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Nonpharmaceutical interventions are important for addressing the psychosocial needs of children living with atopic dermatitis (AD). The current study aimed to investigate the effects of an integrative body–mind–spirit (IBMS) intervention on the subjective experiences of affected children and explore the mechanisms underlying the effects. Using a drawing-based, qualitative approach, the current study conducted two rounds of interviews with 13 children (aged 8–12 years) diagnosed with moderate or severe AD before and after they attended the IBMS intervention. Data were analyzed by using the thematic analysis method. The IBMS intervention worked by changing participants' perceptions at the cognitive level, improving their coping strategies at the behavioral level, and constructing their social support network at the environmental level. Cognitive, behavioral, and environmental factors might mediate the relationships between the IBMS intervention and participants' psychological and physical outcomes. This study highlighted the wider inclusion of child-centered qualitative research in the evaluation of the effects of psychosocial interventions designed for children. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) imposes significant physical and psychosocial burdens on affected children. However, little has been done to learn from the subjective experiences, perspectives and emotions of children living with AD. Their voices are not heard in healthcare settings. This study aims to share these children's voices and provide a deep understanding of the subjective experiences of children living with AD. We conducted qualitative research by conducting semi‐structured interviews and analysing the drawings of 17 children in Hong Kong aged between 8 and 12 years who were diagnosed with AD. Using a phenomenological approach, we transcribed, coded and described the interviews. We found that for the children in this study, living with AD meant contending with an accumulation of challenges and crises. At the individual level, the essential experience of living with AD manifested a vicious cycle of skin and mental issues. At the family level, conflicts between children and parents concerning AD management coexisted with parental support. The children commonly experienced bullying and isolation in school and discrimination and stigmatisation in their neighbourhood, thereby making living with AD a traumatic experience. The synergy between individual and environmental factors contributed to shaping an incapable and wounded "self" living with AD. Based on our findings, we propose a child‐centred biopsychosocial framework for understanding the living experiences of children with AD. This study suggests different practice strategies for healthcare professionals working with the individual challenges experienced by children living with AD and the challenges these children experience in their family, school, and neighbourhood. The needs of these children should be addressed through an integrated, holistic approach for improving their long‐term health outcomes. [ABSTRACT FROM AUTHOR]

Assessing the psychological effects on children and adolescents of suffering atopic dermatitis (AD) is essential, when planning successful management. This study aimed to systematically review the literature regarding risk of mental disorders in children and adolescents with, or without, AD; and to explore confounders. We identified potentially relevant studies from EMBASE, MEDLINE, PsycINFO, ERIC, the British Nursing Index, the Family and Society Studies Worldwide, the Social Work Abstracts, and the Sociological Abstracts from inception to Sep 30, 2018. Investigators independently screened titles and abstracts, and then full-texts. Investigators independently extracted data from included studies. Meta-analyses using random-effects models were performed, reporting odds ratios (ORs; 95% CIs). Thirty-seven studies (n = 2,068,911 children/ adolescents) were included. Meta-analysis of 35 studies found that children and adolescents with AD had significantly higher risk of total mental disorders than those without AD (OR = 1.652; 95% CI, 1.463–1.864). There was no significant difference in risks for ADHD (OR = 1.563; 95% CI, 1.382–1.769); sleep disorders (OR = 2.100; 95% CI, 1.322–3.336); anxiety (OR = 1.339; 95% CI, 1.062–1.687); depression (OR = 1.402 95% CI, 1.256–1.565); conduct disorder (OR = 1.494 95% CI, 1.230–1.815); or ASD (OR = 2.574; 95% CI, 1.469–4.510; Q b = 8.344, p = 0.138). Race/ethnicity of child, target of comparison, type of studies, representativeness of the sample, measures of AD and mental disorders were significant moderators for total mental disorders. Integrated, holistic, multidisciplinary management of pediatric AD is significantly important, which emphasizes the well-being of the whole person. [ABSTRACT FROM AUTHOR]

• Psychosocial needs of children with AD have been commonly ignored. • This study examines the effects of an IBMS group intervention on children with AD. • The intervention is effective in improving participants' skin symptoms and psychosocial well-being. The symptomatology of atopic dermatitis (AD) imposes heavy physical, psychological, and social burdens on children, yet their psychosocial needs have been commonly ignored in AD management. Evidence of the psychosocial effects of psychosocial interventions on childhood AD is thin. The present study aimed to examine the effects of a customized Integrative Body-Mind-Spirit (IBMS) group intervention on physical, psychological, and social outcomes for children with AD. A randomized-waitlisted controlled trial was conducted. Children of primary-school age who had been diagnosed with AD and their parents were recruited. Parent-child dyads were randomized to either the IBMS group or waitlisted controlled (WLC) group. Children and their parents attended six three-hour sessions incorporating treatment components based on the IBMS intervention model. The group intervention was conducted in parallel format that the children and parents attended independently of each other. Outcome measures included the severity of AD, generalized and social anxiety symptoms, emotion regulation, self-esteem, quality of relationships with parents, and dermatology-specific quality of life (QoL) at pre-intervention (T0), post-intervention (T1) and 5-weeks post-intervention (T2). Data from 58 children in the IBMS group and 55 children in the WLC group were analyzed. There were no differences in baseline measures. Children in the IBMS group displayed significant decrease in severity of AD, generalized anxiety and social phobia, and improvement in emotion regulation as compared with the WLC group. No significant difference in self-esteem, quality of relationships with parents, or dermatology-specific QoL between the two groups was found. With a rigorously designed evaluation, the study found that the IBMS parallel-group intervention based on a holistic perspective and Eastern philosophies on health and well-being was effective in improving skin symptoms and psychosocial well-being among 6–12-year old children living with AD. Future research needs to customize this IBMS intervention to other developmental stages of children with AD in other geographical contexts so as to benefit wider populations. [ABSTRACT FROM AUTHOR]