improvement of psychologic and quality of life outcomes. Adverse events were rare and mild for all therapies evaluated. LIMITATIONS Inconsistent or poorly reported study methodology and nonstandardized outcomes limit the conclusions that can be made from these studies. CONCLUSIONS This work serves to inform physician treatment of patients with AA seeking CAM while encouraging further investigation into these therapies to address some of the therapeutic challenges of AA.
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Affiliation(s)
- Elizabeth Tkachenko
- University of Massachusetts Medical School, Worcester, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jean-Phillip Okhovat
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Priya Manjaly
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Kathie P Huang
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Maryanne M Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.
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10
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Hewitt RM, Ploszajski M, Purcell C, Pattinson R, Jones B, Wren GH, Hughes O, Ridd MJ, Thompson AR, Bundy C. A mixed methods systematic review of digital interventions to support the psychological health and well-being of people living with dermatological conditions. Front Med (Lausanne) 2022; 9:1024879. [PMID: 36405626 PMCID: PMC9669071 DOI: 10.3389/fmed.2022.1024879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background Dermatological conditions can have a substantial impact on psychological as well as physical health yet dedicated face-to-face psychological support for patients is lacking. Thus, individuals may require additional support to self-manage dermatological conditions effectively. Digital technology can contribute to long-term condition management, but knowledge of the effectiveness of digital interventions addressing psychological (cognitive, emotional, and behavioural) aspects of dermatological conditions is limited. Objectives To identify, determine the effectiveness, and explore people’s views and experiences of digital interventions supporting the psychological health of people with dermatological conditions. Methods A mixed methods systematic review informed by JBI methodology. The protocol was registered on PROSPERO. Eight electronic databases were searched for papers written between January 2002 and October 2021. Data screening and extraction were conducted in Covidence. The methodological quality of studies were scrutinised against JBI critical appraisal tools. Intervention characteristics were captured using the Template for Intervention Description and Replication checklist and guide. Data were synthesised using a convergent segregated approach. The results were reported in a narrative summary. Results Twenty-three papers were identified from 4,883 references, including 15 randomised controlled trials. Nineteen interventions were condition-specific, 13 were delivered online, 16 involved an educational component, and 7 endorsed established, evidence-based therapeutic approaches. Improvements in knowledge, mood, quality of life, the therapeutic relationship, and reduced disease severity in the short to medium term, were reported, although there was substantial heterogeneity within the literature. Thirteen studies captured feedback from users, who considered various digital interventions as convenient and helpful for improving knowledge, emotion regulation, and personal control, but technical and individual barriers to use were reported. Use of established qualitative methodologies was limited and, in some cases, poorly reported. Conclusion Some web-based digital psychological interventions seem to be acceptable to people living with mainly psoriasis and eczema. Whilst some digital interventions benefitted cognitive and emotional factors, heterogeneity and inconsistencies in the literature meant definitive statements about their effectiveness could not be drawn. Interdisciplinary and patient-centred approaches to research are needed to develop and test quality digital interventions supporting the psychological health of adults living with common and rare dermatological conditions. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=285435], identifier [CRD42021285435].
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Affiliation(s)
- Rachael M. Hewitt
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
- Wales Centre for Evidence Based Care–A JBI Centre of Excellence, Cardiff, United Kingdom
- *Correspondence: Rachael M. Hewitt,
| | | | - Catherine Purcell
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| | - Rachael Pattinson
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| | - Bethan Jones
- School of Health and Social Wellbeing, University of the West of England, Bristol, United Kingdom
| | - Georgina H. Wren
- School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Olivia Hughes
- School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Matthew J. Ridd
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Andrew R. Thompson
- School of Psychology, Cardiff University, Cardiff, United Kingdom
- South Wales Clinical Psychology Training Programme, Cardiff and Vale University Health Board – School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Chris Bundy
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
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11
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Mindfulness and Meditation for Psoriasis: A Systematic Review. Dermatol Ther (Heidelb) 2022; 12:2273-2283. [PMID: 36103011 PMCID: PMC9515248 DOI: 10.1007/s13555-022-00802-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022] Open
Abstract
Psoriasis is a chronic, recurrent inflammatory skin condition in which flares are commonly associated with stress. One important non-pharmacological method for managing stress in patients with psoriasis is mindfulness and/or meditation. The objective of this review is to provide an update on research studies investigating the role of mindfulness and meditation in treating psoriasis symptoms, severity, and quality of life. Of six randomized control trials (RCTs) identified, five demonstrated improvement in self-administered psoriasis area and severity index (saPASI) after 8 or 12 weeks of guided meditation. One RCT and one non-randomized control trial reported mental health benefits in psoriasis patients following guided meditation. These results suggest that meditation can be used as a tool to improve both psoriasis skin severity and patient quality of life in the short term. More research is needed to evaluate the effect of meditation on psoriasis severity and quality of life in the long term.
