Mindfulness, self-compassion training may help patients with atopic dermatitis

Key takeaways:

• The intervention group had significantly greater improvement in DLQI score.
• The intervention group had greater improvement in adherence to dermatologic treatment.

Mindfulness and self-compassion training may be an effective treatment option to increase the quality of life for adults with atopic dermatitis, according to data published in JAMA Dermatology.

“The present study demonstrated the efficacy of integrated online mindfulness and self-compassion for adults with moderate to severe AD,” Sanae Kishimoto, MHS, MPH, and colleagues wrote. “We found that skin disease-specific [quality of life (QOL)] improved over time with a large effect size.”

In a randomized clinical trial of 107 adults with atopic dermatitis recruited between July 2019 and June 2022 from throughout Japan, participants were randomly assigned to receive eight 90-minute weekly sessions of online mindfulness and self-compassion training (n = 56; mean age, 37.2 years; 82.1% women; mean AD duration, 27.6 years) or to join a waiting list (n = 51; mean age, 35.2 years; 76.5% women; mean AD duration, 25.5 years).

In the intervention group, participants were given psychological and behavioral training using elements of mindfulness-based stress reduction and mindful self-compassion, as well as an optional meditation retreat and optional Zoom video conference booster session. Both groups could additionally receive usual care as determined by the patient and their physicians; however, patients were also instructed to not start dupilumab, psychotherapy or other mindfulness practices during the trial.

At 13 weeks, the researchers found that the intervention group experienced significantly greater improvement in DLQI score than the control group (least-squares mean estimate, 5.89 vs. 11.1; between-group difference, –6.34; 95% CI, –8.27 to –4.41). Further, 81.5% of participants in the mindfulness and self-compassion group exhibited a minimal clinically important DLQI score difference vs. 33.3% in the waiting list group at this same timepoint.

The researchers also found that adherence to dermatologic treatment was significantly more improved in the intervention group compared with the control group.

“Comments from participants suggested that their feeling of resistance or worry about use of medications decreased, and they applied them early, mindfully and compassionately rather than automatically,” Kishimoto and colleagues wrote.

Most participants in the intervention group reported completing home practice every day or every other day, with a mean duration of home practice of 43.5 minutes at week 4, 41.7 minutes at week 9, and 32.9 minutes at week 13.

One limitation of the study was that only highly motivated patients applied to participate, which the researchers said may indicate greater urgency surrounding AD treatment.

“Further research with other populations and clinical settings is necessary to increase generalizability and transportability of the current findings,” Kishimoto and colleagues wrote.