Suffering from skin conditions could be ended by psychological interventions

Psychological interventions such as habit reversal, relaxation and cognitive behavioural therapy have for the first time been shown to help prevent skin conditions, University of Sheffield experts have found.

In a study, published in the British Journal of Dermatology, a team from the Department of Psychology at the University of Sheffield analysed the combined results of previous studies and determined that psychological interventions provide benefits to patients with skin conditions like psoriasis and atopic dermatitis.

Skin conditions have long been associated with psychological distress but for the first time interventions such as habit reversal, relaxation, cognitive behavioural therapy (CBT) and other psychological interventions have been found to help end suffering.

Following analysis of 22 studies involving more than 900 participants the team at the University of Sheffield concluded that there was evidence of benefits but also that there was the need to develop further specific interventions and to conduct more rigorous evaluation of these, including assessments of effects over longer follow-up periods and a wider range of skin conditions.

From their evaluation they found that psychological interventions had a medium-sized effect on skin conditions but that a number of different factors influenced the effectiveness of the interventions, including: the type of intervention, the time interval between the end of the intervention and follow-up, and the type of outcome.

The number of skin conditions represented by the study was small but a medium-sized effect was seen for interventions treating psoriasis and atopic dermatitis.  The analysis showed that psychological interventions generally had less effect on skin conditions accompanied by pain.

From the studies analysed only four types of intervention were well enough represented for analysis: Habit reversal, CBT, arousal reduction and combined techniques. Habit reversal had the largest effect size, followed by CBT (medium to large) and arousal reduction and combined techniques (medium).

Although the duration of the intervention did not have a great impact on effectiveness, the length of time between the end of the intervention and the follow-up did have a significant impact with longer follow-up periods being associated with smaller effects, suggesting that there may be a need to provide booster sessions.

Group therapies appeared to be as effective as one-to-one sessions. However, the authors also drew attention to the finding that age was negatively associated with effect sizes, for example the older the person was, the less effective the psychological intervention was.

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