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12
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Psychological Therapies and Mind-Body Techniques in the Management of Dermatologic Diseases: A Systematic Review. Am J Clin Dermatol 2022; 23:755-773. [PMID: 35945404 DOI: 10.1007/s40257-022-00714-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND There is a clear link between skin disease and psychological factors and this relationship works both ways: skin diseases can cause psychological distress and psychological issues can worsen skin disease. There are a number of therapies that approach this problem from the psychological side and may be useful, especially as adjunctive therapies in select patients. OBJECTIVE The aim of this review was to determine the efficacy of various psychological therapies and mind-body techniques in the management of common dermatologic diseases in individuals of all ages. METHODS A systematic review of PubMed, Elsevier, and Wiley was performed for studies investigating psychological and mind-body interventions in the management of various skin diseases. Both physical and non-physical treatment outcomes were considered. Studies were evaluated for both risk of bias and overall quality of evidence. RESULTS A total of 40 articles studying unique sets of dermatological patients receiving psychological therapies or mind-body interventions were identified. Of the 40 included articles encompassing 3112 patients, 18 investigated these interventions in psoriasis management while 15 focused on atopic dermatitis. The remaining studies investigated vitiligo (2), pruritus (2), acne vulgaris (2), and acne excoriée (1). CONCLUSIONS Based on the analysis of included studies and an assessment of their quality of evidence, the most promising interventions are cognitive behavioral therapy, mindfulness-based interventions, and habit reversal therapy.
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13
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Law M, Jarrett P, Nieuwoudt MK, Holtkamp H, Giglio C, Broadbent E. The Effects of Interacting With a Paro Robot After a Stressor in Patients With Psoriasis: A Randomised Pilot Study. Front Psychol 2022; 13:871295. [PMID: 35645866 PMCID: PMC9133624 DOI: 10.3389/fpsyg.2022.871295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Stress can play a role in the onset and exacerbation of psoriasis. Psychological interventions to reduce stress have been shown to improve psychological and psoriasis-related outcomes. This pilot randomised study investigated the feasibility of a brief interaction with a Paro robot to reduce stress and improve skin parameters, after a stressor, in patients with psoriasis. Methods Around 25 patients with psoriasis participated in a laboratory stress task, before being randomised to either interact with a Paro robot or sit quietly (control condition) for 30 min. Raman spectroscopy and trans-epidermal water loss were measured at baseline, after the stressor and after the intervention as indexes of acute skin changes. Psychological variables, including self-reported stress and affect, were also measured at the three time-points. Results No statistically significant differences between the two conditions were found for any of the outcomes measured. However, effect sizes suggest significance could be possible with a larger sample size. Changes in the psychological and Raman spectroscopy outcomes across the experimental session were found, indicating the feasibility of the procedures. Conclusion This pilot study showed that a brief interaction with a Paro robot was a feasible intervention for patients with psoriasis, but future trials should broaden the inclusion criteria to try to increase recruitment rates. Studying people who are highly stressed, depressed or who are stress-responders may increase the power of the intervention to show effects using a longer-term intervention.
