***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Between 1978 and 1982 an experiment on group treatment for and by psoriasis sufferers was conducted , based on a pyramid of previous investigations since 1968 . Each group was facilitated by a duo consisting of a fellow sufferer and a physician , both having trained together . The subjects practice d the procedure described , directed toward self-care and mutual aid facilitated and supported by the duo , in a series of ten 2-hour weekly sessions . A pretest/posttest control group design was used . Comparing the results of the quantitative analysis of the experimental groups with those of the control groups , the experimental groups showed significant change . The results of the qualitative analysis showed that decrease of anxiety correlated with mastering of the skills involved . The key element affecting outcome was the balance in cooperation within the duo , the expertise of the patient lying in his personal experience of the condition , and the expertise of the physician in his knowledge and skills . One of the method 's main characteristics was the intrinsic complementarity of the duo partners OBJECTIVES The purpose of this study was to investigate the effects of a cognitive-behavioral psoriasis symptom management programme ( PSMP ) on patient-held perceptions about their condition and patients ' use of self-reported coping strategies , and to examine the influence of alexithymia scores at induction on response to treatment . DESIGN Age- and sex-matched case-controlled prospect i ve study . METHODS A total of 40 patients with psoriasis were treated in the PSMP  , and an age- and sex-matched cohort received  st and ard pharmacological care only . The Illness Perception Question  naire was used to assess patients ' beliefs about illness identity , time-line , consequences , cure/control and perceptions of the cause of their psoriasis . Participants also completed the  COPE question naire  and the  Toronto Alexithymia Scale ( TAS-20 ) . RESULTS Results suggested that at 6-month follow-up , patients who chose the PSMP showed significant reductions in illness identity ( the frequency and severity of symptoms that patients associate with their condition ) , the strength of belief in severity of consequences of their illness , and their attributions for emotional causes of their psoriasis . Perceptions about the anticipated course of the disease ( time-line ) , its cure or controllability , ideas about physical agents of causation , and coping strategies did not differ between PSMP patients or controls at 6-week or 6-month follow-up . Alexithymia had no effect on response to treatment . Regression analyses demonstrated the importance of both participation in the PSMP and demographic/ clinical history variables in accounting for significant variance in illness-perception-change scores . CONCLUSION The findings are generally supportive of multivariate models of intervention , but the lack of a demonstrated effect of the intervention on coping may have implication s for both the assessment of coping in psoriasis and the nature of psychological interventions proposed for its management Psychological difficulty , particularly in social situations , is widely reported by disfigured people , but many receive no formal psychological treatment . This study r and omly allocated 106 facially disfigured people either to receive a  self-help leaflet offering cognitive-behavioural guidance or not . Participants were assessed pre-treatment and at 3 month follow-up . The untreated group then received the leaflet . Participants in the leaflet group fared better than controls on 3 of the 9 scales employed ( Social Leisure [ SAQ ] ( t=2.31 , p=0.012 ) , HADS anxiety ( t=2.22 , p=0.015 ) , HADS depression ( t=1.83 , p=0.036 ) . There is support for a cognitive-behavioural approach and the usefulness of self-help instructions in addressing the social difficulties of facially disfigured people . The approach merits further development and investigation Vitiligo is a progressive condition involving a loss of pigmentation in the skin ; it can be disfiguring and no effective treatment or cure exists . Although vitiligo 's medical effects have been studied extensively , little attention has been paid to its psychological impact or to the effects of psychological state on the illness itself . To address these issues , the present study examined the effect of cognitive behavioural therapy on coping with vitiligo and adaptation to the negative effects on body image , quality of life and self-esteem in adult patients . The study also examined whether any psychological gains acquired from psychological therapy would influence the progression of the condition itself . Two matched groups of vitiligo patients were compared , one of which received cognitive-behavioural therapy over a period of 8 weeks , while the other received no changes to their treatment status . All patients were assessed on self-esteem , body image and quality of life , prior to , immediately following and 5 months following the end of therapy . The progression of the condition was assessed by photographing patients prior to the start of counselling and 5 months following counselling . Results suggest that patients can benefit from cognitive behavioural therapy in terms of coping and living with vitiligo . There is also preliminary evidence to suggest that psychological therapy may have a positive effect on the progression of the condition itself . Implication s for incorporating psychological counselling into patient care and management are discussed Summary Background Patients with psoriasis may experience significant psychological and social disabilities . Stress or distress are proposed aggravators of the disease process in psoriasis . Preliminary studies to date have suggested that adjunctive psychological therapies may be effective in the clinical management of psoriasis 
    Output:
    
None of the papers demonstrated adequately the clinical effectiveness of the interventions .