Coping with the disfiguring effects of vitiligo: A preliminary investigation into the effects of cognitive‐behavioural therapy

Abstract

Vitiligo is a progressive condition involving a loss of pigmentation in the skin; it can be disfiguring and no effective treatment or cure exists. Although vitiligo's medical effects have been studied extensively, little attention has been paid to its psychological impact or to the effects of psychological state on the illness itself. To address these issues, the present study examined the effect of cognitive behavioural therapy on coping with vitiligo and adaptation to the negative effects on body image, quality of life and self-esteem in adult patients. The study also examined whether any psychological gains acquired from psychological therapy would influence the progression of the condition itself. Two matched groups of vitiligo patients were compared, one of which received cognitive-behavioural therapy over a period of 8 weeks, while the other received no changes to their treatment status. All patients were assessed on self-esteem, body image and quality of life, prior to, immediately following and 5 months following the end of therapy. The progression of the condition was assessed by photographing patients prior to the start of counselling and 5 months following counselling. Results suggest that patients can benefit from cognitive behavioural therapy in terms of coping and living with vitiligo. There is also preliminary evidence to suggest that psychological therapy may have a positive effect on the progression of the condition itself. Implications for incorporating psychological counselling into patient care and management are discussed.

Assessment of quality of life in Indian patients with vitiligo, an observational study

“…29 There are two types of strategies to counter vitiligo psycho-social impact. Behavioural strategies focused on the problems and involved avoidance of situations and concealment of the vitiligo lesions.…”

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

“…Although neither life-threatening nor symptomatic (except that depigmented patches burn easily when exposed to the sun), vitiligo can be cosmetically and psychologically devastating, 378 resulting in reduced self-esteem, 379 poor body image, 380 difficulties in sexual relationships 381 and feelings of social isolation and stigmatisation. 382 Some people with vitiligo experience discrimination in employment, particularly in jobs where they have to deal with the public.…”

Importance of Psychosomatic Approach For Dermatological Diseases

“…Son y›llarda yap›lan çal›flma-lar bu görüflleri desteklemifl ve genel olarak stresli yaflam olaylar› ile deri hastal›klar›n›n ortaya ç›k›fl› aras›nda bir iliflki oldu¤u üzerinde görüfl birli¤ine var›lm›flt›r 8,9,10 . S.Freud'un gelifltirdi¤i psikanalitik söylemden yola ç›kan baz› araflt›rmac›lar, deri hastal›klar›n› psikolojik baz› çat›flmalar›n konversiyon mekanizmalar› arac›l›¤› ile bedensel belirtilere neden olmas›yla aç›klam›fl ya da özgün nörofizyolojik bozukluklara ba¤lam›fllard›r 11 .…”

“…Deri lezyonu olan kiflilerin hijyen kurallar›na uymad›¤›, ya da derideki lezyonun bulafl›c› oldu¤u önyarg›lar› di¤er kiflilerin hastaya yaklafl›m›n› olumsuz etkileyebilir. Bu yaftalanma nedeniyle de hastalar›n beden alg›lar› bozulur ve görü-nebilecekleri sosyal ortamlardan kaç›nmaya çal›fl›rlar 10 . Yap›lan baflka çal›flmalarda da araflt›rmac›lar görünümleri ortalamadan farkl› kiflilerin bedenlerinin daha fazla fark›nda olduklar›n›, bu farkl›l›¤›n bask›s›yla iliflkilerinin ve kariyerlerinin etkilendi¤ini ileri sürmüfllerdir 24 .…”