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Affiliation(s)
- Mikaela Law
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Paul Jarrett
- Department of Dermatology, Middlemore Hospital, Auckland, New Zealand.,Department of Medicine, The University of Auckland, Auckland, New Zealand
| | - Michel K Nieuwoudt
- The Photon Factory, The University of Auckland, Auckland, New Zealand.,School of Chemical Sciences, The University of Auckland, Auckland, New Zealand.,The MacDiarmid Institute for Advanced Materials and Nanotechnology, Wellington, New Zealand.,The Dodd-Walls Centre for Photonic and Quantum Technologies, Dunedin, New Zealand
| | - Hannah Holtkamp
- The Photon Factory, The University of Auckland, Auckland, New Zealand.,School of Chemical Sciences, The University of Auckland, Auckland, New Zealand.,The MacDiarmid Institute for Advanced Materials and Nanotechnology, Wellington, New Zealand.,The Dodd-Walls Centre for Photonic and Quantum Technologies, Dunedin, New Zealand
| | - Cannon Giglio
- The Photon Factory, The University of Auckland, Auckland, New Zealand.,School of Chemical Sciences, The University of Auckland, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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14
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von Spreckelsen R, Gerdes S, Mrowietz U, Emmert H. Zugang und Inanspruchnahme psychosomatischer Versorgung aus ärztlicher Sicht: Eine qualitative Interviewstudie. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1754-4332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Zusammenfassung
Hintergrund Chronisch entzündliche Hauterkrankungen sind häufig mit psychosozialen Beeinträchtigungen und einer reduzierten Lebensqualität vergesellschaftet. Ziel dieser Studie war es zu erfassen, wie spezialisiertes medizinisches Personal eines universitären Haut-Entzündungszentrums die Zugangswege und die Inanspruchnahme psychosomatischer Sondierungsgespräche oder Kurzzeitinterventionen bei PatientInnen mit chronisch entzündlichen Hauterkrankungen wahrnimmt.
Methoden Es wurden qualitative Erhebungen in Form von 10 Einzelinterviews mit medizinischem Personal durchgeführt, das zum Zeitpunkt der Befragung im Zentrum für entzündliche Hauterkrankungen der Uni-Hautklinik tätig war. Die Daten wurden inhaltsanalytisch mithilfe einer qualitativen Analysesoftware ausgewertet.
Ergebnisse Die Ergebnisse aus den geführten Einzelinterviews ergaben, dass die Einbindung einer psychosomatischen Versorgung innerhalb eines dermatologischen Entzündungszentrums vom ärztlichen Personal als durchweg positiv bewertet wurde. Die Option auf ein zeit- und zentrumsnahes Gesprächsangebot nimmt dabei eine besondere Rolle ein. Experten fühlen sich mit der ortsnahen Einbindung psychosomatischer Expertise sicherer im Umgang mit belasteten Patient*innen. Der holistische Ansatz scheint einen positiven Einfluss auf die individuelle Behandlung und die Beziehungsgestaltung mit den Patient*innen zu nehmen. Dabei zeigten sich keine wesentlichen Unterschiede im Geschlecht und über verschiedene Altersgruppen hinweg.
Diskussion Die Möglichkeit zur zentrumsnahen Anbindung von belasteten Patient*innen in Form von zusätzlichen psychosomatischen Sondierungsgesprächen wie auch dem Einsatz von adaptierten Kurzzeitinterventionen trägt zur holistischen Behandlung bei, scheint einen günstigen Einfluss auf den somatischen Behandlungsverlauf zu nehmen und unterstützt Ärzt*innen in ihrer Behandlung.
