Vitiligo and depression: a systematic review and meta‐analysis of observational studies

Abstract

Vitiligo is a common depigmenting disorder with profound psychosocial impacts. Previous observational studies have suggested a link between vitiligo and psychiatric morbidity, such as depression. However, variability in study design makes it difficult to quantify accurately the relationship between vitiligo and depression. We aimed to investigate the underlying prevalence and risk of depression among patients with vitiligo. A comprehensive search of MEDLINE, Embase and the Cochrane Library was conducted. Cross-sectional, case-control or cohort studies that assessed the prevalence of depression among patients with vitiligo or the relationship between vitiligo and depression were included. DerSimonian and Laird random-effects models were utilized to calculate the pooled prevalence and relative risks. Publication bias was evaluated by funnel plots and Egger's tests. Twenty-five studies with 2708 cases of vitiligo were included. Based on diagnostic codes, the pooled prevalence of depression among patients with vitiligo was 0·253 [95% confidence interval (CI) 0·16-0·34; P < 0·001)]. Using self-reported questionnaires, the pooled prevalence of depressive symptoms was 0·336 (95% CI 0·25-0·42; P < 0·001). The pooled odds ratio of depression among patients with vitiligo was 5·05 vs. controls (95% CI 2·21-11·51; P < 0·001). Moderate-to-high heterogeneity was observed between the studies. Patients with vitiligo were significantly more likely to suffer from depression. Clinical depression or depressive symptoms can be prevalent, with the actual prevalence differing depending on screening instruments or, possibly, geographical regions. Clinicians should actively evaluate patients with vitiligo for signs/symptoms of depression and provide appropriate referrals to manage their psychiatric symptoms accordingly.

Association of vitiligo with hospitalization for mental health disorders in US adults

“…This study expands on previous studies that showed higher rates of MH disorders in persons with vitiligo compared to those without vitiligo. A meta‐analysis study pooled data on 1080 patients with vitiligo and found that at least one in four vitiligo patients were diagnosed with a form of clinical depression when using a validated screening questionnaire . A cross‐sectional study of 150 patients with vitiligo reported high prevalences of depression (34%) and anxiety (60%) .…”

Quality of life, depression, and anxiety in Turkish children with vitiligo and their parents

“…Approximately 1/3 of vitiligo patients were said to have reported depressive symptoms or impaired general health issues, while close to one-fourth of the given population met diagnostic criteria for clinical depression [49]. There are studies in literature suggesting that depressive symptoms might predict overall life quality [6,50].…”

Therapeutic options in vitiligo with special emphasis on immunomodulators: A comprehensive update with review of literature

“…Vitiligo is an acquired, depigmenting skin disease commonly affecting the human population without any ethnic, racial, or socioeconomic predilection; it may have a profound adverse impact on the patient's psychological state and quality of life (Lai, Yew, Kennedy, & Schwartz, ). The classification of vitiligo is important, as it helps to decide on the course of treatment and may predict the prognosis.…”