vitiligo and psychodrama therapy

Conditions: Vitiligo

Summary: the goal of this pilot clinical trial is to assess the effectiveness of psychodramatic psychotherapy in reducing the psychological distress and/or the skin condition in patients with vitiligo. the main questions it aims to answer are: 1. is there any improvement in terms of psychological distress in patients with vitiligo participating in a psychodramatic psychotherapy, compared to a control group? 2. is there any improvement in terms of skin condition in patients with vitiligo participating in a psychodramatic psychotherapy, compared to a control group? participants in the experimental group will receive the dermatological drug treatment usually recommended for vitiligo, and in addition they will participate in a 6 months psychodramatic psychotherapy. researchers will compare the results of the experimental group with the results of a control group including vitiligo patients who will receive the dermatological pharmacological treatment usually recommended for vitiligo and participate in a 6 months program of self-help activities.

the primary aim of this pilot study is to assess any possible improvement in terms of psychological distress in patients with vitiligo participating in a psychodramatic psychotherapy (psd), in addition to the usual pharmacological treatment with hydrocortisone and heliotherapy. the secondary aim is to assess any improvement in terms of vitiligo skin condition and/or other systemic autoimmune diseases symptoms. the study will involve 24 patients with vitiligo aged between 18 and 55 years, attending the dermatology services of the azienda provinciale per i servizi sanitari (apss) of trento. patients will be randomly assigned to one of the two groups: * 12 patients will receive the dermatological pharmacological treatment usually recommended for vitiligo, and in addition they will participate in a psychodramatic group psychotherapy for 6 months (psd experimental group); * 12 patients will receive the dermatological pharmacological treatment usually recommended for vitiligo, and in addition they will receive self-help activities for 6 months (non-psd control group). the experimental group (psd) will attend the psychodramatic psychotherapy, which will include: * 1 individual motivational interview; * 1 weekly group session lasting 2 hours for 1 month (total 4 meetings); * 1 group session every 15 days lasting 2 hours, for 5 months (total 10 meetings). the control group (non-psd) will attend self-help activities as follows: * 1 individual motivational interview; * 1 weekly, 2 hours group meeting, for 1 month (total 4 meetings); * 1 group meeting lasting 2 hours every 15 days, for 5 months (total 10 meetings). to all patients participating in the study, the following pharmacological treatment will be administered: * hydrocortisone acetate with the following dosage: 1 finger unit /15 cm2 per day. duration: 10 days a month for 6 months. * free exposure to the sun without photoprotection from 9.00 am to 11.00 am. a clinical evaluation will be carried out at: time 0 (t0): right before the beginning of the intervention time 1 (t1): after 6 months, at the end of the intervention for both groups, a follow-up will be performed after 6 months from the end of the intervention (psychodramatic psychotherapy or self-help activities).

Eligibility criteria:
inclusion criteria: 1. segmental vitiligo with unilateral localization. 2. non-segmental vitiligo (acrofacial; mucosal with more than one side affected; generalized universal; mixed associated with segmental vitiligo). 3. vitiligo-associated autoimmune comorbidity referred to in points 1-2: thyroiditis. 4. symptoms of depression and/or anxiety and/or low self-esteem associated with vitiligo mentioned in points 1-2. exclusion criteria: * cognitive impairment/dementia (clinically diagnosed). * individual and/or group psychotherapy in progress. * have previously received other psychotherapy. * use of psychiatric drugs in the last 3 months.