Indeed, no good evidence-based studies have been performed 4. Recently, in a research letter 9 , we presented the preliminary results of a prospective cohort study into the use of hypnosis combined with self-hypnosis without any other form of treatment in patients with refractory forms of AA. Patients were compared with other AA patients with similar baseline characteristics receiving only standard AA treatment. Our data showed that treatment with hypnosis produced significantly beneficial effects on psychological well-being 9.
In the present study, we present the results of following up our treatment group 6 months post-hypnosis in order to find out whether the psychological improvements were maintained. We describe the long-term evolution of patients treated with hypnosis in terms of quality of life, psychological well-being and alexithymia status. The study was performed between September 1, and August 30, at the Outpatient Clinic of the Department of Dermatology of Universitair Ziekenhuis Brussel and in the private practice of the first author. All patients gave written informed consent. The study protocol was approved by our local ethical committee and by our institutional review board.
The following parameters were evaluated using several questionnaires see below : alexithymia, psychological well-being and quality of life. All questionnaires were completed before treatment was started T1 , at the end of hypnosis treatment T2 , and at 6 months follow-up T3. At T1, motivation for treatment was evaluated using a visual analogue scale range: 0, no motivation to 10, maximum motivation.
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At each consultation, patients were asked to report the frequency of daily self-hypnosis, performed at home between the hypnotherapy sessions. It comprises a item self-report scale with a three-factor structure congruent with the alexithymia construct: difficulty in identifying feelings e. Subjects are asked to respond on a 5-point scale, rating the extent to which they agree or disagree with each statement. The results are expressed as the TAS global score, as well as three subscale scores. The TAS score ranges from 20 to ; subjects scoring 61 or more are considered alexithymic, and those scoring 51 or less non-alexithymic.
Patients obtaining scores between 51 and 61 are classified as borderline alexithymic The Symptom Check List SCL 11 evaluates a broad range of psychological problems and symptoms of psychopathology. It measures eight different psychological symptoms: agoraphobia, anxiety, depression, somatisation, insufficiency in thinking and behaving, paranoid ideation and interpersonal sensitivity, hostility and sleep problems.
The sum of the scores on these subscales yields a global severity index.
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Previous studies 12, 13 have demonstrated the reliability, validity and usefulness of this instrument. The SF version 2. It consists of eight scales: physical functioning, social functioning, role limitations caused by physical problems, bodily pain, general mental health, role limitations caused by emotional problems, vitality and general health perception. For each scale, a score from 0 to is calculated, with higher scores indicating a better quality of life.
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The summary scores are converted to standardised T scores with an overall mean of 50 and a standard deviation of A summary score of 50 SD 10 reflects the average quality life in the general population. Accordingly, the SF has proven useful in surveys of general and specific populations, comparing the relative burden of diseases, and in differentiating the health benefits produced by a wide range of different treatments.
It retains the excellent properties of the original Skindex and has been psychometrically validated in heterogeneous groups of dermatology patients It consists of both psychology- and symptom-related items, which are used to calculate separate psychosocial and symptom scores. Skindex is considered to be a promising new instrument in the field of dermatology After one introductory session aimed at explaining the rationale of the treatment, patients received 10 different individual sessions of hypnotherapy. Each session lasted one hour and included a short discussion on patient-specific topics, such as family or work stress, quality of sleep, and the psychological consequences of the disease, such as feeling ashamed, having low self-esteem, being anxious in public places Next, a minute manual-based hypnosis session was performed, each time following a standardised protocol.
The first two sessions focused on learning hypnotic relaxation and on the learning of self-hypnosis. From the third session onwards, patients received a variety of suggestions during hypnosis to improve their self-esteem. Suggestions were also aimed at decreasing the negative psychological consequences of the disease, such as feeling ashamed and being anxious in public places.
Patients received a self-hypnosis CD lasting approximately 20 min and were asked to perform exercises on a daily base. Statistical analyses were conducted using SPSS version We did not focus on one single primary outcome.
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