Psychosocial interventions, including cognitive-behavioral or mindfulness techniques, may be effective in reducing anxiety and improving quality of life measures in patients with psoriasis, according to a review published in the British Journal of Dermatology.
The investigators of this study sought to examine the effects of all forms of psychosocial or psychoeducative interventions on patient-reported outcomes in individuals with psoriasis.
Researchers performed a systematic search of 4 databases (CENTRAL, MEDLINE, EMBASE, and PsychINFO) and found 19 studies on psychosocial interventions for patients with psoriasis that involved a comparison group and used patient-reported outcome measures. Data extraction was performed for each study, and information was available on study design, type of intervention, sample demographics, and risk of bias rated according to the Cochrane Handbook for Systematic Reviews of Interventions. The researchers further performed a meta-analysis to compare patient-reported outcomes between the intervention and control groups for quality of life, depression, and anxiety measures.
Cognitive-behavioral or mindfulness-based techniques (including meditation and emotional writing) were the primary psychosocial interventions used among the included studies. Although only 1 study reported blinding of patients, the risk of bias for the majority of studies yielded unclear results due to nontransparent or selective reporting of study protocols. Findings from the meta-analysis revealed that psychosocial interventions had a significant, small to medium effect on quality of life, assessed in 9 studies (n = 664), and on anxiety, assessed in 6 studies (n = 363), when compared to the control groups. Only 5 studies (n = 326) reported that the intervention had an effect on depression, and the effect size was not considered significant.
Limitations of the studies included unclear risk of bias from a lack of nontransparent reporting and small sample populations that resulted in a low statistical power attributed to effect sizes.
In this systematic review, the study investigators concluded that existing psychosocial interventions using cognitive-behavioral and mindfulness-based approaches had a small but significant effect on quality of life and anxiety outcomes in patients with psoriasis. Further randomized controlled trials with larger sample sizes and lower risk of bias are needed to help clarify the evidence.
Multiple authors declare associations with Lilly Deutschland GmbH. Please see original reference for a full list of authors’ disclosures.
Zill JM, Christalle E, Tillenburg N, et al. Effects of psychosocial interventions on patient-reported outcomes in patients with psoriasis: a systematic review and meta-analysis [published online October 6, 2018]. Br J Dermatol. doi:10.1111/bjd.17272