Magazine article Clinical Psychiatry News

Explore Emotions of Atopic Dermatitis Patients

Magazine article Clinical Psychiatry News

Explore Emotions of Atopic Dermatitis Patients

Article excerpt

ROME -- A pediatric atopic dermatitis treatment plan is not complete without a psychological element, Dr. Caroline Koblenzer said at the 10th World Congress of Pediatric Dermatology.

"Without adding a psychological component to treatment, patients with atopic dermatitis can stay in a chronic course of remission and exacerbation," said Dr. Koblenzer of the University of Pennsylvania, Philadelphia.

"Most patients do respond well to treatment, but in recalcitrant patients, you need to explore the experience of early infancy."

Studies have shown that up to 60% of dermatology patients have at least one coexisting psychiatric condition, she said.

Atopic children tend to be more emotionally and behaviorally immature than do controls.

Often, these children use their scratching behavior as a tool to manipulate their parents, define weak boundaries, or express anger and aggression.

The foundation for these behaviors is laid in infancy, when the atopic infant, itchy and restless, fails to perceive empathic touch while absorbing negative psychic energy from an anxious, guilt-ridden mother.

This initiates a self-renewing cycle of emotionally and physically related events that trigger more atopic flares for the infant.

In infancy, Dr. Koblenzer said, empathic touch, usually from the mother, helps develop the infant's capacity to release and regulate tension.

This release is modulated by nonverbal two-way communication with the mother. The infant uses the mother as a mirror of his/her feelings until he/she develops emotional self-regulation.

"The relaxed mother will have a soothing effect, while the anxious, unhappy mother will increase the infant's distress," Dr. Koblenzer said.

"Failure to internalize this emotional control can lead to continued tension discharge through physical pathways.

"This stress may cause physical symptoms. …

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