Effects of family constellation seminars on itch in patients with atopic dermatitis and psoriasis: A patient preference controlled trial

Family Constellation Therapy in the Context of Esotericism

In the past decades, Bert Hellinger's family constellation method has become a highly popular psychotherapeutic modality. Although some research has emerged concerning the foundations, effectiveness, and ethical aspects of family constellation therapy, psychological inquiry has neither reflected on the popularity of the method nor addressed its specific content in detail. In this article, I trace and interpret family constellation therapy within the context of esotericism. Given that parallels between Western esoteric thought and the family constellation system developed by Hellinger can be observed, this article explores the extent to which family constellation therapy is embedded within esotericism. By exploring family constellation therapy and thus broadening the scope of esoteric spirituality, this analysis contributes to contemporary research on Western esoteric thought.

Alternative Psychotherapeutic Approaches to the Treatment of Eczema

INTRODUCTION

Patients with eczema suffer from high psychological burden, often caused and exacerbated by chronic pruritus, which leads to a vicious itch-scratch cycle. Although much of the literature focuses on treating the physiological factors that lead to pruritus, little attention has been given to the cognitive, behavioral, and social factors associated with the itch-scratch cycle. We conducted a literature review to investigate whether treatments aimed at psychosocial factors could be effective for patients with eczema.

METHODS

A systematic literature review was conducted through PubMed and EMBASE. Original investigative articles that focused on psychotherapeutic interventions for eczema and/or eczema-related psychological morbidities were reviewed.

RESULTS

Psychotherapeutic interventions alongside standard medical care are shown to be beneficial compared to conventional treatments alone, both for eczema and for eczema-associated psychological symptoms. Such interventions include meditation and mindfulness, stress-reduction, habit-reversal training, hypnotherapy, music therapy, massage therapy, and standard psychological treatments such as cognitive behavioral therapy.

CONCLUSION

It is important to recognize the reciprocal relationship between eczema and psychosocial distress. Alternative treatment options to address psychological factors associated with eczema can improve disease trajectory and quality of life.

Psychologic interventions in patients with the chronic dermatologic itch in atopic dermatitis and psoriasis: A step forward with family constellations seminars

Chronic itch is a complex psychophysiological sensation, which can severely affect the quality of life in patients with atopic dermatitis and psoriasis. Itch depends on the irritation of receptors in the skin and the processing of sensory information in the central nervous system. Severe itch leads to activation and later on to disruption of the stress response, resulting in disorders of skin repair, functional and microstructural changes in the areas of the central nervous system that are responsible for the perception of itch. Psychosocial stress can be an essential factor, activating neurohumoral mechanisms which lead to increased itch and scratch, exacerbating skin damage. Patients with chronic itch often have sleep disorders, increased irritability, and depletion of the nervous system. They are characterized by disrupting social relationships, high incidence of anxiety, depressive disorders, and suicidal tendencies. Psychological methods of intervention can effectively influence various mechanisms in the pathogenesis of itch and scratch and improve social functioning in patients with chronic dermatological itch. In this mini-review, we discuss family constellation seminars as an effective method of psychological intervention that can reduce the intensity of itch, and improve sleep and performance in patients with atopic dermatitis and psoriasis. This method is insufficiently described in previous reviews of psychological interventions in atopic dermatitis and psoriasis patients. The positive impact of family constellations seminars in patients with chronic dermatological itch may be related to reducing stress by improving understanding of the family situation, appropriate management of family secrets, and enhancing interactions with the social environment.

Psychological Therapies and Mind-Body Techniques in the Management of Dermatologic Diseases: A Systematic Review

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.

New Frontiers in Psoriatic Disease Research, Part II: Comorbidities and Targeted Therapies

Although psoriasis and psoriatic arthritis (PsA) have been classically considered to be diseases of the skin and joints, respectively, emerging evidence suggests that a combination of innate and environmental factors creates widespread immune dysfunction, affecting multiple organ systems. A greater understanding of the pathogenesis of psoriasis and the systemic effects of psoriatic inflammation has allowed for the development of new, more effective treatments. The second portion of this two-part review series examines the comorbidities associated with psoriasis and PsA as well as the most recent advances in targeted systemic therapies for these conditions.

The Effectiveness of Family Constellation Therapy in Improving Mental Health: A Systematic Review

Family/systemic constellation therapy is a short-term group intervention aiming to help clients better understand and then change their conflictive experiences within a social system (e.g., family). The aim of the present systematic review was to synthetize the empirical evidence on the tolerability and effectiveness of this intervention in improving mental health. The PsycINFO, Embase, MEDLINE, ISI Web of Science, Psyndex, PsycEXTRA, ProQuest Dissertations & Theses, The Cochrane Library, Google Scholar, and an intervention-specific organization's databases were searched for quantitative, prospective studies published in English, German, Spanish, French, Dutch or Hungarian up until April 2020. Out of 4,197 identified records, 67 were assessed for eligibility, with 12 studies fulfilling inclusion criteria (10 independent samples; altogether 568 participants). Outcome variables were diverse ranging from positive self-image through psychopathology to perceived quality of family relationships. Out of the 12 studies, nine showed statistically significant improvement postintervention. The studies showing no significant treatment benefit were of lower methodological quality. The random-effect meta-analysis-conducted on five studies in relation to general psychopathology-indicated a moderate effect (Hedges' g of 0.531, CI: 0.387-0.676). Authors of seven studies also investigated potential iatrogenic effects and four studies reported minor or moderate negative effects in a small proportion (5-8%) of participants that potentially could have been linked to the intervention. The data accumulated to date point into the direction that family constellation therapy is an effective intervention with significant mental health benefits in the general population; however, the quantity and overall quality of the evidence is low.