Study Assesses Relationship Between Vitiligo and Depression

Image Credit: © Savory

A recent study out of Saudi Arabia aimed to better understand the relationship between vitiligo and major depressive disorder (MDD), highlighting the broader implications on mental health among affected individuals. Researchers found that patients with vitiligo face an increased risk of severe depression, underlining the need for integrated dermatological and psychological treatment approaches to address all aspects of the disease.¹

Methods

Using a cross-sectional design, the study employed the Vitiligo Area Severity Index (VASI) and the Patient Health Questionnaire-9 (PHQ-9) to measure the extent of vitiligo and depression severity respectively. A total of 340 patients with vitiligo were randomly selected to be included in the study, which was conducted from April 2023 to April 2024 at participating hospitals across Saudi Arabia.

Results

Researchers found that 58.8% of patients with vitiligo (200 out of 340) suffered from depression, with female patients showing a “significantly” higher prevalence. According to the study, 109 out of 156 (69.9%) of women experienced depression, compared to 91 out of 184 men (49.5%). Moreover, the study also found age played a significant role, with the 18 to 25 age group having the highest depression rate of 73.9% (51 out of 69).

Results of the study also showed that marital status played a factor in depression development, with divorced and single individuals more likely to be depressed. Researchers stated that 34 out of 41 divorced participants (82.9%) and 115 out of 153 single participants (75.2%) experienced depression compared to 51 out of 146 married participants (34.9%).The study found that depression development varied across income levels, with the lowest income group having a higher depression proportion at 181 out of 253 participants (71.5%) and the high-moderate income category showing lower depression prevalence with 6 out of 43 participants (14%) experiencing depression.

Vitiligo Type and Depression Severity

The study reported that vitiligo types varied “significantly” in their association with depression severity. Researchers found the most common type, acrofacial vitiligo which affected 165 patients, showed a high proportion of moderate to severe depression. They reported 73 out of 165 patients (44.2%) experiencing moderate to severe depression, compared to 16 out of 65 patients (24.7%) with more localized focal vitiligo. The study found the highest proportion of moderate to severe depression was observed in patients with vulgaris vitiligo, with 42 out of 73 patients (57.6%) experiencing it. Adversely, researchers stated that out of the 11 patients with universalis vitiligo, 10 (90.9%) had no depression and 1 (9.1%) had mild depression. The study found those with genital vitiligo had similar experiences, with 10 out of 16 patients (62.5%) having no depression.

Similar Findings

The study conducted by Amr Molla, assistant professor and dermatology consultant at Saudi German Hospital in Madinah, Saudi Arabia, and his colleagues, reflected themes found in similar studies, such as that published by Rosmarin et al last month. Their study found a high patient burden reported by dermatologists and their patients with vitiligo, including psychosocial and psychological consequences.² Another study, also conducted out of Saudi Arabia, concluded that vitiligo has a “substantial negative psychological impact” on patients, reported a prevalence of depressive symptoms of 30.9%. The researchers behind this study noted that although this is still high, they recognized quality of life and depressive symptoms scores have improved over the years in Saudi Arabia. They suggested this may be due to increased public awareness and education, recommending further social awareness campaigns may continue this trend of improvement.³

Conclusion and Future Research

Overall, the study investigators concluded that they found a notably high prevalence of depression in patients with vitiligo. Researchers noted the findings underscore the psychological impact of vitiligo, “reinforcing the need for comprehensive treatment approaches that address both the dermatological and psychological aspects of the disorder.” They suggested that future research should focus on longitudinal studies to investigate the causative mechanisms between vitiligo and depression, and evaluate the effectiveness of integrated treatment strategies.

References

1. Molla A, Jannadi R, Alayoubi H, et al. Assessing the relationship between vitiligo and major depressive disorder severity: a cross-sectional study. JMIR Dermatol. Published online June 18, 2024. doi:10.2196/60686
2. Rosmarin D, Lofland JH, Marwaha S, et al. Patient burden of nonsegmental vitiligo: a US real-world survey of dermatologists and their patients. Dermatol Ther (Heidelb). 2024;14(6):1531-1546. doi:10.1007/s13555-024-01165-5
3. Alkhowailed M, Alotaibi HM, Alshwieer MA, et al. The psychological impact of vitiligo in Saudi Arabia. Cureus. 2023;15(8):e43767. Published 2023 Aug 19. doi:10.7759/cureus.43767