Self-help based on compassion and mindfulness can reduce shame and improve quality of life in patients with psoriasis, researchers reported in a study published in the British Journal of Dermatology.

The 4-week online feasibility trial evaluated the acceptability, adherence, and efficacy of compassion-focused self-help interventions accessed through e-mail. Eligible participants were adults aged 16 years or older with a self-reported diagnosis of psoriasis by a general practitioner or dermatologist and an experience of emotional distress—such as low mood and anxiety—in managing psoriasis.

A total of 130 participants were randomly assigned into either the compassionate (n = 65; 40 women; 33 aged 16-35 years; 56 White) or mindfulness intervention (n = 65; 47 women; 42 aged 36-66 years; 54 White).


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The compassionate self-help intervention is designed to strengthen compassionate intention and competencies and teach patients with psoriasis how to act in a kind, caring, and compassionate way by physically saying and doing things to alleviate psoriasis-related distress, the investigators explained. The mindfulness self-help intervention focuses on cultivating a soothing-breathing rhythm and in fostering flexible attention to the psoriasis experience instead of on self-defeating thoughts and behaviors.

The 2 interventions showed modest yet statistically significant reductions in shame as measured with the Other as Shamer Scale scores (compassion, Cohen’s d = .23; mindfulness, Cohen’s d = .20) and improvements in quality of life according to Dermatology Life Quality Index scores (compassion, Cohen’s d = .45; mindfulness, Cohen’s d = .43).

High agreement in the interventions was found regarding that the audio techniques were “easy to follow”—compassion 86% and mindfulness 96%. High agreement was also observed in the helpfulness of the information specific to the respective technique—compassion 74% and mindfulness 88%.

Study limitations include the online-only recruitment and delivery, and that 80% of participants were recruited from the UK Psoriasis Association. Also, the patients were well educated, and the overall sample size was small. In addition, information on onset age, pruritus intensity, use of illegal substances, or current treatment was not available.

“The current study suggests that self-help interventions based on compassion-focused therapy have clinical relevance and are welcomed by a community psoriasis sample,” the researchers commented. “The improvements were modest yet demonstrate potential for the benefit of brief self-help interventions. It is encouraging that despite the limitations of unguided self-help, the study has shown that self-help can reach a wide audience who do not have access to structured psychological support.”

Reference

Muftin Z, Gilbert P, Thompson AR. A randomised controlled feasibility trial of online compassion-focused self-help for psoriasis. Br J Dermatol. Published online January 18, 2022. doi:10.1111/bjd.21020