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Atopic dermatitis (AD) is a chronic, inflammatory skin disease that carries a significant psychological burden.1 Beyond the visible cutaneous symptoms, individuals with AD are associated with an increased risk of anxiety and depression.1 While standard treatments focus on alleviating the physical symptoms of AD, psychological stress and emotional factors play a significant role in triggering or worsening disease activity.2 However, add-on psychotherapeutic interventions remain underused in clinical practice. This implementation gap highlights the need for multidisciplinary care strategies that include psychological support. To address this, we conducted a systematic review and meta-analysis evaluating the impact of add-on psychotherapeutic interventions on disease severity and quality of life in adults with AD. We searched MEDLINE, EMBASE, and Cochrane CENTRAL on November 12, 2024, for interventional studies evaluating psychotherapy plus standard care for AD. A total of 6995 publications were screened by three independent reviewers. Sixteen clinical trials met the inclusion criteria for the systematic review (Table 1), five of which were eligible for meta-analysis (n = 335). Interventions included cognitive behavioural therapy, behavioural therapy, autogenic therapy, habit reversal, family constellation seminar, mindfulness, hypnotherapy, music therapy, stress management, and brief dynamic psychotherapy. The outcomes were the Eczema Area and Severity Index (EASI) and the Dermatology Life Quality Index (DLQI), assessing disease severity and quality of life, respectively. In the meta-analysis of five studies including 335 patients,3-7 psychotherapeutic interventions compared with standard dermatologic care led to a significant reduction of 3.92 points in EASI (N = 3, n = 126, 95% CI [−7.19, −0.66]) (Figure 1a) and 3.42 points in DLQI (N = 4, n = 315, 95% CI [−5.63, −1.20]) (Figure 1b). These reductions are not only statistically significant but also clinically meaningful. They correspond to a shift in disease severity from moderate to mild and a reduction in quality-of-life impact from moderate–very large to moderate-low across all add-on psychotherapy groups. The clinical impact of these findings is substantial; reduced disease severity may permit treatment de-escalation,8 while improved quality of life promotes patient adherence.9 Together, these can lead to better treatment outcomes and reduced healthcare costs.10 In addition, psychotherapeutic interventions may also help address significant psychological comorbidities associated with AD, such as depression, anxiety, and suicidal ideation, which are increasingly recognized in this population. Despite heterogeneity in intervention type, duration, delivery method, and outcome measures, the findings were directionally consistent. However, the limited number of studies and methodological issues reduce the certainty of the conclusions, warranting cautious interpretation. Our review focused exclusively on adult populations and excluded educational-only interventions, highlighting the direct impact of psychotherapy. It also included newer trials not covered by previous analyses and focused on validated outcomes widely used in clinical practice and research, enhancing the generalizability and translational relevance of our findings. The results suggest that psychotherapeutic interventions have the potential to transform the treatment of AD, particularly in patients with mild to moderate disease. Our findings therefore support its more precise recognition as a distinct psychotherapeutic intervention in official clinical guidelines and protocols. Additionally, future randomized clinical trials with robust methodology and validated outcome measures are needed to build on these findings by enrolling larger patient numbers to further establish the efficacy of add-on psychotherapy. Our results also suggested that psychotherapeutic interventions may have lasting benefits on disease severity and quality of life for up to 1 year, highlighting their potential to be used as part of a long-term management plan. Further research is also warranted in populations with severe AD to evaluate the applicability of psychotherapy in more complex diseases. Lastly, a comparison of the different psychotherapeutic modalities could help identify the most effective intervention for optimized psychotherapeutic care in adults with AD. None. None to declare. No ethical approval was required for this systematic review with meta-analysis. Not applicable. The data that support the findings of this study are available from the corresponding author upon reasonable request.