![]() "We can never presume that the so-called objective severity of a dermatological disorder correlates with the psychological impact," says Fried. Plus, patients may have psychological reactions that seem out of proportion to their actual skin conditions. Unlike hypertension, diabetes or other health problems, skin problems are usually obvious to onlookers. For one, flare-ups of psoriasis, eczema, acne and other conditions can be unpredictable. Skin problems can be extremely distressing, he says. clinicians specializing in psychodermatology. "Coupling this with the lack of psychologists with training in psychodermatology, and the growth potential for psychologists becomes more apparent." "Psychologists' service provision skills are highly applicable and relevant," she says. Psychiatric disorders that manifest themselves via the skin, such as delusional parasitosis.Psychological problems caused by disfiguring skin disorders.Skin problems affected by stress or other emotional states.Psychologists have roles to play in treating all three types of psychodermatology disorders, says Gorbatenko-Roth. "It's classic health psychology, just in a different area." "The skin is the most noticeable part of our body that could be impacted by psychological factors, yet very few psychologists are studying it," she says. The APMNA is eager for psychologists to get involved in the field, says Gorbatenko-Roth, who is working with two European psychologists to develop training materials for those interested in developing a clinical competency in psychodermatology. She became interested in psychodermatology when she developed the hair loss condition alopecia areata and discovered that depression, anxiety and other psychological issues were common among participants posting in an alopecia-related Internet chat room. Gorbatenko-Roth, PhD, a psychology professor at the University of Wisconsin–Stout. What's more, the field consists primarily of dermatologists and psychiatrists, says Kristina G. And there are few researchers and limited research funding in this area. Most medical school curricula don't include psychodermatology material. ![]() There are just a few psychodermatology clinics in the country, the association reports. While psychodermatology is a well-established field in Europe, it has been slower to catch on in the United States, according to a history of the movement on the Association for Psychoneurocutaneous Medicine of North America (APMNA) website. They're also developing interventions, whether to help dermatology patients deal with psychological issues or to help people avoid melanoma and other skin problems in the first place. They're treating the social anxiety, depression and other psychological issues that can arise when people have skin conditions. They're investigating the role that stress and other psychological issues play in acne, psoriasis, eczema, itching, hives and other skin problems. These days, dermatologists are much more accepting of the field now known as psychodermatology, and psychologists are getting more involved in helping dermatology patients. "That's pretty amazing evidence that the mind and body are linked." "How amazing is it that a simple cognition - ‘I said or did something foolish' - can cause virtually every blood vessel in the skin to instantaneously open up, causing a blush or flush?" asks Fried, a psychologist turned dermatologist who is the clinical director of Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania. The skeptic's fly wasn't really down, but his deep blush vividly illustrated the impact that emotions have on the body's largest organ - the skin. Then another dermatologist stepped to Fried's defense, telling her colleague that before he attacked Fried he should at least make sure his zipper was up. When Rick Fried, MD, PhD, gave a talk at a dermatology conference seven years ago on the relationship between psychological and dermatological problems, at least one dermatologist in the audience was skeptical about the mind/body connection.
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