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April 3, 1967

Psychotherapy in Neurodermatitis

JAMA. 1967;200(1):83. doi:10.1001/jama.1967.03120140141040

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To the Editor:—  In QUESTIONS and ANSWERS (198:1230, 1966) there was an extensive discussion on the treatment of neurodermatitis by Dr. Sigfrid A. Muller in his reply to an inquiry.I should like to add to Dr. Muller's answer that psychiatric investigation and treatment are of great value to many patients with this condition even though many do have a personal and family history of allergic diseases. Almost all invariably have emotional problems which precipitate or aggravate their neurodermatitis. Unfortunately, their personality problems are so deeply entrenched that they require skilled psychiatric care, in addition to sedation, tranquilization, and topical treatment.A casual, superficial discussion of their emotional problems usually is fruitless since most patients are reluctant to discuss their personal lives early in the course of treatment. It frequently takes a few lengthy visits before trust and rapport are sufficiently established, and the patient is able to expose