Vitiligo Is Linked to Increased Risk for Psychiatric Disorders

sad girl with vitiligo bowing her head
sad girl with vitiligo bowing her head
Researchers examined the relationship between vitiligo and the risk for psychiatric disorders such as anxiety, major depressive disorder, and manic disorders.

Vitiligo is associated with nearly a 3-fold risk for developing psychiatric disorders, according to study results published in the Journal of Dermatology.

Vitiligo is an autoimmune disease that has major adverse effects on quality of life, No study has analyzed the association between vitiligo and the incidence of inclusive psychiatric diseases in the Asian population. Thus, investigators collected data from the National Health Insurance Research Database (NHIRD) of Taiwan to analyze this association. A total of 7160 patients (1432 with vitiligo and 5728 age-, sex-, and index year-matched controls) were enrolled in this cohort study from 2000 to 2013. Researchers followed all study participants from the date of their first diagnosis of vitiligo until the onset of psychiatric disorder, which were all specified through International Classification of Diseases, Ninth Revision (ICD-9) codes. Multivariable Cox proportional hazard models were used to estimate the cumulative incidence of vitiligo to psychiatric disorders.

The findings revealed that patients with vitiligo had a higher risk for psychiatric disorders compared with healthy individuals, with an overall adjusted hazard ratio (aHR) of 2.926; 95% CI, 2.646-3.236; P <.001. Furthermore, vitiligo had a substantial negative effect on quality of life, with increased incidence of anxiety (aHR 3.845; 95% CI, 3.477-4.253; P <.001) and depression (aHR 3.721; 95% CI, 3.364-4.114; P <.001). The highest aHR was observed for obsessive-compulsive disorder at 10.79; 95% CI, 9.756-11.932; P <.001.

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Study limitations include that not all data was recorded in the NHIRD; thus, the study could not evaluate whether lesion sites, vitiligo subtypes, disease severity, activity type, and other factors affected the incidence of psychiatric disorders. Other confounders such as genetics background and smoking history were also not factored in. Finally, it is possible that coding errors or misclassifications existed both in vitiligo and psychiatric comorbidities.

As the study demonstrated that vitiligo was associated with a nearly 3-foldrisk for developing psychiatric disorders, the researchers recommended follow-up on the mental health of patients with vitiligo. They suggest further studies to explore the pathophysiology of vitiligo for more comprehensive knowledge about the causal relationship between vitiligo and various psychiatric disorders.

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Chen C, Wang W, Chung C, Tsao C, Chien W, Hung C. Increased risk of psychiatric disorders in adult patients with vitiligo: A nationwide, population-based cohort study in Taiwan [published online March 2, 2020]. J Dermatol.