Psoriasis is a chronic, recurrent, systemic inflammatory disease driven by immune-mediated factors and characterized by skin lesions. Psychological comorbidity is common in psoriasis, with depression and anxiety among the most common conditions. Patients with both psoriasis and depression are at greater risk of developing psoriatic arthritis and experience heart attack and stroke.
Mindfulness-Based Cognitive Therapy (MBCT) has been shown to decrease depression and anxiety symptoms in patients with chronic medical conditions, and so may hold promise for psoriasis.
Zhao et al. [Journal of the American Academy of Dermatology-International] conducted a randomized controlled trial to test whether online MBCT, used as an adjunct to usual care, could reduce psychological and physical symptoms in psoriasis patients.
The researchers randomly assigned 109 patients seen at a university hospital in China with mild-to-moderate psoriasis to either treatment as usual alone or MBCT plus treatment as usual (TAU). Participants were in their mid-30s on average, and 52 of the 109 participants were women. MBCT was delivered online using an 8-week asynchronous audio-based format.
The program included body scan breath awareness, observing thoughts as transient, and psoriasis-specific refinements related to acceptance of itch, skin lesions, and urges to scratch. TAU consisted of standard traditional drug and biologic therapies. Participants had daily homework assignments throughout the 8-week period.
Outcomes were assessed at baseline and at 4, 8, and 12 weeks. Primary measures included psoriasis severity, anxiety, depression, and dermatology-related quality of life. Itching was measured as a secondary outcome using a visual analogue scale.
The results showed that, compared with treatment as usual alone, the adjunct MBCT group showed significantly greater improvements in depression (Cohen’s d=0.27), quality of life (d=0.31), psoriasis area and severity (d=0.33) and itching (d=0.30). No significant between-group difference was found for anxiety scores.
The study supports online MBCT as a potentially useful adjunctive treatment for mild-to-moderate psoriasis. Small yet clinically meaningful improvements were produced for skin lesions, mood, and quality of life. The study is limited by its single-site recruitment and limited sample size. There was also limited reporting of treatment details such as length of sessions, number of sessions per week, frequency and length of homework making exposure and fidelity hard to evaluate.
Reference:
Zhao, Y., Li, Y., Zhang, Y., Yan, M., Du, Q., Huang, J., Li, F., Han, D., & Zhou, Y. (2026). Online Mindfulness-Based Cognitive Therapy as an Adjuvant-Treatment for Chinese Patients with Psoriasis: A Randomized Controlled Trial. JAAD International.
Link to study
