Schwender-Groen L, Worm M, Klinger R
Psychotherapeutische Hochschulambulanz Verhaltenstherapie, Fachbereich Psychologie, Universität Hamburg.
Schmerz. 2011 Apr;25(2):207-18; quiz 219-20. doi: 10.1007/s00482-010-0977-0.
Itching is a major symptom of chronic skin diseases such as atopic dermatitis and leads to considerable psychological strain. Chronic itching lowers patient's quality of life similar to chronic pain and influences the medical treatment. The frequently resulting scratching behavior (short-term avoidance of itch) leads to continuation and exacerbation of the disease, just as with specific pain behavior. For the development of itching and pain psychosocial factors have been identified in addition to somatic ones. However, recent data suggest that there is a complex interaction between pain and itching and comparable mechanisms of neuronal sensitization. In contrast to traditional biomedical one-dimensional models which focus mainly on physical and not psychological factors of a disease, recent data support a biopsychosocial model of development and maintenance for itching and pain. Biopsychosocial understanding of a disease should consequently be taken as the basis for treatment and the importance of interdisciplinary treatment is emphasized. This article will focus on chronic itching and pain with particular consideration of psychological factors.
瘙痒是特应性皮炎等慢性皮肤病的主要症状,会导致相当大的心理压力。慢性瘙痒会降低患者的生活质量,其程度与慢性疼痛相似,并影响医学治疗。频繁出现的搔抓行为(短期缓解瘙痒)会导致疾病持续和加重,就像特定的疼痛行为一样。除了躯体因素外,心理社会因素也被认为与瘙痒和疼痛的发生有关。然而,最近的数据表明,疼痛和瘙痒之间存在复杂的相互作用以及类似的神经元致敏机制。与主要关注疾病物理而非心理因素的传统生物医学一维模型不同,最近的数据支持瘙痒和疼痛发生及维持的生物心理社会模型。因此,对疾病的生物心理社会理解应作为治疗的基础,并强调跨学科治疗的重要性。本文将特别考虑心理因素,重点关注慢性瘙痒和疼痛。