Capec Szergej, Petrek Martin, Capec Gabriella, Yaremkevych Roman, Andrashko Yuriy
Department of Pathological Physiology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czechia.
Department of Skin and Venereal Diseases, Faculty of Medicine, Uzhhorod National University, Uzhhorod, Ukraine.
Front Med (Lausanne). 2022 Aug 12;9:965133. doi: 10.3389/fmed.2022.965133. eCollection 2022.
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.
慢性瘙痒是一种复杂的心理生理感觉，会严重影响特应性皮炎和银屑病患者的生活质量。瘙痒取决于皮肤中受体的刺激以及中枢神经系统中感觉信息的处理。严重的瘙痒会导致应激反应的激活，随后导致其紊乱，进而导致皮肤修复障碍、负责瘙痒感知的中枢神经系统区域出现功能和微观结构变化。心理社会压力可能是一个重要因素，它会激活神经体液机制，导致瘙痒和搔抓加剧，使皮肤损伤恶化。慢性瘙痒患者常伴有睡眠障碍、易怒增加和神经系统耗竭。其特点是社会关系受到破坏、焦虑症、抑郁症和自杀倾向的发生率较高。心理干预方法可以有效影响瘙痒和搔抓发病机制中的各种机制，并改善慢性皮肤瘙痒患者的社会功能。在本综述中，我们讨论了家庭系统排列研讨会作为一种有效的心理干预方法，它可以减轻特应性皮炎和银屑病患者的瘙痒强度，改善睡眠和表现。在之前关于特应性皮炎和银屑病患者心理干预的综述中，对这种方法的描述并不充分。家庭系统排列研讨会对慢性皮肤瘙痒患者的积极影响可能与通过改善对家庭情况的理解、妥善处理家庭秘密以及加强与社会环境的互动来减轻压力有关。
