{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:52:48Z","timestamp":1791337968484,"version":"4.3.1"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by persistent itch and a prolonged clinical course and can affect mental health and impair quality of life. Stress and anxiety exacerbate the symptoms of itch, leading to a vicious cycle that influences patient scratching behaviors and worsens disease prognosis. Dermatologists should consider psychosomatic correlations in patients with AD and provide psychosomatic intervention. However, standardized, consensus\u2010based non\u2010pharmacological psychosomatic approaches for patients with AD have not been established in Japan. This study sought to establish a Japanese consensus on non\u2010pharmacological psychosomatic approaches to patients with AD. Japanese experts in psychosomatic dermatology stated their level of agreement with 28 items in round 1 plus one added in round 2 (29 items in total) regarding psychosomatic approaches as non\u2010pharmacological approaches among patients with AD over Delphi rounds. Consensus was defined a priori as agreement from \u2265\u200975% of participants. The response rate was 17\/21 (81.0%) in the first round and 17\/17 (100%) in the second round. Twenty\u2010five statements were adopted over both rounds. Performance of medical interviews and physical examinations, recognition of patient efforts, and respect for the interpretive model of the patient categorized to establish a good therapeutic relationship showed agreement. Evaluation of pathology from physical and psychological perspectives (addictive scratching, building a bio\u2010psycho\u2010social [BPS] model and pathophysiological hypothesis) showed high\u2010level agreement. Indirectly promoting patient awareness of aggravating factors of AD and sharing the BPS model and pathophysiological hypothesis with the patient showed consensus. Further, 14 statements about the application of psychosomatic correlations to therapy showed agreement. In the second round, group therapy also gained consensus as a useful intervention. Our Delphi panel provides recommendations about psychosomatic interventions for patients with AD to standardize approaches in clinical practice and research.<\/jats:p>","DOI":"10.1111\/1346-8138.70523","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:45:51Z","timestamp":1791337551000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non\u2010Pharmacological Psychosomatic Approaches to Patients With Atopic Dermatitis: A Delphi Consensus of Expert Opinions in Japan"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1274-2644","authenticated-orcid":false,"given":"Masako","family":"Minami\u2010Hori","sequence":"first","affiliation":[{"name":"Department of Dermatology Asahikawa City Hospital  Asahikawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8094-9029","authenticated-orcid":false,"given":"Hideaki","family":"Hasuo","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine Kansai Medical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3357-0026","authenticated-orcid":false,"given":"Takashi","family":"Yamakita","sequence":"additional","affiliation":[{"name":"Department of Dermatology Fujita Health University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3387-9664","authenticated-orcid":false,"given":"Makoto","family":"Hashiro","sequence":"additional","affiliation":[{"name":"Hashiro Clinic Dermatology Psychosomatics  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-9377","authenticated-orcid":false,"given":"Yoshinobu","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Internal Medicine NHO Kinki Chuo Chest Medical Center  Sakai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-1971","authenticated-orcid":false,"given":"Hiromichi","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Division of Psycho\u2010Oncology National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasunari","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Mori","sequence":"additional","affiliation":[{"name":"Division of Palliative and Supportive Care Seirei Mikatahara General Hospital  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7935-878X","authenticated-orcid":false,"given":"Nobuyuki","family":"Sudo","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.1111\/1346-8138.17544","article-title":"English Version of Clinical Practice Guidelines for the Management of Atopic Dermatitis 2024","volume":"52","author":"Saeki H.","year":"2025","journal-title":"Journal of Dermatology"},{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.alit.2021.10.002","article-title":"Exacerbating Factors and Disease Burden in Patients With Atopic Dermatitis","volume":"71","author":"Murota H.","year":"2022","journal-title":"Allergology International"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.neubiorev.2018.01.009","article-title":"The Vicious Cycle of Itch and Anxiety","volume":"87","author":"Sanders K. M.","year":"2018","journal-title":"Neuroscience & Biobehavioral Reviews"},{"issue":"6","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.3390\/jcm13061602","article-title":"The Psychology of Atopic Dermatitis","volume":"13","author":"Courtney A.","year":"2024","journal-title":"Journal of Clinical Medicine"},{"issue":"4","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/1346-8138.14218","article-title":"Burden of Atopic Dermatitis in Japanese Adults: Analysis of Data From