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Affiliation(s)
- Regina von Spreckelsen
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
- Klinik für Psychotherapie und Psychosomatik, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Sascha Gerdes
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Ulrich Mrowietz
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Hila Emmert
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
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15
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Fortune DG, Ravnkilde V, Ryan S, Ramsay B, Clough S, Richards HL. A digital therapeutic for management of psychosocial aspects of psoriasis: A pre‐post proof of concept study. SKIN HEALTH AND DISEASE 2022; 2:e103. [PMID: 35677915 PMCID: PMC9168014 DOI: 10.1002/ski2.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/08/2022]
Abstract
Background Despite the psychosocial challenges of living with psoriasis many patients may not be able to access appropriate services to manage these challenges. Mobile health interventions may be helpful as a means to support patients in managing the impact of their condition. Objective To conduct a preliminary examination of the feasibility and acceptability of a bespoke psoriasis‐specific digital therapeutic solution (hereafter termed Allay), and to provide initial data on psychological changes pre‐post. Methods Phase one proof of concept pre‐post study. Eligible patients were provided with Allay on their smartphone and assessed at baseline and at 12 weeks on a range of indices of well‐being. Participants experiences on usability were collected by telephone interview at 4 weeks, 8 and 12 weeks. Results Out of 66 participants recruited, 59 persisted in using Allay after the familiarisation phase, and 34 participants completed the 12 weeks programme. Participants showed a statistically significant improvement between induction and the end of the 12 weeks programme on Quality of life, Resilience, Perceptions of ‘Overall impact’ of psoriasis, and ‘Emotional impact’. There was a significant change over the course of using Allay for symptoms of depression but not anxiety. While there was an interaction effect of changes in severity of psoriasis symptoms over the course of the study for dermatology‐specific measures, there was no interaction between such changes in psoriasis symptoms and changes in depression, resilience or beliefs in emotional impact. Conclusions Study results suggest that the use of Allay as an adjunct to medical management of psoriasis may help patients improve resilience, mood, beliefs about their condition and enhance their quality of life. Given that this is a phase one proof of concept study, and our rates of attrition further research is necessary to examine comparative effectiveness and stability of these findings.
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Affiliation(s)
- D. G. Fortune
- Department of Psychology University of Limerick Limerick Republic of Ireland
| | - V. Ravnkilde
- Charles Centre for Dermatology University Hospital Limerick Dooradoyle Republic of Ireland
| | - S. Ryan
- Charles Centre for Dermatology University Hospital Limerick Dooradoyle Republic of Ireland
| | - B. Ramsay
- Charles Centre for Dermatology University Hospital Limerick Dooradoyle Republic of Ireland
| | | | - H. L. Richards
- Department of Clinical Health Psychology Mercy University Hospital Cork Republic of Ireland
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16
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Does Guided Written Disclosure Reduce Distress and Improve Psychological Functioning in Patients with Skin Diseases? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052943. [PMID: 35270635 PMCID: PMC8910263 DOI: 10.3390/ijerph19052943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/18/2022] [Accepted: 02/28/2022] [Indexed: 02/06/2023]
Abstract
Background. Skin diseases (e.g., psoriasis and systemic sclerosis) are generally associated with negative psychosocial outcomes. Although different psychological interventions have been used to improve the quality of life of dermatological patients, the effects of the guided written disclosure (GWD) protocol have not been previously examined in these patients. Moreover, little attention has been paid to positive psychology constructs. Methods. This study investigates the effectiveness of GWD on positive and negative functioning in dermatological patients. Pre- and 1-month post-intervention measures included emotion regulation, sense of inner peace, skin-related symptoms and functioning, sense of coherence, and psychological distress. Results. A total of 196 consecutive outpatients were randomly assigned to GWD and active control groups, of whom 60 (30.6%) completed the study and 45 (GWD: n = 24; AC: n = 21) provided complete data. Our results did not show any significant difference between the experimental and control groups in the outcome variables, whereas non-completers reported higher levels of distress, unpleasant skin-related emotions, and lower cognitive reappraisal compared to completers. Conclusions. These findings show a poor compliance, and suggest that expressive writing is not well accepted by patients and is not effective in improving positive and negative psychological functioning in dermatological patients.
