Educational, Psychological Interventions Reduce Atopic Dermatitis Severity

Jonathan I. Silverberg, MD, PhD, MPH

A recent study presented at the American Academy of Pediatrics (AAP) 2021 Virtual Conference suggested that educational and psychological interventions reduced atopic dermatitis severity in pediatric patients.

Investigators said that the greatest benefit was seen in combined interventions.

Jonathan I. Silverberg, MD, PhD, MPH, George Washington University School of Medicine and Health Sciences, Washington DC, and colleagues involved in the study noted that there had been a myriad of studies involving medications that reduced the severity of atopic dermatitis.

However, by their estimations psychological and educational interventions were not fully elucidated.

In their AAP session, “Can Psychological and Educational Interventions Reduce Atopic Dermatitis Severity in Children?”, Silverberg and investigators explored the potential of such investigations on pediatric populations.

The Study

For the study, Silverberg and colleagues performed a systematic review of all studies that evaluated the clinical efficacy of psychological and educational interventions in Atopic Dermatitis.

The investigators included studies from MEDLINE, EMBASE, SCOPUS, LILACS, Cochrane, the China National Knowledge Infrastructure, Taiwan electronic periodical services and CiNii.

At least 2 authors independently performed reviews of titles and abstracts as well as data extraction.

A total of 12 prospective studies were included in the review.

The endpoints measured in each study included SCORing Atopic Dermatitis (SCORAD n=8)Infants’ Dermatitis Quality of Life (IDQOL; n=4), Children’s Dermatology Life Quality Index (CDLQI; n=5), or other measurements (n=2).

The Findings

Of the 8 total SCORAD studies, 5 of them noted that educational interventions showed greater improvement of SCORAD than psychological intervention (n=1) or combined psychological and educational (n=2) intervention.

For the IDQOL studies, only educational interventions (n=4) were available. A statistically significant increase in IDQOL was not recorded with the educational interventions.

Intriguingly, studies that included CDLQI found that educational (n=4) interventions showed greater improvement in CDLQI than psychological (n=1) intervention, which was nearly the exact opposite of the data extracted from the SCORAD studies.

As for other measurements, psychological and educational (n=1) intervention showed improvement in extent and total severity of atopic dermatitis. Similarly to the IDQOL studies, educational (n=1) intervention showed mixed findings for improvement in measurement of severity of atopic dermatitis.

Overall, Silverberg and fellow investigators believed they had enough data to suggest that the combined efforts of educational and psychological interventions reduced atopic dermatitis severity among pediatric populations.

However, they suggested more data be obtained to arrive at a satisfying conclusion.

“Future, larger-scale, well-designed randomized controlled trials (RCTs) are needed to confirm these findings and determine the most effective type of non-medication intervention and duration,” the team wrote.