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Can psychotherapy help psoriasis patients?

Do you recommend psychotherapy to your psoriasis patients? While there is a well-established connection between psoriasis and mental health, there is little data available on the impact of psychological interventions on psoriasis. These study authors look to fill that gap.

Several studies have linked anxiety, depression and other psychological comorbidities to skin disease, and have even found that skin disease can be alleviated or exacerbated by psychological factors.

To determine the impact of psychological treatments on psoriasis, a study published in April in The American Journal of Clinical Dermatology examined evidence based psychological treatment options for patients with psoriasis.

Authors sought out studies regarding the use of psychological therapy in the management of psoriasis published from 1990 through 2018. Ultimately, 28 articles were included in their review. Articles were then assigned levels of evidence based on the Scottich Intercollegiate Guidelines Network (SIGN) Level of Evidence. The categories of studies included:

  • Ten studies investigating cognitive behavioral therapy, variants of cognitive behavioral therapy and biofeedback
  • Seven studies investigating meditation and mindfulness-based therapies, hypnosis, music resonance therapy and motivational interviewing
  • Three studies investigating emotional disclosure therapies
  • Seven studies investigating educational and multidisciplinary interventions

Cognitive Behavioral Therapy (CBT)
CBT is a time-oriented, structured psychotherapy focused on finding current solutions and teaching skills that modify dysfunctional behavior and/or thoughts. In the studies conducted using CBT, direct influence on disease severity improvement is unclear from the present literature, and studies are limited by high mean attrition of 26.4 ± 4.8% in the six trials included.

However, the authors note, “Mean post-intervention follow-up was 4.6 months for the eight included studies and 4.2 ± 1.2 months for the subset of six trials.” They conclude that “CBT and its variants as adjunct therapy confer benefits to patients with psoriasis, particularly in terms of psychological parameters and QoL.”

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