Aspects of comprehensive treatment for adolescents with acne vulgaris from the perspective of psychological counseling

Abstract

This article discusses the manifestations of the adolescence crisis in patients with acne vulgaris, using a four-level personality model (biological, psychological, social, and spiritual levels). On the one hand, the adolescence crisis can trigger acne vulgaris in case of a genetic predisposition; on the other hand, acne can aggravate the process of experiencing the adolescence crisis. The authors suggest the use of psychological counseling (relaxation techniques, methods of rational psychotherapy, etc.) within the dermatological care for adolescent patients with mild and moderate acne vulgaris. The authors present the results of a study of the efficacy of comprehensive therapy (including psychological counseling) in adolescent patients with mild-to-moderate acne vulgaris, compared with traditional dermatotropic therapy. Statistically significant differences between two groups were revealed in the changes in the indicators of the mental condition presentation (r = -0.90; p < 0.05), the dermatological index of acne (DIA) (r = -0.34; p < 0.05), and indicators of quality of life (r = -0.72 and r = -0.68. according to the questionnaires of the Dermatology Life Quality Index and Skindex-29, resp.; p < 0.05). Simultaneous improvement in the psychoemotional status was correlated with positive cutaneous changes, as evidenced by the direct rather than pronounced statistically significant relationship between the indices of the experience scale and the ADI index (r = 0.52; p <  0.05). The obtained results show that the use of psychological counseling in the comprehensive treatment for adolescents with mild-to-moderate acne vulgaris is more effective compared with the traditional dermatotropic therapy.

Keywords

acne vulgaris / adolescence crisis / psychological counseling / the quality of life / stress

References

[1] Olisova O.Yu. The efficacy of systemic retinoids in acne. Russian Medical Journal. Dermatology (Russkii Medicinskii Zhurnal). 2016; 24(10): 602-6. (in Russian)

[2] Олисова О.Ю. Эффективность системных ретиноидов при акне. Русский медицинский журнал. 2016; 24(10): 602-6.

[3] Snarskaya E.S. Antibacterial therapy of vulgar acne. Bulletin of Dermatology and Venereology. Russian Journal (Vestnik Dermatologii i Venerologii). 2019; 95(5): 58-67. (in Russian)

[4] Снарская Е.С. Антибактериальная терапия вульгарных акне. Вестник дерматологии и венерологии. 2019; 95(5): 58-67.

[5] Nikolaeva N.N. Ineffectiveness of external therapy in patients with acne: modern solutions. Cosmetics and Medicine. Russian Journal. 2019; (1): 8-13. (in Russian)

[6] Николаева Н.Н. Неэффективность наружной терапии у пациентов с акне: современные пути решения. Косметика и медицина. 2019;(1):8-13.

[7] Albanova V.I., Zabnenkova O.V. Acne. Moscow: GEOTAR-

[8] Альбанова В.И., Забненкова О.В. Угри. М.: ГЭОТАР-Медиа; 2013.

[9] Media; 2013. (in Russian)

[10] Сысоева Т.А. Алгоритм осмотра и обследования пациенток с ювенильными акне. Вестник последипломного медицинского образования. 2003; (3-4): 74-5.

[11] Sysoeva T.A. Algorithm of examination and examination of patients with juvenile acne. Bulletin of Postgraduate Medical Education. Russian Journal (Vestnik poslediplomnogo medicinskogo obrazovaniya). 2003 ;(3-4): 74-5. (in Russian)

[12] Альбанова В.И., Сазыкина Л.Н., Гольченко В.А. Результаты пострегистрационного изучения эффективности терапии топическим эритромицин-цинка ацетатом при обычных и поздних угрях, влияние данного заболевания и лечения на психологический статус пациентов. Клиническая дерматология и венерология. 2012; 10(3): 83-91.

[13] Albanova V.I., Sazykina L.N., Golchenko V.A. Results of postmarketing studies on the effecacy of therapy of vulgar and late-onset acne with the use of erythromycin/zinc acetate for topical application and the influence of this disease and its treatment on the psychological status of the patients. Clinical Dermatology and Venereology. Russian Journal (Klinicheskaya Dermatologiya i Venerologiya). 2012; 10(3): 83-91.

[14] Арипова М.Л., Хардикова С.А. Психоэмоциональное состояние пациентов с тяжелой степенью акне на фоне терапии изотретиноином. Вестник дерматологии и венерологии. 2015; (5): 122-7.

