The skin-brain connection and pleasant touch as supportive care for psychocutaneous disorders.

Psychodermatology is a subdiscipline of dermatology at the intersection of dermatology, psychiatry, and psychology. In dermatology clinical practice, patients may present with skin disease that affects their mental health, or skin disorders induced or worsened by psychological/psychiatric problems so there is a need for specialised education of dermatologists, as well as multidisciplinary teams, to achieve better management of these patients. Understanding the interaction between the central nervous system and the skin underlying psychocutaneous disorders could help identify alternative therapies that may improve patient well-being. The concept of pleasurable touch has received increasing attention following the discovery of C-tactile (CT) fibres. While afferent C-fibre stimulation is usually associated with pain, temperature, or itch, CT-fibres are stimulated optimally by a stimulus not in the nociceptor range but by a gentle, low-force stroking. As this affective touch may counteract unpleasurable sensations, such as pain and itch, and elicit positive feelings, the potential benefits of gentle touch and massage are interesting for dermatological, especially psychocutaneous, disorders. Here we provide an overview of the skin-brain connection to help understand the benefits of touch and massage, as illustrated with studies on atopic dermatitis and burns, as an adjunct to dermatological treatment for improving patient well-being and optimising treatment outcomes.

"Letting go" coping is associated with successful IVF treatment outcome.

OBJECTIVE: To examine whether women's baseline coping strategies are associated with IVF outcomes. Psychologic factors have been found to be prospectively associated with the outcome of IVF treatments in several studies. However, the exact role of coping strategies, which are modifiable, remains unclear. Problem-focused coping may be more adaptive for controllable situations, whereas emotion-focused coping (EFC) may be more adaptive for uncontrollable situations, such as most stages of IVF treatment. DESIGN: Prospective study. Coping strategies were assessed before IVF treatment began. SETTING: Infertility and IVF unit in a university-affiliated tertiary medical center. PATIENT(S): Eighty-eight women undergoing IVF treatment in our unit. MAIN OUTCOME MEASURE(S): Pregnancy. RESULT(S): Of 88 women participating in the study, 23.9% became pregnant. In the male and female factor infertility groups, the EFC strategy of "letting go" was positively and significantly associated with pregnancy. Adjusting for age, cause of infertility, and number of cycles, the relative risk for pregnancy by "letting go" was 1.88 (95% confidence interval 1.1-3.2). CONCLUSION(S): These findings support the notion that in the context of a low-control situation such as IVF treatment, women who try to be actively in control may pay a higher price in terms of pregnancy probabilities. Means of increasing "letting go" are discussed.