Efficacy of Biofeedback and Cognitive-behavioural Therapy in Psoriatic PatientsA Single-blind, Randomized and Controlled Study with Added Narrow-band Ultraviolet B Therapy

Abstract

Increasing data suggests that there is a connection between stress and the appearance of psoriasis symptoms. We therefore performed a clinical trial enrolling 40 participants who were randomly allocated to either an 8-week cognitive-behavioural therapy (CBT) (treatment group) plus narrow-band UVB phototherapy or to an 8-week course of only narrow-band UVB phototherapy (control group). We evaluated the clinical severity of psoriasis (PASI), General Health Questionnaire (GHQ)-12, Skindex-29 and State-Trait Anxiety Inventory (STAI) at baseline and by the end of the study. Sixty-five percent of patients in the treatment group achieved PASI75 compared with 15% of standard UVB patients (p = 0.007). GHQ-12 cases were reduced from 45% to 10% in the treatment group and from 30% to 20% in the control group (p = 0.05). The Skindex-29 emotional domain showed a significant improvement in the CBT/biofeedback group compared with control patients (-2.8 points, p = 0.04). This study shows that an adjunctive 8-week intervention with CBT combined with biofeedback increases the beneficial effect of UVB therapy in the overall management of psoriasis, reduces the clinical severity of psoriasis, improving quality of life and decreases the number of minor psychiatric disorders.

Attachment Styles of Dermatological Patients in Europe: A Multi­centre Study in 13 Countries

“…The conclusion of Lahousen et al's study of and our results also suggests that "psychological interventions should be integrated in the treatment of psoriasis" (28). The following interventions can be beneficial in the management of psoriasis: managing social isolation/withdrawal and improving self-esteem (29), applying support and education to reduce the intensity of pruritus (30), using adjunctive cognitive behavioural therapy combined with biofeedback (31), applying concepts from the life course approach to better understand the impact of chronic skin disease over the life course (32). The work of a psychodermatology multidisciplinary team (which may also include a dermatologist, a psychiatrist, a psychologist and other health professionals) has been identified as a successful way to manage patients with psychocutaneous disease (33).…”

Stress and psoriasis

“…The quality of life evaluated by two scores (General Health Questionnaire [GHQ]‐12, Skindex‐29) was also significantly improved in the group treated with bitherapy. Anxiety assessed by the STAI score was improved in both groups, and there was no significant difference …”

Utilization of mental health resources and complementary and alternative therapies for alopecia areata: A U.S. survey

“…Complementary and alternative therapies are defined as treatments outside of the contemporary allopathic treatments including biofeedback,[ 16 ] cognitive behavioral therapy,[ 17 ] and support group use. [ 18 19 ] Little is known about patients' current satisfaction with medical treatments for AA, and less is known about their interest in and use of alternative treatments.…”