INFLUENCE OF A MINDFULNESS MEDITATION-BASED STRESS REDUCTION INTERVENTION ON RATES OF SKIN CLEARING IN PATIENTS WITH MODERATE TO SEVERE PSORIASIS UNDERGOING PHOTOTHERAPY (UVB) AND PHOTOCHEMOTHERAPY (PUVA)

Objective: This study tests the hypothesis that stress reduction metho ds based on mindfulness meditation can positively influence the rate a t which psoriasis clears in patients undergoing phototherapy or photoc hemotherapy treatment. Methods: Thirty-seven patients with psoriasis a bout to undergo ultraviolet phototherapy (UVB) or photochemotherapy (P UVA) were randomly assigned to one of two conditions: a mindfulness me ditation-based stress reduction intervention guided by audiotaped inst ructions during light treatments, or a control condition consisting of the light treatments alone with no taped instructions. Psoriasis stat us was assessed in three ways: direct inspection by unblinded clinic n urses; direct inspection by physicians blinded to the patient's study condition (tape or no-tape); and blinded physician evaluation of photo graphs of psoriasis lesions. Four sequential indicators of skin status were monitored during the study: a First Response Point, a Turning Po int, a Halfway Point, and a Clearing Point. Results: Cox-proportional hazards regression analysis showed that subjects in the tape groups re ached the Halfway Point (p =.013) and the Clearing Point (p =.033) sig nificantly more rapidly than those in the no-tape condition, for both UVB and PUVA treatments. Conclusions: A brief mindfulness meditation-b ased stress reduction intervention delivered by audiotape during ultra violet light therapy can increase the rate of resolution of psoriatic lesions in patients with psoriasis.