title: Psychosomatic treatment for allergic diseases.
abstract: Many reports have been published concerning how psychosocial stress influences the occurrence and progression of allergic diseases such as bronchial asthma and atopic dermatitis. As for asthma, a typical allergic disease often accompanied by psychosomatic related problems, the Global Initiative for Asthma (GINA), international medical guidelines for asthma, describes psychosocial problems as causative factors of poor asthma control and as risk factors for asthma exacerbation, even if symptoms are well controlled. However, because there is little high quality evidence for effective treatments for asthma patients with psychosocial problems, concrete assessments and treatments for such problems is scarcely described in GINA. Therefore, psychosomatic intervention for asthma patients is not effectively conducted on a worldwide scale. In contrast, the "Japanese Guidelines for the Diagnosis and Treatment of Psychosomatic Diseases" describe the assessment and treatment of psychosomatic disorders in detail. In the guidelines, psychosocial factors are classified into five categories; 1) Relation between stress and asthma occurrence or progression, 2) Relation between emotion and asthma symptoms, 3) Problems related to a patient's character and behaviors, 4) Problems of daily life and Quality of Life (QOL), and 5) Problems related to family relationships and life history. The employment of a self-administered questionnaire, the "Psychosomatic Questionnaire related to Asthmatic Occurrence and Progression", is useful for clarifying psychosocial factors and for setting up treatment strategies according to the problems identified. The Japanese guidelines have been proven to be useful, but empirical evidence for their effectiveness is still relatively limited. It will be necessary in the future to accumulate high-quality evidence and to revise the psychosomatic approaches in the guidelines that are universally valid.
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582 Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Yoshihara
keywords: Allergy; Asthma; Guideline; Psychosomatic assessment; Psychosomatic disorder; Psychosomatic treatment; Stress
references.citation: Eur Respir J. 2011 Jun;37(6):1360-5
references.pmid: 21030455
references.citation: Appl Psychophysiol Biofeedback. 1998 Mar;23(1):13-41
references.pmid: 9653510
references.citation: Psychophysiology. 2005 Jan;42(1):92-7
references.pmid: 15720584
references.citation: Immunol Allergy Clin North Am. 2005 Feb;25(1):83-105
references.pmid: 15579366
references.citation: Psychosom Med. 1992 Mar-Apr;54(2):192-216
references.pmid: 1565756
references.citation: J Behav Med. 1999 Apr;22(2):179-93
references.pmid: 10374142
references.citation: J Allergy Clin Immunol. 2000 Nov;106(5 Suppl):S275-91
references.pmid: 11080744
references.citation: PLoS One. 2011;6(6):e20750
references.pmid: 21698276
references.citation: Dermatoendocrinol. 2011 Jan;3(1):37-40
references.pmid: 21519408
references.citation: Brain Behav Immun. 2013 Mar;29:11-27
references.pmid: 23041248
references.citation: Respir Med. 2007 Feb;101(2):194-202
references.pmid: 16781132
references.citation: Respir Med. 2009 Jul;103(7):1033-40
references.pmid: 19217764
references.citation: J Investig Allergol Clin Immunol. 2009;19 Suppl 1:40-7
references.pmid: 19476053
references.citation: Psychother Psychosom. 1986;45(3):118-26
references.pmid: 3547451
references.citation: Am J Respir Crit Care Med. 2007 Feb 15;175(4):316-22
references.pmid: 17110645
references.citation: J Allergy Clin Immunol. 1987 Sep;80(3 Pt 2):481-6
references.pmid: 3624703
references.citation: Am J Respir Crit Care Med. 2005 Jun 1;171(11):1224-30
references.pmid: 15764721
references.citation: Clin Nurs Res. 2005 May;14(2):131-57
references.pmid: 15793272
references.citation: Brain Behav Immun. 2007 Nov;21(8):993-9
references.pmid: 17493786
references.citation: Prim Care Respir J. 2011 Sep;20(3):250-6
references.pmid: 21674122
references.citation: Respir Med. 2012 Jun;106(6):802-10
references.pmid: 22398158
references.citation: Biol Psychiatry. 2005 Dec 1;58(11):865-70
references.pmid: 15993860
references.citation: Psychother Psychosom. 1973;22(2):255-62
references.pmid: 4770536
references.citation: Thorax. 1998 Dec;53(12):1066-74
references.pmid: 10195081
references.citation: Fukuoka Igaku Zasshi. 1979 Jun;70(6):340-59
references.pmid: 478425
references.citation: N Engl J Med. 1991 Aug 29;325(9):606-12
references.pmid: 1713648
references.citation: Lancet. 2000 Sep 16;356(9234):982-7
references.pmid: 11041399