Psychodermatologie: Grundlagen für den Aufbruch zu neuen Versorgungsformen

Die Belastung durch eine Hauterkrankung ist durch ihre Sichtbarkeit für jeden Betrachter gut nachzuvollziehen: Psychosoziale Themen sind in der Dermatologie daher allgegenwärtig. Aktuelle Erkenntnisse zeigen nun, dass dieser Bezug in beide Richtungen besteht, denn psychosoziale Belastungen können Hauterkrankungen und ihre Verschlechterung bewirken. Diese Wechselbeziehung stellt eine große Herausforderung dar.

Abstract

The burden of a skin disease is easily understood by any observer due to its visibility: psychosocial issues are therefore ubiquitous in dermatology. Current evidence now shows that this relationship is two-way, as psychosocial stress can cause skin disease and its worsening. This interrelationship poses a major challenge.

Schlüsselwörter

Psychodermatologie - Stress - Psychoneuroimmunologie - biopsychosoziales Model - Neurodermitis - Psoriasis - Alopezie

Keywords

psychodermatology - stress - psychoneuroimmunology - atopic dermatitis - psoriasis - alopecia

• Literatur

• 1 Egger J. Das biopsychosoziale Krankheitsmodell. Grundzüge eines wissenschaftlich begründeten ganzheitlichen Verständnisses von Krankheit. Psych Med 2005; 2: 2-12
• 2 Kruse J, Peters EMJ. Biologische Grundlagen der Anpassung und ihre Entwicklung – Einführung. In: Adler RH. Uexküll, Psychosomatische Medizin. Amsterdam: Elsevier; 2016
• 3 Dhabhar FS. Psychological stress and immunoprotection versus immunopathology in the skin. Clin Dermatol 2013; 31: 18-30
• 4 Peters EM. Stressed skin? A molecular psychosomatic update on stress-causes and effects in dermatologic diseases. J Dtsch Dermatol Ges 2016; 14: 233-252
• 5 Pavlovic S, Liezmann C, Blois SM. et al. Substance P is a key mediator of stress-induced protection from allergic sensitization via modified antigen presentation. J Immunol 2011; 186: 848-855
• 6 Peters EMJ, Gieler U. Dermatologische Erkrankungen. In: Egle U. Psychosomatik: Neurobiologisch fundiert und evidenzbasiert, ein Lehr- und Handbuch. Stuttgart: Kohlhammer; 2020
• 7 Walter H. From the sense organ of the skin to the imaginary envelope of the self. On Didier Anzieu’s “The skin self”. Psyche 1992; 46: 653-667
• 8 Koblenzer CS. The emotional impact of chronic and disabling skin disease: a psychoanalytic perspective. Dermatol Clin 2005; 23: 619-627
• 9 Finlay AY. Quality of life assessments in dermatology. Semin Cutan Med Surg 1998; 17: 291-296
• 10 Kosaraju SK, Reddy KSR, Vadlamani N. et al. Psychological morbidity among dermatological patients in a rural setting. Ind J Dermatol 2015; 60: 635
• 11 Ring J, Zink A, Arents BWM. et al. Atopic eczema: burden of disease and individual suffering – results from a large EU study in adults. J Eur Acad Dermatol Venereol 2019; 33: 1331-1340
• 12 Dalgard FFJ, Gieler U, Tomas-Aragones L. et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Inv Dermatol 2015; 135: 984-991
• 13 Dalgard FJ, Bewley A, Evers AW. et al. Stigmatisation and body image impairment in dermatological patients: protocol for an observational multicentre study in 16 European countries. BMJ Open 2018; 8: e024877
• 14 Chida Y, Hamer M, Steptoe A. A bidirectional relationship between psychosocial factors and atopic disorders: a systematic review and meta-analysis. Psychosom Med 2008; 70: 102-116
• 15 Cheng CM, Hsu J-W, Huang K-L. et al. Risk of developing major depressive disorder and anxiety disorders among adolescents and adults with atopic dermatitis: a nationwide longitudinal study. J Aff Dis 2015; 178: 60-65
• 16 Senra MS, Wollenberg A. Psychodermatological aspects of atopic dermatitis. Br J Dermatol 2014; 170: 38-43
• 17 Flanigan C, Sheikh A, DunnGalvin A. et al. Prenatal maternal psychosocial stress and offspringʼs asthma and allergic disease: A systematic review and meta-analysis. Clin Exp Aller 2018; 48: 403-414
• 18 Guseva D, Rüdrich U, Kotnik N. et al. Neuronal branching of sensory neurons is associated with BDNF-positive eosinophils in atopic dermatitis. Clin Exp Aller 2020; 50: 577-584
• 19 Siiskonen H, Harvima I. Mast cells and sensory nerves contribute to neurogenic inflammation and pruritus in chronic skin inflammation. Front Cell Neurosci 2019; 13: 422
