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 Table of Contents  
LETTER TO EDITOR
Year : 2020  |  Volume : 9  |  Issue : 4  |  Page : 386-387

Group therapy in vitiligo: A single-session intervention


1 Department of Psychiatry, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
2 Department of Dermatology, Venerology and Leprosy, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India

Date of Submission20-Feb-2020
Date of Decision02-May-2020
Date of Acceptance07-Jul-2020
Date of Web Publication15-Oct-2020

Correspondence Address:
Dr. M Kishor
Department of Psychiatry, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_23_20

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How to cite this article:
Kishor M, Ashwini P K, Betkerur J, Shastry V. Group therapy in vitiligo: A single-session intervention. Int J Health Allied Sci 2020;9:386-7

How to cite this URL:
Kishor M, Ashwini P K, Betkerur J, Shastry V. Group therapy in vitiligo: A single-session intervention. Int J Health Allied Sci [serial online] 2020 [cited 2020 Oct 21];9:386-7. Available from: https://www.ijhas.in/text.asp?2020/9/4/386/298126



Sir,

Vitiligo is a common acquired, idiopathic, heritable depigmentary disorder of the skin and or mucous membranes, characterized by depigmented macules of varying sizes and shapes.[1] It is a major social and cosmetic concern in India.[2] Vitiligo is the most common pigmentary disorder involving complex interaction of the environmental and genetic factors that ultimately contribute to melanocytes destruction leading to characteristic depigmented macules.[3]

Vitiligo can be extremely disfiguring, leading to significant morbidity. Low self-esteem, poor body image, and poor quality of life have been found in patients with vitiligo leading to psychiatric morbidity. Even though the perception of illness is distressing across all age groups, this is, of particular concern for children and adolescents, as they are in their formative years and developing their sense of self.[4]

Vitiligo occurs worldwide with an overall prevalence of 1%.[5] Some dermatologic outpatient records show the incidence of vitiligo to be 3%–4% in India, although an incidence as high as 8.8% also been reported.[6] In Indian states of Gujarat and Rajasthan, the prevalence of vitiligo is very high being described by some as of epidemic proportion.[7]

As part of the patient care services, periodic “group therapy”can be beneficial for patients in building coping skills, sharing the distress, clarifying myths, and misconception. The group therapy can be carried out with small group of the patients affected with moderator who can be dermatologist/psychiatrist/clinical psychologist/a patient who is activist in the area of concern. Here, we describe one such group therapy session for small group of six patients with vitiligo who gave informed consent, from both genders (aged 10–64 years) along with three accompanying parents, all of whom gave informed consent to participate. Psychiatrist was the moderator for the session. The approach cycled through three rounds. Each round was for 5–6 min to each participant. All the participants were briefed about the program.

The first round, the concept was to share. All the participants narrated what they think about the vitiligo, how they feel about, and how they deal with it. The participants were asked to speak without being interrupted or inhibited, of being judged. Since all the participants had the similar condition they felt uninhibited sharing their views. Group had two children in the group aged 10 and 12 years. The parent accompanying the children also shared their views about the condition. The participants shared their feelings in the following ways to exemplify - “I used to question why I have got this condition?”, “What sin have I have committed?”, “none from my family had this why me?”“My concern is my child has got this problem in a very young age how will she respond to treatment?”, and “It worries me about my girl's marriage as she grows up with this condition.”

The second round was an open question round, where any of the participants could ask their queries to anyone in the group depending on what was shared in the previous round. In this round, the moderator facilitated questions among the participants. This helped participants to open up further on the issue with others. Facts regarding, age of onset, different treatments they tried, responses seen, factors which helped them cope with the condition were shared by the participants.

The third round was about the participants reflecting on how they felt at the end of the session. The participants concluded with following perspectives - “ it's not only me having the condition, many more have vitiligo in the population”, “ I got to know that the condition can make its appearance in any age”, “I get some hope as I see good treatment response in others”, “ I can manage it”and “I have assumed many things, the facts seems different.”

At the end of the three rounds, the participants had an open discussion regarding different aspects of vitiligo with the treating dermatologists who were present at the discussion hall but participated only in the last session.

Group therapies were found to be beneficial in chronic dermatological disease like psoriasis. It helped as an adjuvant in managing these patients. They were found to cope better with their illness.[8] All the participants in this group came out with increasingly positive feedback at the end of the session. They felt sharing their issues related to vitiligo with people having the same condition, as a closed group discussion, helped them to have better insight to deal with it. They felt more confident about their ability to cope with the condition. The participants did appreciate the fact that concerned dermatologist were also present during the session. The concept of group therapy in patients with vitiligo can be replicated with further rigorous research methodology to study the long-term benefits of such patient-centered services; however, it suffices to conclude that patients do welcome the approach.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Prasad D, Kumaran SM. Depigmentary and hypopigmentary disorders. In: Sacchidanand S, editors. IADVL Text Book of Dermatology. 4th ed. Mumbai: Bhalani Publishing House; 2015. p. 1317-22.  Back to cited text no. 1
    
2.
Ortonne JP, Passeron T. Vitiligo and other disorders of hypopigmentation. In: Bolognia JL, editors. Text Book of Dermatology. 3rd ed. China: Elsevier Publishing Company; 2008. p. 1023-48.  Back to cited text no. 2
    
3.
Savant S. Introduction to Vitiligo surgery. In: Satishsavant, editor. Textbook of Dermatosurgery and Cosmetology. 2nd ed. India: ASCAD Publishers; 2008. p. 336-7.  Back to cited text no. 3
    
4.
Geel NV, speeckart R. Acquired pigmentary disorders. In: Griffiths C, Barker J, Bleiker T, Chalmers R, Creamer D. editors. Rook's Textbook of Dermatology. 9th ed. India: Wiley Blackwell Publishers; 2016. p. 88.1-56.  Back to cited text no. 4
    
5.
Birlea SA, Spritz RA, Norris DA. Vitiligo. In: Goldsmith L, Katz S, Gilchrest B, Paller A, Leffell D, Wolff K. editors. Fitxpatrick's Dermatology in General Medicine. 8th ed. New York:McGraw-Hill; 2012. p. 792-803.  Back to cited text no. 5
    
6.
Morison WL, Marwaha S, Beck L. PUVA-induced phototoxicity: Incidence and causes. J Am Acad Dermatol 1997;36:183-5.  Back to cited text no. 6
    
7.
Mehraban S, Feily A. 308nm excimer laser in dermatology. J Lasers Med Sci 2014;5:8-12.  Back to cited text no. 7
    
8.
Seng TK, Nee TS. Group therapy: A useful and supportive treatment for psoriasis patients. Int J Dermatol 1997;36:110-2.  Back to cited text no. 8
    




 

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