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17
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Blackstone B, Patel R, Bewley A. Assessing and Improving Psychological Well-Being in Psoriasis: Considerations for the Clinician. Psoriasis (Auckl) 2022; 12:25-33. [PMID: 35371967 PMCID: PMC8965012 DOI: 10.2147/ptt.s328447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/02/2022] [Indexed: 11/27/2022] Open
Abstract
Psoriasis is a common chronic, systemic inflammatory disease, affecting approximately 2% of the population worldwide. Psoriasis is associated with profound psychosocial comorbidity with a burden that extends well beyond the physical signs and symptoms. Psychosocial comorbidities strongly associated with psoriasis include anxiety and depression, suicidal ideation, and substance misuse. There is a substantial unmet need for access to psychological support for people with skin disease in the UK. Recent reports found that while up to 98% of patients felt that their skin disease had affected their emotional or psychological well-being, only 18% sought help. This care gap is largely due to a lack of awareness about the limited available services alongside poor recognition, diagnosis, and triaging. Addressing psychosocial support needs starts with early identification, which can be complex and challenging. Once patients who need further support are identified, outcomes can be improved through prompt and effective treatment of inflammation, cognitive behavioural therapy, meditation and mindfulness-based therapy (including motivational interviewing), and to some extent psychotropic medication. Finally, resources for mental health support are notoriously limited, with dire consequences for patients. It is imperative that a proportion of the new funding promised for mental health services is bookmarked for dermatology patients and adequate provision of multidisciplinary psychodermatology teams to best serve the needs of this population. Ultimately, psoriasis is a complex condition with multifactorial psychological and biological drivers. Psoriasis is associated with high levels of distress, which is often under-recognized. Fully addressing this condition requires a holistic approach to the physical and psychosocial aspects to maximise adherence, efficacy, and optimise patient quality of life.
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Affiliation(s)
- Brittany Blackstone
- Bart’s Health NHS Foundation Trust, London, UK
- Correspondence: Brittany Blackstone, Department of General Internal Medicine, The Royal London Hospital, Whitechapel Road, London, E1 1FR, UK, Email ; Radhika Patel, Bart's Health NHS Foundation Trust, London, UK, Email
| | - Radhika Patel
- Bart’s Health NHS Foundation Trust, London, UK
- Correspondence: Brittany Blackstone, Department of General Internal Medicine, The Royal London Hospital, Whitechapel Road, London, E1 1FR, UK, Email ; Radhika Patel, Bart's Health NHS Foundation Trust, London, UK, Email
| | - Anthony Bewley
- Barts Health NHS Trust, Queen Mary University London, London, UK
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18
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Muftin Z, Gilbert P, Thompson AR. A Randomised Controlled Feasibility Trial of Online Compassion-focused Self-Help for Psoriasis. Br J Dermatol 2022; 186:955-962. [PMID: 35041766 PMCID: PMC9322264 DOI: 10.1111/bjd.21020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 12/21/2021] [Accepted: 01/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with psoriasis can experience psychological distress that might be amenable to psychosocial self-help. OBJECTIVES This study tested the feasibility and acceptability of two theoretically developed self-help interventions designed to reduce feelings of shame and improve quality of life. METHODS A randomised controlled feasibility trial was conducted with one hundred and thirty participants with psoriasis who were randomly allocated to receive either compassion-based self-help (n =65) or mindfulness-based self-help (n =65), over a four-week period. RESULTS The interventions were found to be acceptable with over 70% of study completers reported finding the materials helpful. Ninety-two participants completed the study with attrition at 30%. Both interventions showed modest yet statistically significant reductions in shame (d = .20) and improvements in quality of life (d = .40). CONCLUSIONS Self-help based on compassion and mindfulness is acceptable to users and can reduce feelings of shame and improve quality of life for people living with psoriasis.