• 20 Crosta ML, De Simone C, Di Pietro S. et al. Childhood trauma and resilience in psoriatic patients: A preliminary report. J Psychosom Res 2018; 106: 25-28
• 21 Lesner K, Reich A, Szepietowski JC. et al. Determinants of psychosocial health in psoriatic patients: A multi-national study. Acta Derm Venereol 2017; 97: 1182-1188
• 22 Lapsley CR, Irwin R, McLafferty M. et al. Methylome profiling of young adults with depression supports a link with immune response and psoriasis. Clin Epigen 2020; 12: 85
• 23 Peters EMJ, Sabat R, Philipp S. et al. Neuroimmunological links in dermatology: psoriasis as a model disease in stress research. Exp Rev Dermatol 2012; 7: 367-375
• 24 Ferreira BI, Abreu JL, Dos Reis JP. et al. Psoriasis and associated psychiatric disorders: A systematic review on etiopathogenesis and clinical correlation. J Clin Aesthet Dermatol 2016; 9: 36-43
• 25 Sjahrir M, Roesyanto-Mahadi ID, Effendy E. Correlation between serum brain-derived neurotrophic factor level and depression severity in psoriasis vulgaris patients. Open Acc Maced J Med Sci 2019; 7: 583-586
• 26 Kara T, Topkarci Z. Interactions between posttraumatic stress disorder and alopecia areata in child with trauma exposure: Two case reports. Int J Trichol 2018; 10: 131-134
• 27 Titeca G, Goudetsidis L, Francq B. et al. The psychosocial burden of alopecia areata and androgenetica: a crosssectional multicentre study among dermatological out-patients in 13 European countries. J Eur Acad Dermatol Venereol 2020; 34: 406-411
• 28 Paus R. Exploring the “brain-skin connection”: Leads and lessons from the hair follicle. Curr Res Transl Med 2016; 64: 207-214
• 29 Mubki T, Rudnicka L, Olszewska M. et al. Evaluation and diagnosis of the hair loss patient: part I. History and clinical examination. J Am Acad Dermatol 2014; 71: 415e1-415e15
• 30 Hadshiew IM, Foitzik K, Arck PC. et al. Burden of hair loss: stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia. J Invest Dermatol 2004; 123: 455-457
• 31 Russo PA, Ilchef R, Cooper AJ. Psychiatric morbidity in psoriasis: a review. Australas J Dermatol 2004; 45: 155-159
• 32 Ersser SJ, Cowdell F, Latter S. et al. Psychological and educational interventions for atopic eczema in children. Coch Data Syst Rev 2014; 00: CD004054
• 33 Stetter F, Kupper S. Autogenes Training – Qualitative Meta-Analyse kontrollierter klinischer Studien und Beziehungen zur Naturheilkunde. Forsch Komplmed 1998; 5: 211-223
• 34 Chida Y, Steptoe A, Hirakawa N. et al. The effects of psychological intervention on atopic dermatitis. A systematic review and meta-analysis. Int Arch Allergy Immunol 2007; 144: 1-9
• 35 Lindsay K, Goulding J, Solomon M. et al. Treating chronic spontaneous urticaria using a brief ‘whole person’ treatment approach: A proof-of-concept study. Clin Transl All 2015; 5: 40
• 36 Gruchała A, Marski K, Zalewska-Janowska A. Psychotherapeutic methods in psoriasis. Our Dermatol Onl 2020; 11: 113-119
• 37 Spreckelsen R, Mrowietz U, Emmert H. Schematherapeutische Kurzintervention bei Patienten mit Psoriasis – Fallbericht und klinisches Mangement. JDDG 2020; 18: 905-907
• 38 Saxena S. Acceptance and commitment therapy for acne vulgaris. Delphi Psych J 2020; 23: 155-160
• 39 Schakel L, Veldhuijzen DS, Crompvoets PI. et al. Effectiveness of stress-reducing interventions on the response to challenges to the immune system: A meta-analytic review. Psychother Psychosom 2019; 88: 1-13
• 40 Markowitsch HJ, Fink G, Thone A. et al. A PET Study of persistent psychogenic amnesia covering the whole life span. Cogn Neuropsy 1997; 2: 135-158
• 41 Langewitz W, Izakovic J, Wyler J. et al. Effect of self-hypnosis on hay fever symptoms – a randomised controlled intervention study. Psychother Psychosom 2005; 74: 165-172
• 42 Kelso JM, Connaughton C, Helm RM. et al. Psychosomatic peanut allergy. J Aller Clin Immunol 2003; 111: 650-651
• 43 Gieler U, Gieler T, Peters EMJ. et al. Haut und Psychosomatik – Psychodermatologie heute. J Dtsch Dermatol Ges 2020; 18: 1280-1300
• 44 Torales J, Melgarejo O, Gonzalez I. et al. Psychopharmacology in dermatology: Treatment of primary psychiatric conditions in dermatology. Dermatol Ther 2020; 33: e13557