Effects of a Brief Mindfulness-based Intervention in Patients with Psoriasis: A Randomized Controlled Trial

Authors

  • Markus Eckardt Institute of Medical Psychology, University of Gießen, Germany
  • Laura Stadtmueller Institute of Medical Psychology, University of Gießen, Germany
  • Christoph Zick Department of Dermatology, Rehabilitation Clinic Borkum Riff, Borkum, Germany
  • Jörg Kupfer Institute of Medical Psychology, University of Gießen, Germany
  • Christina Schut Institute of Medical Psychology, University of Gießen, Germany https://orcid.org/0000-0001-5366-6285

DOI:

https://doi.org/10.2340/actadv.v104.18277

Keywords:

clinical trial, psoriasis, psychodermatology, mindfulness

Abstract

Mindfulness is a special type of attention, namely focusing on the current moment in a non-judgmental manner. Extensive mindfulness-based interventions have been shown to have positive effects in patients with psoriasis. However, it is unclear whether brief (2-week) interventions are also beneficial. Therefore, the aim of this study was to investigate the effects of a 2-week mindfulness-based intervention in patients with psoriasis. Patients were randomly assigned to an experimental (treatment-as-usual + mindfulness-based intervention) or control group (treatment-as-usual) during their clinic stay. All variables were measured by self-report using validated questionnaires: primary outcomes were mindfulness and self-compassion, secondary outcomes were itch catastrophizing, social anxiety, stress and skin status. Variables were assessed prior to, immediately and 3 months after the intervention. Effects were tested by repeated-measures analysis of variance (ANOVA). Analyses of pre-post-measurements (n = 39) revealed a significant interaction effect on self-reported mindfulness [F(1,35) = 7.46, p = 0.010, η2p = 0.18] and a tendency to a significant effect on self-reported self-compassion [F(1,36) = 3.03, p = 0.090, η2p = 0.08]. There were no other significant effects, but most descriptive data were in favour of the experimental group. However, the control group showed a greater improvement in skin status. Further studies are needed to replicate these findings and investigate which subgroups especially profit from such an intervention.

Downloads

Download data is not yet available.

References

Augustin M, Reich K, Glaeske G, Schaefer I, Radtke M. Co-morbidity and age-related prevalence of psoriasis: analysis of health insurance data in Germany. Acta Derm Venereol 2010; 90: 147-151.

https://doi.org/10.2340/00015555-0770 DOI: https://doi.org/10.2340/00015555-0770

Schut C, Dalgard F, Halvorsen J, Gieler U, Lien L, Aragones L, et al. Occurrence, chronicity and intensity of itch in a clinical consecutive sample of patients with skin diseases: a multi-centre study in 13 European Countries. Acta Derm Venereol 2019; 99: 146-151.

https://doi.org/10.2340/00015555-3040 DOI: https://doi.org/10.2340/00015555-3040

Kurd SK, Troxel AB, Crits-Christoph P, Gelfand JM. The risk of depression, anxiety and suicidality in patients with psoriasis: a population-based cohort study. Arch Dermatol 2010; 146: 891-895.

https://doi.org/10.1001/archdermatol.2010.186 DOI: https://doi.org/10.1001/archdermatol.2010.186

Kabat-Zinn J. Wherever You Go, There You are: mindfulness meditation for everyday life. London: Piatkus; 2004. 304 p.

Khoury B, Sharma M, Rush SE, Fournier C. Mindfulness-based stress reduction for healthy individuals: a meta-analysis. J Psychosom Res 2015; 78: 519-528.

https://doi.org/10.1016/j.jpsychores.2015.03.009 DOI: https://doi.org/10.1016/j.jpsychores.2015.03.009

Santorelli SF, Meleo-Meyer F, Koerbel L, Kabat-Zinn J. Mindfulness-based stress reduction (MBSR) Authorized Curriculum Guide. 2017. [cited 2019 Jan 30]. Available from: https://www.umassmed.edu/globalassets/center-for-mindfulness/documents/mbsr-curriculum-guide-2017.pdf

Segal ZV, Williams JMG, Teasdale JDT. Die Achtsamkeitsbasierte Kognitive Therapie der Depression: Ein neuer Ansatz zur Rückfallprävention. 2., erw. und überarb. Aufl. Tübingen: dgvt-Verlag; 2015. 494 p.

Norton AR, Abbott MJ, Norberg MM, Hunt C. A systematic review of mindfulness and acceptance-based treatments for social anxiety disorder: mindfulness interventions for SAD. J Clin Psychol 2015; 71: 283-301.

https://doi.org/10.1002/jclp.22144 DOI: https://doi.org/10.1002/jclp.22144

Veehof MM, Trompetter HR, Bohlmeijer ET, Schreurs KMG. Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review. Cogn Behav Ther 2016; 45: 5-31.

https://doi.org/10.1080/16506073.2015.1098724 DOI: https://doi.org/10.1080/16506073.2015.1098724

Piet J, Hougaard E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clin Psychol Rev 2011; 31: 1032-1040.

https://doi.org/10.1016/j.cpr.2011.05.002 DOI: https://doi.org/10.1016/j.cpr.2011.05.002