the 2013 National Health and Wellness Survey","volume":"45","author":"Arima K.","year":"2018","journal-title":"Journal of Dermatology"},{"issue":"3","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.jid.2018.08.028","article-title":"Atopic Dermatitis in America Study: A Cross\u2010Sectional Study Examining the Prevalence and Disease Burden of Atopic Dermatitis in the US Adult Population","volume":"139","author":"Chiesa Fuxench Z. C.","year":"2019","journal-title":"Journal of Investigative Dermatology"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.1111\/jdv.18429","article-title":"European Guideline (EuroGuiDerm) on Atopic Eczema\u2014Part II: Non\u2010Systemic Treatments and Treatment Recommendations for Special AE Patient Populations","volume":"36","author":"Wollenberg A.","year":"2022","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"1","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000101940","article-title":"The Effects of Psychological Intervention on Atopic Dermatitis","volume":"144","author":"Chida Y.","year":"2007","journal-title":"International Archives of Allergy and Immunology"},{"issue":"4","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.5662\/wjm.v11.i4.116","article-title":"Delphi Methodology in Healthcare Research: How to Decide Its Appropriateness","volume":"11","author":"Nasa P.","year":"2021","journal-title":"World Journal of Methodology"},{"key":"e_1_2_12_11_1","first-page":"340","article-title":"Iwayuru Nanchisei Zensoku Nitaisuru Shinshinigakuteki Kenkyu (Psychosomatic Research on So\u2010Called Intractable Asthma)","volume":"70","author":"Ago Y.","year":"1979","journal-title":"Fukuoka Acta Medica"},{"issue":"8","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","DOI":"10.1186\/s13030-015-0036-2","article-title":"Psychosomatic Treatment for Allergic Diseases","volume":"9","author":"Yoshihara K.","year":"2015","journal-title":"BioPsychoSocial Medicine"},{"issue":"1","key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00520-017-3830-5","article-title":"Automatic Referral to Standardize Palliative Care Access: An International Delphi Survey","volume":"26","author":"Hui D.","year":"2018","journal-title":"Supportive Care in Cancer"},{"key":"e_1_2_12_14_1","doi-asserted-by":"crossref","DOI":"10.2340\/00015555-3751","article-title":"Treat\u2010To\u2010Target in Atopic Dermatitis: An International Consensus on a Set of Core Decision Points for Systemic Therapies","volume":"101","author":"De Bruin\u2010Weller M.","year":"2021","journal-title":"Acta Dermato\u2010Venereologica"},{"issue":"2","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s13555-021-00497-w","article-title":"Atopic Dermatitis: A Patient and Dermatologist's Perspective","volume":"11","author":"Berruyer M.","year":"2021","journal-title":"Dermatology and Therapy"},{"issue":"12","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1111\/jdv.15913","article-title":"A Systematic Review of Factors Influencing Treatment Adherence in Chronic Inflammatory Skin Disease \u2010 Strategies for Optimizing Treatment Outcome","volume":"33","author":"Eicher L.","year":"2019","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"12","key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1111\/exd.14029","article-title":"Addiction and the Itch\u2010Scratch Cycle. What Do They Have in Common?","volume":"28","author":"Ishiuji Y.","year":"2019","journal-title":"Experimental Dermatology"},{"key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1089\/derm.2025.0021","article-title":"Breaking the Itch\u2010Scratch Cycle: An Integrative Approach for Atopic Dermatitis","volume":"37","author":"Steinhoff M.","year":"2025","journal-title":"Dermatitis"},{"issue":"13","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13185368","article-title":"Integrative Treatment Approaches With Mind\u2010Body Therapies in the Management of Atopic Dermatitis","volume":"11","author":"Yosipovitch G.","year":"2024","journal-title":"Journal of Clinical Medicine"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1111\/jdv.14888","article-title":"Consensus\u2010Based European Guidelines for Treatment of Atopic Eczema (Atopic Dermatitis) in Adults and Children: Part II","volume":"32","author":"Wollenberg A.","year":"2018","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"6","key":"e_1_2_12_21_1","first-page":"1218","article-title":"Guidelines of Care for the Management of Atopic Dermatitis Part 4: Prevention of Disease Flares and Use of Adjunctive Therapies and Approaches","volume":"71","author":"Sidbury R.","year":"2014","journal-title":"Journal of the American Academy of Dermatology"}],"container-title":["The Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.70523","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1346-8138.70523","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.70523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:45:54Z","timestamp":1791337554000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1346-8138.70523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":20,"alternative-id":["10.1111\/1346-8138.70523"],"URL":"https:\/\/doi.org\/10.1111\/1346-8138.70523","archive":["Portico"],"relation":{},"ISSN":["0385-2407","1346-8138"],"issn-type":[{"value":"0385-2407","type":"print"},{"value":"1346-8138","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2026-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1346-8138.70523"}}