[15] (in Russian)

[16] Dalgard F., Gieler U., Hoim J.O., Bjertness E., Hauser S. Self-esteem and body satisfaction among late adolescents with acne: results from a population survey. J Am Acad Dermatol. 2008; 59(5): 746-51.

[17] Aripova M.L., Khardikova S.A. Psychoemotional state of the patients with severe acneassociated with isotretinoin therapy. Bulletin of Dermatology and Venereology. Russian Journal (Vestnik Dermatologii i Venerologii). 2015; 88(5): 122-7. (in Russian)

[18] Ritvo E., Del Rosso J.Q., Stillman M.A., La Riche C. Psychosocial judgements and perceptions of adolescents with acne vulgaris: A blinded, controlled comparison of adult and peer evaluations. Biopsychosoc Med. 2011; 5(1): 11.

[19] Dalgard F., Gieler U., Hoim J.O., Bjertness E., Hauser S. Self-esteem and body satisfaction among late adolescents with acne: results from a population survey. J Am Acad Dermatol. 2008; 59(5): 746-51.

[20] Magin P., Adams J., Heading G., Pond D., Smith W. Psychological sequelae of acne vulgaris: Results of a qualitative study. Can Fam Physician. 2006; 52(8): 978-9.

[21] Ritvo E., Del Rosso J.Q., Stillman M.A., La Riche C. Psychosocial judgements and perceptions of adolescents with acne vulgaris: A blinded, controlled comparison of adult and peer evaluations. Biopsychosoc Med. 2011; 5(1): 11.

[22] Николаева Н.Н. Психологические аспекты в практике косметолога. Иркутск: ИГМУ; 2018.

[23] Magin P., Adams J., Heading G., Pond D., Smith W. Psychological sequelae of acne vulgaris: Results of a qualitative study. Can Fam Physician. 2006; 52(8): 978-9.

[24] Божович Л.И. Избранные психологические труды: Проблема формирования личности. М.: Педагогика; 1995.

[25] Nikolaeva N.N. Psychological aspects in the practice of cosmetologist. Irkutsk: Irkutsk state medical University; 2018.

[26] Выготский Л.С. Собрание сочинений. В 6 т. М.: Педагогика; 1982. т. 1.

[27] (in Russian)

[28] Эриксон Э. Идентичность: юность и кризис. Пер. с англ. М.: Прогресс; 1996.

[29] Bozhovich L.I. Selected psychological works: the problem of personality formation. Moscow: Pedagogy; 1995. (in Russian)

[30] Stathakis V., Kilkenny M., Marks R. Descriptive epidemiology of acne vulgaris in the community. Australas J Dermatol. 1997; 38(3): 115-23.

[31] Vygotsky L.S. Collected works. Moscow: Pedagogy; 1982.

[32] Хьелл Л., Зиглер Д. Теории личности. Пер. с англ. СПб.:

[33] vol. 1. (in Russian)

[34] Питер; 2003.

[35] Erikson E.H. Identity: youth and crisis. New York: Norton Company; 1968.

[36] Ивлев Ю.В. Логика. М.: Логос; 2001.

[37] Stathakis V., Kilkenny M., Marks R. Descriptive epidemiology of acne vulgaris in the community. Australas J Dermatol. 1997; 38(3): 115-23.

[38] Батлер-Боудон Т. 50 великих книг по психологии. Пер. с англ. М.: ЭКСМО; 2012.

[39] Hjelle L., Ziegler D. Personality Theories: Basic Assumptions, Research, and Applications. McGrow-Hill: 1992.

[40] Яурова А.С. Взаимоcвязь жизнестойкости и самоотношения у подростков с акне (угревой болезнью). Педиатр. 2017; 8(5): 110-6.

[41] Ivlev Yu.V. Logika. Moscow: Logos; 2001. (in Russian)

[42] Пономарева Ж.В. Психологическое сопровождение лечения подростков, больных акне. Российский педиатрический журнал. 2011;(1):53-6.

[43] Butler-Bowdon T. 50 Psychology Classics. Bookwell; 2007.