Cavanagh K, Churchard A, O'Hanlon P, Mundy T, Votolato P, Jones F, et al. A randomised controlled trial of a brief online mindfulness-based intervention in a non-clinical population: replication and extension. Mindfulness 2018; 9: 1191-1205.

https://doi.org/10.1007/s12671-017-0856-1 DOI: https://doi.org/10.1007/s12671-017-0856-1

Vesa N, Liedberg L, Rönnlund M. Two-week web-based mindfulness training reduces stress, anxiety, and depressive symptoms in individuals with self-reported stress: a randomized control trial. Int J Neurorehabilitation 2016 [cited 2022 Mar 5]; 3. Available from: http://www.omicsgroup.org/journals/twoweek-webbased-mindfulness-training-reduces-stress-anxiety-and-depressive-symptoms-in-individuals-with-selfreported-stress-a-ran-2376-0281-1000209.php?aid=74146.

https://doi.org/10.4172/2376-0281.1000209 DOI: https://doi.org/10.4172/2376-0281.1000209

Demarzo M, Montero-Marin J, Puebla-Guedea M, Navarro-Gil M, Herrera-Mercadal P, Moreno-González S, et al. Efficacy of 8- and 4-session mindfulness-based interventions in a non-clinical population: a controlled study. Front Psychol 2017 [cited 2023 Oct 25]; 8. Available from: https://www.frontiersin.org/articles/10.3389/fpsyg.2017.01343

https://doi.org/10.3389/fpsyg.2017.01343 DOI: https://doi.org/10.3389/fpsyg.2017.01343

Howarth A, Smith JG, Perkins-Porras L, Ussher M. Effects of brief mindfulness-based interventions on health-related outcomes: a systematic review. Mindfulness 2019; 10: 1957-1968.

https://doi.org/10.1007/s12671-019-01163-1 DOI: https://doi.org/10.1007/s12671-019-01163-1

Schumer MC, Lindsay EK, Creswell JD. Brief mindfulness training for negative affectivity: a systematic review and meta-analysis. J Consult Clin Psychol 2018; 86: 569-583.

https://doi.org/10.1037/ccp0000324 DOI: https://doi.org/10.1037/ccp0000324

Lüßmann K, Montgomery K, Thompson A, Gieler U, Zick C, Kupfer J, et al. Mindfulness as predictor of itch catastrophizing in patients with atopic dermatitis: results of a cross-sectional questionnaire study. Front Med 2021; 8: 627611.

https://doi.org/10.3389/fmed.2021.627611 DOI: https://doi.org/10.3389/fmed.2021.627611

Montgomery K, Norman P, Messenger AG, Thompson AR. The importance of mindfulness in psychosocial distress and quality of life in dermatology patients. Br J Dermatol 2016; 175: 930-936.

https://doi.org/10.1111/bjd.14719 DOI: https://doi.org/10.1111/bjd.14719

Fordham B, Griffiths CEM, Bundy C. A pilot study examining mindfulness-based cognitive therapy in psoriasis. Psychol Health Med 2015; 20: 121-127.

https://doi.org/10.1080/13548506.2014.902483 DOI: https://doi.org/10.1080/13548506.2014.902483

Maddock A, Hevey D, D'Alton P, Kirby B. A Randomized trial of mindfulness-based cognitive therapy with psoriasis patients. Mindfulness 2019; 10: 2606-2619.

https://doi.org/10.1007/s12671-019-01242-3 DOI: https://doi.org/10.1007/s12671-019-01242-3

Gaston L, Crombez JC, Joly J, Hodgins S, Dumont M. Efficacy of imagery and meditation techniques in treating psoriasis. Imagin Cogn Personal 1989; 8: 25-38.

https://doi.org/10.2190/PQKE-CMAM-T4MT-QVBL DOI: https://doi.org/10.2190/PQKE-CMAM-T4MT-QVBL

Kabat-Zinn J, Wheeler E, Light T, Skillings A, Scharf MJ, Cropley TG, et al. Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing photo therapy (UVB) and photochemotherapy (PUVA). Psychosom Med 1998; 60: 625-632.

https://doi.org/10.1097/00006842-199809000-00020 DOI: https://doi.org/10.1097/00006842-199809000-00020

D'Alton P, Kinsella L, Walsh O, Sweeney C, Timoney I, Lynch M, et al. Mindfulness-based interventions for psoriasis: a randomized controlled trial. Mindfulness 2019; 10: 288-300.

https://doi.org/10.1007/s12671-018-0973-5 DOI: https://doi.org/10.1007/s12671-018-0973-5

Stadtmüller L, Eckardt M, Zick C, Kupfer J, Schut C. Investigation of predictors of interest in a brief mindfulness-based intervention and its effects in patients with psoriasis at a rehabilitation clinic (SkinMind): an observational study and randomised controlled trial. BMJ Open 2020; 10: e033952.

https://doi.org/10.1136/bmjopen-2019-033952 DOI: https://doi.org/10.1136/bmjopen-2019-033952

Stadtmüller LR, Eckardt MA, Zick C, Kupfer J, Schut C. Interest in a short psychological intervention in patients with psoriasis: a cross-sectional observational study at a German clinic. Front Med 2023; 10: 1074632.

https://doi.org/10.3389/fmed.2023.1074632 DOI: https://doi.org/10.3389/fmed.2023.1074632

Lustyk MKB, Chawla N, Nolan RS, Marlatt GA. Mindfulness meditation research: issues of participant screening, safety procedures, and researcher training. Adv Mind Body Med 2009; 24: 20-30.

