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Internet-delivered cognitive behaviour therapy effective for AD

Researchers at the Karolinska Institute evaluated the treatment of adult patients with atopic dermatitis (AD) using internet-delivered cognitive behavioural therapy (iCBT). They found that iCBT can be effective for treating patients’ psychological symptoms related to AD while using minimal therapist resources.

Results of the study conducted in Stockholm and published online ahead of print in JAMA Dermatology (May 19, 2021), showed patients who received iCBT for their AD fared better than the control group that received only traditional treatment.

“We have carried out a promising pilot study but we’re still surprised at how effective internet-iCBT seems to be against AD,” said Erik Hedman-Lagerlöf, PhD, in a press release. “ICBT requires much less therapy time than the normal treatment format and has the potential to reach many patients who don’t have access to a psychologist.”

Dr. Hedman-Lagerlöf, the study’s first author, is an adjunct professor in the Department of Clinical Neuroscience at the Karolinska Institute.

To study the efficacy of iCBT for the treatment of adult patients with AD, the researchers conducted a randomized clinical trial of 102 adults with AD recruited from across Sweden. The patients received 12 weeks of iCBT from Mar. 29, 2017 to Feb. 16, 2018.

The participants were randomized into two large groups both of which received the same instructions on self-care with existing medications. Half of the participants also received iCBT with access to a therapist for 12 weeks.

According to the study’s authors, participants receiving iCBT, compared to controls, had a larger weekly reduction in symptoms of AD as measured with the Patient-Oriented Eczema Measure (POEM).

Further analysis showed that iCBT also produced significantly larger reductions in itch intensity, perceived stress, sleep problems and depression. The findings showed that the improvements were sustained at 12 months of follow-up and that treatment satisfaction was high.

“As far as we know, this is the first randomized controlled study of iCBT for the treatment of AD,” said Maria Bradley, PhD, in the release. “The results show that participants who underwent iCBT had significantly less eczema and itching and felt better than a control group who received instructions on conventional AD care.”

Dr. Bradley, the paper’s senior author, is a professor in the Department of Medicine at the Karolinska Institute in Solna, Sweden.

The authors note that one of the limitations of the study was that since the control group received iCBT after 12 weeks, only controlled inter-group comparisons could be made immediately after treatment was concluded and not during the later follow-ups.

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