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Influence of a Mindfulness Meditation-Based Stress Reduction Intervention on Rates of Skin Clearing in Patients With Moderate to Severe Psoriasis Undergoing Photo Therapy (UVB) and Photochemotherapy (PUVA)

Kabat-Zinn, Jon PhD; Wheeler, Elizabeth PhD; Light, Timothy MD; Skillings, Anne MS; Scharf, Mark J. MD; Cropley, Thomas G. MD; Hosmer, David PhD; Bernhard, Jeffrey D. MD

Original Articles

Objective: This study tests the hypothesis that stress reduction methods based on mindfulness meditation can positively influence the rate at which psoriasis clears in patients undergoing phototherapy or photochemotherapy treatment.

Methods: Thirty-seven patients with psoriasis about to undergo ultraviolet phototherapy (UVB) or photochemotherapy (PUVA) were randomly assigned to one of two conditions: a mindfulness meditation-based stress reduction intervention guided by audiotaped instructions during light treatments, or a control condition consisting of the light treatments alone with no taped instructions. Psoriasis status was assessed in three ways: direct inspection by unblinded clinic nurses; direct inspection by physicians blinded to the patient's study condition (tape or no-tape); and blinded physician evaluation of photographs of psoriasis lesions. Four sequential indicators of skin status were monitored during the study: a First Response Point, a Turning Point, a Halfway Point, and a Clearing Point.

Results: Cox-proportional hazards regression analysis showed that subjects in the tape groups reached the Halfway Point (p = .013) and the Clearing Point (p = .033) significantly more rapidly than those in the no-tape condition, for both UVB and PUVA treatments.

Conclusions: A brief mindfulness meditation-based stress reduction intervention delivered by audiotape during ultraviolet light therapy can increase the rate of resolution of psoriatic lesions in patients with psoriasis.

From the Stress Reduction Clinic, Center for Mindfulness in Medicine, Health Care, and Society, Division of Preventive and Behavioral Medicine, Department of Medicine (J.K-Z., E.W., T.L., A.S.) and the Division of Dermatology, Department of Medicine (M.J.S., T.G.C., J.D.B.), University of Massachusetts Medical Center, Worcester, Massachusetts; and the Department of Epidemiology and Biostatistics, School of Public Health and Health Sciences, University of Massachusetts (D.H.), Amherst, Massachusetts.

Address reprint requests to: Dr. Jon Kabat-Zinn, Center for Mindfulness, Shaw Bldg., University of Massachusetts Medical Center, Worcester, MA 01655-0267. E-mail: jon.kabat-zinn@banyan.ummed.edu.

Received for publication May 9, 1997; revision received January 13, 1998.

Copyright © 1998 by American Psychosomatic Society
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