Bergomi C, Tschacher W, Kupper Z. Konstruktion und erste Validierung eines Fragebogens zur umfassenden Erfassung von Achtsamkeit: Das Comprehensive Inventory of Mindfulness Experiences. Diagnostica 2014; 60: 111-125.

https://doi.org/10.1026/0012-1924/a000109 DOI: https://doi.org/10.1026/0012-1924/a000109

Hupfeld J, Ruffieux N. Validierung einer deutschen Version der Self-Compassion Scale (SCS-D). Z Für Klin Psychol Psychother 2011; 40: 115-123.

https://doi.org/10.1026/1616-3443/a000088 DOI: https://doi.org/10.1026/1616-3443/a000088

Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother 2011; 18: 250-255.

https://doi.org/10.1002/cpp.702 DOI: https://doi.org/10.1002/cpp.702

Ehlers A, Stangier U, Dohn D, Gieler U. Kognitive Faktoren beim Juckreiz: Entwicklung und Validierung eines Fragebogens. Verhaltenstherapie. 1993; 3: 112-119.

https://doi.org/10.1159/000258752 DOI: https://doi.org/10.1159/000258752

Reichenberger J, Schwarz M, König D, Wilhelm FH, Voderholzer U, Hillert A, et al. Angst vor negativer sozialer Bewertung: Übersetzung und Validierung der Furcht vor negativer Evaluation-Kurzskala (FNE-K). Diagnostica 2016; 62: 169-181.

https://doi.org/10.1026/0012-1924/a000148 DOI: https://doi.org/10.1026/0012-1924/a000148

Klein EM, Brähler E, Dreier M, Reinecke L, Müller KW, Schmutzer G, et al. The German version of the Perceived Stress Scale - psychometric characteristics in a representative German community sample. BMC Psychiatry 2016; 16: 159.

https://doi.org/10.1186/s12888-016-0875-9 DOI: https://doi.org/10.1186/s12888-016-0875-9

Feldman SR, Fleischer AB, Reboussin DM, Rapp SR, Lyn Exum M, Clark AR, et al. The self-administered psoriasis area and severity index is valid and reliable. J Invest Dermatol 1996; 106: 183-186.

https://doi.org/10.1111/1523-1747.ep12329912 DOI: https://doi.org/10.1111/1523-1747.ep12329912

Fleischer AB, Feldman SR, Rapp SR, Reboussin DM, Exum ML, Clark AR, et al. Disease severity measures in a population of psoriasis patients: the symptoms of psoriasis correlate with self-administered psoriasis area severity index scores. J Invest Dermatol 1996; 107: 26-29.

https://doi.org/10.1111/1523-1747.ep12297659 DOI: https://doi.org/10.1111/1523-1747.ep12297659

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39: 175-191.

https://doi.org/10.3758/BF03193146 DOI: https://doi.org/10.3758/BF03193146

IBM Corp. IBM SPSS Statistics for Macintosh, Version 27.0. Armonk, NY; 2020.

Bennett DA. How can I deal with missing data in my study? Aust N Z J Public Health 2001; 25: 464-469.

https://doi.org/10.1111/j.1467-842X.2001.tb00659.x DOI: https://doi.org/10.1111/j.1467-842X.2001.tb00659.x

Field A. Discovering statistics using IBM SPSS statistics. 5th edn. Thousand Oaks, CA: SAGE Publications; 2017.

Cohen J. Statistical power analysis for the behavioral sciences. Saint Louis, USA: Elsevier Science & Technology; 1977. [cited 2022 May 2]. Available from: http://ebookcentral.proquest.com/lib/unigiessen/detail.action?docID=1882849.

Alsubaie M, Abbott R, Dunn B, Dickens C, Keil TF, Henley W, et al. Mechanisms of action in mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) in people with physical and/or psychological conditions: a systematic review. Clin Psychol Rev 2017; 55: 74-91.

https://doi.org/10.1016/j.cpr.2017.04.008 DOI: https://doi.org/10.1016/j.cpr.2017.04.008

Galante J, Grabovac A, Wright M, Ingram DM, Van Dam NT, Sanguinetti JL, et al. A framework for the empirical investigation of mindfulness meditative development. Mindfulness 2023; 14: 1054-1067.

https://doi.org/10.1007/s12671-023-02113-8 DOI: https://doi.org/10.1007/s12671-023-02113-8

Mrazek MD, Franklin MS, Phillips DT, Baird B, Schooler JW. Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering. Psychol Sci 2013; 24: 776-781.

https://doi.org/10.1177/0956797612459659 DOI: https://doi.org/10.1177/0956797612459659

Published

2024-04-19

How to Cite

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