Identifying key components for psychological intervention for people with vitiligo
A poster based on the findings of a survey of patients and health professionals to identify psychological interventions for vitiligo has been accepted for display at the 2015 BAD meeting in Manchester. The work was funded by a grant from the UK Dermatology Clinical Trials Network.
Many of our members will have taken part in this survey which has provided useful information to assist in developing new ways of addressing the psychological impact of vitiligo on people's lives. The value of psychological interventions in the management of vitiligo has been recognised as a research priority. Despite this, there is only one published randomised trial on the use of group cognitive behavioural therapy (CBT) compared with group person-centred therapy for vitiligo. As far as we are aware, no published paper has tried to establish an appropriate psychological therapy for vitiligo from both patient and clinician perspectives. The unique survey referenced here is therefore of value to the future treatment of vitiligo patients.
On-line questionnaires were submitted by people with vitiligo and a separate version was also completed by health professionals involved in the care of vitiligo patients. The patients' survey recorded personal data and focused on the effect of vitiligo on normal life,. It also sought to establish the most difficult problems faced by patients as well as which approaches they thought would be helpful to them in coping with their vitiligo. The survey also looked at the feasibility of providing these interventions under the NHS.
A hundred vitiligo patients, 82% of whom had vitiligo for 10 years or more, responded to the patient questionnaire . 70% of the respondents were female; 92% were Caucasian (a similar proportion of the population in the national statistics). Thirty nine health professionals completed the survey of whom 67% were dermatologists and 15% were psychologists.
The most important issues reported by patients were: acceptance of their vitiligo, the duration of the disease and managing embarrassment. Other concerns were participating in sporting activities and exposure to sunlight. Similar results were found in the survey completed by healthcare professionals, although the psychosexual issues indentified by them were not considered as important to the patients.
Patients thought that mechanisms that helped in accepting and understanding vitiligo were important when designing interventions, as was coping with embarrassment caused by the disease in social situations. Improving self-confidence and self-esteem were also key issues.
Interventions considered useful by professionals to address these issues included: cognitive behavioural therapy (CBT,) acceptance and commitment therapy (ACT) and mindfulness therapy. These therapies could be delivered in groups or individually, although 58% of patients had a preference for individual therapy.
This survey confirmed that both patients and healthcare professionals support the need for psychological interventions in vitiligo.
The authors of the survey are A Ahmed, E Steed, E Burden-Teh, R Shah, S Tour, S Sanyal, M Whitton,
J Batchelor, A Bewley