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Affiliation(s)
- Zina Muftin
- Department of Psychology, University of Sheffield, Cathedral Court, University of Sheffield, S1 2LT, UK
| | - Paul Gilbert
- Centre for Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby, Kedleston Road, Derby, DE22 1GB, UK
| | - Andrew R Thompson
- Department of Psychology, University of Sheffield, Cathedral Court, University of Sheffield, S1 2LT, UK.,South Wales Clinical Psychology Training, Cardiff University, 11th Floor, Tower Building, 70 Park Place, Cardiff, CF10 3AT, Wales
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19
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Martin A, Chopra R, Nicassio PM. Nonpharmacologic Pain Management in Inflammatory Arthritis. Rheum Dis Clin North Am 2021; 47:277-295. [PMID: 33781495 DOI: 10.1016/j.rdc.2020.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This article provides an overview of nonpharmacologic options for the treatment of pain in patients with inflammatory arthritis, such as peripheral spondyloarthritis, psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis. The experience of pain in chronic disease is a complex process influenced by multiple domains of health. The discussion focuses on the establishment of a framework for pain control that engages with factors that influence the experience of pain and explores the evidence base that supports specific modalities of nonpharmacologic pain control, such as mindfulness, cognitive behavioral therapy, exercise, massage, splinting, and heat therapy. Rheumatoid and spondyloarthritides are considered separately.
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Affiliation(s)
- Alexander Martin
- Division of Rheumatology, UMass Medical School, 119 Belmont Street, Worcester, MA 01605, USA
| | - Ratnesh Chopra
- Division of Rheumatology, UMass Medical School, 119 Belmont Street, Worcester, MA 01605, USA.
| | - Perry M Nicassio
- Department of Psychiatry, UCLA, 760 Westwood Plaza, C9-402, Los Angeles, CA 90095, USA
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20
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Misery L, Shourick J, Sénéschal J, Paul C, de Pouvourville G, Jullien D, Mahé E, Bachelez H, Aubert R, Joly P, Héas S, Reguiai Z, Ezzedine K, Taieb C, Richard MA. Use of mind-body practices by patients with psoriasis: results from a study on 2562 patients. J Eur Acad Dermatol Venereol 2020; 35:e305-e307. [PMID: 33277731 DOI: 10.1111/jdv.17061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | | | - J Sénéschal
- Department of Dermatology, University Hospital of Bordeaux, Bordeaux, France
| | - C Paul
- Department of Dermatology, University Hospital of Toulouse, Toulouse, France
| | | | - D Jullien
- Department of Dermatology, Edouard Herriot Hospital, University Hospital of Lyon, Lyon, France
| | - E Mahé
- Department of Dermatology, Hospital of Argenteuil, Argenteuil, France
| | - H Bachelez
- Department of Dermatology, Saint Louis Hospital, AP-HP, Paris, France
| | - R Aubert
- Association France Psoriasis, Paris, France
| | - P Joly
- Department of Dermatology, University Hospital of Rouen, Rouen, France
| | - S Héas
- University of Rennes 2, Rennes, France
| | - Z Reguiai
- Department of Dermatology, Courlancy Polyclinic, Reims, France
| | - K Ezzedine
- Department of Dermatology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - C Taieb
- EMMA, Fontenay sous Bois, France
| | - M A Richard
- Department of Dermatology, Timone Hospital, University Hospital of Marseille, Marseille, France
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21
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Gieler U, Gieler T, Peters EMJ, Linder D. Haut und Psychosomatik – Psychodermatologie heute. J Dtsch Dermatol Ges 2020; 18:1280-1300. [PMID: 33251743 DOI: 10.1111/ddg.14328_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 09/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Uwe Gieler
- Universitäts-Hautklinik, Universitätsklinikum Gießen
| | - Tanja Gieler
- Kinder- und Jugendpsychosomatik, Universitäts-Kinderklinik, Universitätsklinikum Gießen
| | - Eva Milena Johanne Peters
- Psychoneuroimmunologie Labor, Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Gießen, Gießen in Kooperation mit der Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin - Charité, Berlin
| | - Dennis Linder
- Universitäts-Hautklinik, Universität Padua, Italien, Institut für Medizinische Psychologie und Psychotherapie, Medizinische Universität Graz, Österreich
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22
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Gieler U, Gieler T, Peters EMJ, Linder D. Skin and Psychosomatics - Psychodermatology today. J Dtsch Dermatol Ges 2020; 18:1280-1298. [PMID: 33251751 PMCID: PMC7756276 DOI: 10.1111/ddg.14328] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 09/21/2020] [Indexed: 02/06/2023]
Abstract
Modern psychodermatology relies on the bio-psycho-social disease model in psychosomatics, according to which biological, psychological and social factors (on various levels, from molecules to the biosphere) play a major role in the disease pathogenesis through complex, non-linear interactions over the entire disease course. It is nowadays experimentally proven that "emotions get into the skin". Recent research shows close anatomical, physiological and functional connections between skin and nervous system, already known to be ontogenetically related. These connections are reflected in many skin diseases where psychological and somatic etiological factors are closely intertwined. A holistic approach by the physician should do justice to this interdependence; biological, psychological and social factors should be adequately taken into account when taking anamnesis, making a diagnosis and choosing a therapy. The "visibility" of the skin organ bestows dermatology a special position among the various other clinical subjects, and renders a holistic, psychosomatic approach to the patient that is particularly important. The life course belongs also to modern psychodermatological approaches. Based on the modern psychodermatology concept, other corresponding sub-areas such as psychogastroenterology, psychocardiology etc. have emerged. After the theoretical part of this article, some selected skin diseases are discussed in more detail from the psychosomatic point of view.
