Efficacy of Heartfulness Meditation as Adjunctive Therapy for Moderate to Severe Psoriasis: A Randomised Controlled Trial

Abstract Background: Psoriasis is a chronic inflammatory skin condition significantly impacting quality of life. Traditional treatments, such as methotrexate, are effective but often have side effects and do not address psychosocial stressors. Heartfulness meditation, which emphasises relaxation and self-awareness, may complement standard treatments by reducing stress. Objective: The primary objective was to evaluate the effectiveness of heartfulness meditation as an adjunct to methotrexate in achieving a 75% reduction in Psoriasis Area and Severity Index (PASI 75) at 4 months. Secondary objectives included changes in body surface area (BSA), Dermatology Life Quality Index (DLQI), Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), and biomarkers (serum cortisol and IL-6 levels). Methods: This randomised controlled trial was conducted at the dermatology outpatient department of the institute, India, involving 50 adults (18–60 years) with moderate to severe psoriasis (PASI ≥10 or BSA involvement ≥10%). Participants were randomised into two groups: the intervention group (n = 25) received heartfulness meditation alongside methotrexate (7.5 mg to 25 mg weekly), while the control group (n = 25) received methotrexate alone. Randomisation used a computer-generated sequence, with blinding applied to outcome assessors and data analysts. Results: Of the 50 participants randomised, 44 were included in the final analysis. PASI 75 was achieved in 61.1% of the intervention group compared to 52.38% in the control group ( P = 0.548). Trends towards better improvements in BSA, DLQI, PSS, and PSQI were observed in the intervention group, though not statistically significant. Both groups showed reductions in serum cortisol and IL-6 levels, with slightly greater reductions in the intervention group. No adverse events related to heartfulness meditation were reported. Conclusion: Heartfulness meditation may offer additional benefits when combined with methotrexate for treating moderate to severe psoriasis, though findings were not statistically significant. Larger studies are needed to confirm these results.