Psychosocial characterization of patients with atopic dermatitis in conventional versus alternative-medical therapy

Objective: Recording of psychosocial differences: between patients with atopic dermatitis (AD) undergoing conventional versus alternative-medical treatment as indication of a center-related selection effect. Study Design: In this prospective comparative study, inpatients of an alternative-medical clinic and of the University Dermatology Clinic Freiburg were given standardized questionnaires on psychosocial characteristics in the areas of disease-specific stress, social support, and coping with the disease. Patients: Fifty-nine consecutive AD patients were recruited at the alternative-medical clinic and 79 AD patients at the University Dermatology Clinic.: Fifty-five (93.2%) and 73 (92.4%) patients respectively returned completed questionnaires. Results: The two treatment groups differed markedly from one another with respect to psychosocial parameters. Patients of the alternative-medical clinic showed greater disease-specific stress, lower social integration, and higher values in the coping scales 'depressive coping' and 'religious conviction and search for meaning: Compared to patients with acne vulgaris, both patient groups were under significantly greater disease-specific stress. The factor 'social integration', was determined by logistical regression analysis to be the most important differentiation characteristic between the groups. Conclusions: Patients under alternative-medical treatment may show significant psychosocial differences in comparison with conventionally treated patients. In comparative studies between conventional and alternative-medical therapy centers, selection effects must be assumed and taken into account when evaluating the study.