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Affiliation(s)
- Uwe Gieler
- Department of DermatologyUniversity Hospital Gießen
| | - Tanja Gieler
- Psychosomatic Medicine for Children and AdolescentsDepartment of PediatricsUniversity Hospital Gießen
| | - Eva Milena Johanne Peters
- Laboratory for PsychoneuroimmunologyDepartment of Psychosomatic Medicine and PsychotherapyUniversity Hospital Gießen in cooperation with the Department of Psychosomatic Medicine and PsychotherapyUniversity Hospital – CharitéBerlin
| | - Dennis Linder
- Department of DermatologyUniversity of PaduaItalyInstitute for Medical Psychology and PsychotherapyMedical University GrazAustria
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23
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Marasca C, De Rosa A, Fabbrocini G, Cantelli M, Patrì A, Vastarella M, Gallo L, di Vico F, Poggi S, Ruggiero A. Psychological teleconsultations in patients suffering from chronic skin diseases during the COVID-19 era: a service to improve patients’ quality of life. J DERMATOL TREAT 2020; 33:1736-1737. [DOI: 10.1080/09546634.2020.1809625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Claudio Marasca
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Anna De Rosa
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Mariateresa Cantelli
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Angela Patrì
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Maria Vastarella
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Lucia Gallo
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Francesca di Vico
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Serena Poggi
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
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24
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Sijercic I, Ennis N, Monson CM. A systematic review of cognitive and behavioral treatments for individuals with psoriasis. J DERMATOL TREAT 2019; 31:631-638. [PMID: 31696748 DOI: 10.1080/09546634.2019.1690625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Although there are effective dermatological treatments for psoriasis, a proportion of individuals also experience psychological distress not addressed by these treatments. Psychological factors may be targeted by cognitive behavioral therapy (CBT) which may in turn also decrease psoriasis severity.Method: A systematic review using PsycINFO, PubMed, and SCOPUS databases was performed in 2019 to examine the efficacy of treatments that delivered psychotherapy with a major cognitive/behavioral component to patients with psoriasis. Quality of included studies was assessed.Results: Nine randomized controlled trials with 8 unique samples met inclusion criteria. Study quality ranged from fair to good. Half of the studies found improved psoriasis severity following treatment. Several studies found improvements following treatment in anxiety, depression, and stress. The studies that reported non-significant findings on psychological outcomes had samples with healthy baseline psychological functioning. Nearly all studies that examined quality of life as an outcome found improvements following treatment.Conclusion: CBT as an adjunct to conventional dermatological treatments may be particularly beneficial for individuals with more severe pretreatment psychopathology in improving psoriasis severity, anxiety, and depression symptoms. CBT appears to be generally effective in improving quality of life. Greater methodological rigor is needed in future research.
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Affiliation(s)
- Iris Sijercic
- Psychology Department, Ryerson University, Toronto, Canada
| | - Naomi Ennis
- Psychology Department, Ryerson University, Toronto, Canada
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