PS22 Development of the German S3 guideline on psychosomatic dermatology: launching modern, integrative and evidence-based care for patients with psychodermatological conditions

Abstract

Members of the AWMF MenDaSkin Consortium are M Augustin, S Bender-Säbelkampf, R Blaga, M Böhm, C Gallinat, S Gass, U Gieler, O Gießler-Fichtner, B Glöer, J Hockmann, L Hollatz, I Hübner, S Hüning, M Jagla-Franke, C Jung, S Kämper, J Kahle, A Koechel, J Kupfer, T Lahousen-Luxenberger, P Lepping, C Liebram, E Loos, J Matzat, M Mengoni, A Meyer, S Müller, U Müller-Ladner, G Pliszewski, N Schnopp, R Sommer, C Stierle, R-M Szeimies, K-M Taube, A Tsianakas, L Vogler, C Zeidler and M Zipser

Psychosomatic conditions and comorbidities in patients with dermatological disorders often receive little attention in routine clinical care. Expert groups such as the European Academy of Dermatology and Venereology’s Psychodermatology Task Force, the European Society for Dermatology and Psychiatry and the German Working Group of Psychodermatology are calling for the establishment of specialized, multidisciplinary care structures. A guideline provides a structure, using a consensus-building tool to improve current fragmented and often clinician-dependent psychodermatological care. We present the most important and innovative results and reflect on experiences from the development of the current German S3 guideline ‘Psychosomatic Dermatology’, and derive practical recommendations for future interdisciplinary projects. Thirty-nine experts from 29 professional associations and patient organizations are involved in the development of this S3 guideline, representing the highest-quality version of medical guidelines in Germany. PICO questions on epidemiology, aetiology, diagnostics, prevention, intervention and cost-effectiveness were answered in 16 disorder-specific topic areas. Understanding of the relationships between somatic and psychosocial factors is well advanced in psychodermatology. High rates of psychological comorbidities in patients with dermatological conditions led to a number of recommendations to screen for these disorders in dermatological care. Explanatory models consider psychoneuroimmunological stress regulation, feelings of shame, and stigmatization as drivers of increased stress, and maladaptive coping strategies. Concerning psychosocial interventions for psychodermatological patients, research at various stages of advancement was identified, leading to both recommendations for psychosocial interventions and a broad research agenda. Finally, a lack of reliable data on cost-effectiveness of integrated care was identified. Guideline development in interdisciplinary areas such as psychodermatology is challenging and fruitful at the same time. A structured, moderated process, clearly defined questions and early interdisciplinary networking are crucial for success. Taking these points into consideration, guideline development leads to valuable results such as practical recommendations for healthcare and areas for research funding.