[44] Божко С.А., Шерина Т.Ф. Опыт применения нелекарственных методов в лечении угревой болезни (акне вульгарис). Вестник новых медицинских технологий. Электронное издание. 2015;(4): публ.7-2. [Доступно по: http://www.medtsu.tula.ru/VNMT/Bulletin/E2015-4/5281.pdf дата обращения: 20.04.2020). DOI: 10.12737/16772

[45] Yaurova A.S. The relationship of hardiness and self-attitude in adolescents with acne. Pediatrician. Russian Journal (Pediatr). 2017; 8(5): 110-6. (in Russian)

[46] Линде Н.Д. Психологическое консультирование. Теория и практика М.: Аспект Пресс; 2011.

[47] Ponomareva Zh.V. Psychological accompaniment of treatment of adolescents with acne rash. Russian Pediatric Journal. (Rossijskii pediatricheskii zhurnal). 2011; (1): 53-6. (in Russian)

[48] Сорокина Т.С. История медицины. М.: Академия; 2009.

[49] Bozko S.A., Sherina T.F. The use of non-drug methods in treatment of acne vulgaris in experiment. Bulletin of new medical technologies. Russian Electronic Journal (Vestnik novykh meditsinskikh tekhnologii). 2015; (4): publ.7-2. [Available at: https://www.medtsu.tula.ru/VNMT/Bulletin/E2015-4/5281.pdf. Accessed April 20, 2020] (in Russian)

[50] Кочергин Н.Г., Самгин М.А., Монахов С.А., Игнатьев Д.В. Дерматологический индекс акне. Эстетическая медицина. 2004; 3(1): 62-5.

[51] Linde N.D. Psychological counseling. Theory and practice. Moscow: Aspect Press; 2011. (in Russian)

[52] Федеральные клинические рекомендации. Дерматовенерология 2015: Болезни кожи. Инфекции, передаваемые половым путем. М.: Деловой экспресс; 2016.

[53] Sorokina T.S. History of medicine. Moscow: Academy; 2009.

[54] Прохоров А.О. Психология неравновесных состояний.

[55] (in Russian)

[56] М.: ИПРАН; 1998.

[57] Kochergin N.G., Samgin M.A., Monakhov S.A., Ignatiev D.V. Dermatological index of acne. Aesthetic medicine. Russian Journal (Esteticheskaya meditsina). 2004; 3(1): 62-5. (in Russian)

[58] Адаскевич В.П. Диагностические индексы в дерматологии. М.: Изд-во Панфилова: БИНОМ; 2014.

[59] Federal clinical guidelines. Dermatology, 2015: diseases of the skin. Sexually transmitted infections. Moscow: Delovoy Express; 2016. (in Russian)

[60] Адаскевич В.П. Диагностические индексы в дерматологии. М.: Медицинская книга; 2004.

[61] Prokhorov A.O. Psychology of non-equilibrium States. Moscow: IPRAN; 1998. (in Russian)

[62] Hendrix S. Neuroimmune communication in skin: far from peripheral. J Invest Dermatol. 2008; 128(2): 260-1.

[63] Adaskevich V.P. Diagnostic indices in dermatology, Moscow: BINOM; 2014. (in Russian)

[64] Pavlovic S., Daniltchenko M., Tobin D.J., Hagen E., Hunt S.P., Klapp B.F., et al. Further exploring the brain-skin connection: stress worsens dermatitis via substance P-dependent neurogenic inflammation in mice. J Invest Dermatol. 2008; 128(2): 434-46.

[65] Adaskevich V.P. Diagnostic indices in dermatology. Moscow: Medical Book; 2004. (in Russian)

[66] Бауманн Л. Косметическая дерматология. Принципы и практика. Пер. с англ. М.: МЕДпресс-информ; 2012.

[67] Hendrix S. Neuroimmune communication in skin: far from

[68] Антуан де Сент-Экзюпери. Собрание сочинений. Пер. с франц. В 3 т. Рига: Полярис; 1997. Т. 3.

[69] peripheral. J Invest Dermatol. 2008; 128(2): 260-1.

[70] Pavlovic S, Daniltchenko M, Tobin DJ, Hagen E, Hunt SP, Klapp BF, et al. Further exploring the brain-skin connection: stress worsens dermatitis via substance P-dependent neurogenic

[71] inflammation in mice. J Invest Dermatol. 2008; 128(2): 434-46.

[72] Baumann L. Cosmetic Dermatology. Principles and Practice. McGraw-Hill Companies; 2009.

[73] Antoine de Saint-Exupery. Collected works. In 3 vol. Riga: Polaris; 1997. Vol. 3.

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