Brief Mindfulness Intervention for Psoriasis Boosts Awareness, Not Skin Health

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A brief 2-week mindfulness-based intervention in patients with psoriasis only helps enhance awareness but not improve skin status, a study found.

“Results of the short-term PP analysis indicated a significant large effect on self-reported mindfulness and a tendency to a significant moderate effect on self-reported self-compassion,” wrote investigators led by Markus Eckardt, from the Institute of Medical Psychology at the University of Gießen in Germany. “Results of the medium-term PP analysis also yielded a tendency to a significant moderate effect on mindfulness.”

According to the World Psoriasis Day consortium, 125 million people have psoriasis worldwide—2 to 3 percent of the total population.2 The chronic inflammatory skin condition is linked to an itch, depression, and anxiety.1 Mindfulness-based interventions have been demonstrated to help people with psoriasis, but it was not known whether a short, 2-week intervention would be just as effective.3

Eckardt and colleagues conducted a randomized controlled trial to see if a 2-week mindfulness intervention would influence mindfulness and self-compassion among people with psoriasis.1 The team broke participants (n = 59) into the experimental group (treatment-as-usual and mindfulness-based intervention; n = 28) and the control group (only treatment-as-usual; n = 31).

The primary outcome was self-reported mindfulness and self-compassion. Secondary outcomes included itch catastrophizing, social anxiety, stress, and skin status. The variables were assessed before, during the intervention, and 3 months after.

The team conducted a repeated-measures analysis of variance (ANOA) to evaluate the effects of mindfulness-based intervention. They recruited patients with psoriasis who participated in a special tertiary prevention program for dermatology patients from Clinic Borkum Riff in Germany. The programs are intended to help patients cope with their disease more functionally so they can return to work.

The mindfulness-based intervention consisted of 8 sessions, 45 – 60 minutes each. The intervention focused on different aspects of mindfulness and included exercises such as body scan or mindful breathing. A psychologist with ≥ 5 years in mindfulness meditation conducted the training.

The short-term and medium-term effects analyses had a smaller sample due to dropouts and missing data (39 and 32 participants, respectively). The mean age of the short-term effects analysis was 49.8 years.

The short-term analysis showed a significant interaction effect on self-reported mindfulness (P = .010) and self-compassion (P .090). Investigators did not observe any other significant effects, although most of the data favored the experimental group over the control group.

The control group was more favorable in 1 variable—skin status. The control group demonstrated greater improvement in skin health than the experimental group, showing the intervention only helped the mind but not the actual psoriasis.

However, the medium-term analysis saw a significant interaction with mindfulness (P = .094) but not self-compassion (P = .558). Additionally, they saw a significant interaction in the severity of psoriasis (P = .023), with a t-test showing a reduction in the severity of psoriasis (P = .035). The team observed no interaction effects for itch catastrophizing (P = .424), social anxiety (P = .408)., or perceived stress (P = .927).

Investigators wrote the study was limited by the delivery of the intervention limiting generalizability, the large age range, a possible too-short follow-up period, a lack of an active control group, and the pandemic preventing the planned sample size of 60.

“The effects of such a short intervention should be investigated further in a larger sample and different setting, possibly also using a group receiving a less comprehensive,” investigators concluded.

References

1. ^{Eckardt, M., Stadtmueller, L., Zick, C., Kupfer, J., & Schut, C. (2024). Effects of a Brief Mindfulness-based Intervention in Patients with Psoriasis: A Randomized Controlled Trial. Acta Dermato-Venereologica, 104, adv18277. https://doi.org/10.2340/actadv.v104.18277}
2. ^{Psoriasis Statistics. National Psoriasis Foundation. https://www.psoriasis.org/psoriasis-statistics/#:~:text=Prevalence&text=125%20million%20people%20worldwide%20%E2%80%94%202,the%20World%20Psoriasis%20Day%20consortium. Accessed April 26, 2024.}
3. ^{Bartholomew E, Chung M, Yeroushalmi S, Hakimi M, Bhutani T, Liao W. Mindfulness and Meditation for Psoriasis: A Systematic Review. Dermatol Ther (Heidelb). 2022;12(10):2273-2283. doi:10.1007/s13555-022-00802-1}