The importance of mindfulness in psychosocial distress and quality of life in dermatology patients†

Summary

Background

Mindfulness, defined as purposively and nonjudgementally paying attention in the present moment, could be used within psychosocial interventions to reduce the distress associated with social anxiety and avoidance found in many skin conditions. However, little is known about the relationship between naturally occurring levels of mindfulness and distress in dermatology patients.

Objectives

To examine the relationship between mindfulness and psychosocial distress in a dermatological population. It was hypothesized that higher levels of mindfulness would be associated with lower levels of social anxiety, anxiety, depression and skin shame, and with better quality of life.

Methods

Adult dermatology outpatients ( n = 120) from one hospital completed items assessing subjective severity, skin shame, fear of negative evaluation, anxiety and depression, quality of life, and levels of mindfulness.

Results

Considering depression, 14% reported mild, 5% moderate and 2·5% severe symptoms. For anxiety, 22% reported mild, 23% moderate and 6% severe symptoms. In addition, 33·4% reported clinically significant social anxiety. After controlling for subjective severity, mindfulness explained an additional 19% of the variance in depression, 39% in anxiety, 41% in social anxiety, 13% in skin shame and 6% in dermatological quality of life. One specific facet of mindfulness (acting with awareness) was found to be the most consistent predictor of distress.

Conclusions

The findings indicate that higher levels of mindfulness are associated with lower distress. This suggests that facilitating mindfulness may be helpful in reducing distress in dermatology patients, and the use of mindfulness techniques warrants further investigation.

Abstract

What's already known about this topic?

• Correlation studies suggest that higher levels of mindfulness are related to lower levels of social anxiety.

• Studies indicate that mindfulness can be beneficial for people experiencing a range of long‐term health conditions.

• Mindfulness interventions have been beneficial in improving skin clearance and severity in patients with psoriasis.

What does this study add?

• This is the first study to show that mindfulness accounts for a significant amount of the variance in both psychological distress and quality of life in dermatology patients.

• Mindfulness may play a particularly important role in social anxiety.

• The study suggests that facilitating the ‘ability to attend to the present moment’ is a potential target for psychosocial interventions for patients distressed by their skin condition.

What are the clinical implications of this work?

• High levels of social anxiety, depression and anxiety highlight the need for psychological interventions to be available to dermatology patients.

• Mindfulness interventions could benefit people living with skin conditions who are experiencing psychological distress – either as stand‐alone low‐intensity interventions or incorporated into cognitive behavioural therapy.

• Using mindfulness to bring attention to the present moment may reduce self‐focused attention, which is a key characteristic of social anxiety.

Linked Comment: Fordham. Br J Dermatol 2016; 175:864–865 .

Plain language summary available online

Video Commentary