A cognitive-behavioural symptom management programme as an adjunct in psoriasis therapy

Background Patients with psoriasis may experience significant psychological and social disabilities. Stress or distress are proposed aggravators of the disease process in psoriasis. Preliminary studies to date have suggested that adjunctive psychological therapies may be effective in the clinical management of psoriasis. Objectives To examine whether a 6-week multidisciplinary management approach, the Psoriasis Symptom Management Programme (PSMP) for patients with psoriasis improves clinical severity of psoriasis and its associated psychological distress and disability. Methods In a case-control study, patients with psoriasis attending an out-patient psoriasis speciality clinic chose to receive standard psoriasis treatment alone (n=53) or to enter the PSMP as an adjunct to standard therapy (n=40). They were assessed at baseline, at the end of the 6-week PSMP and after 6 months follow-up. Results As compared with standard treatment alone, analysis of covariance indicated that participation in the PSMP resulted in a greater reduction in clinical severity of psoriasis (P=0.001), anxiety (P=0.001), depression (P=0.001), psoriasis-related stress (P=0.001) and disability (P=0.041) at 6 weeks and 6 months follow-up. Conclusions The management of the physical aspects of psoriasis and its psychological effects are significantly improved for patients who opt for a 6-week integrated multidisciplinary approach. Furthermore, the techniques learnt by participation in the PSMP facilitate continued control of psoriasis for at least 6 months.