The mental health associations of vitiligo: UK population-based cohort study

Abstract

Background: Vitiligo is an acquired, autoimmune depigmenting skin disorder that may affect psychological well-being. Aims: To determine the risk and impact of psychological comorbidity in people with new-onset vitiligo. Method: We conducted a retrospective observational study, using UK general practice data (2004–2020). Adults diagnosed with vitiligo ( n = 7224) were matched 1:4 with controls ( n = 28 880). Associations within 2 years of diagnosis were assessed for psychological conditions: recurrent depressive disorder (RDD), depressive episodes, non-phobia-related anxiety disorder, social phobia, adjustment disorder, substance misuse, self-harm and suicide attempts. Healthcare utilisation, time off work and unemployment within 1 year were compared in those with and without a mental health condition at vitiligo diagnosis. Results: At diagnosis, people with vitiligo had a similar prevalence of mental health conditions as controls, except for anxiety disorder (cases 7.9%, controls 7.0%; P = 0.014). Incident RDD and anxiety disorder were more common in people with vitiligo (RDD: adjusted hazard ratio (aHR) 1.25, 95% CI 1.01–1.55; anxiety disorder: aHR 1.23, 95% CI 1.00–1.51). Risk was highest in Black and minority ethnic individuals (RDD: aHR 1.72, 95% CI 1.06–2.79; depressive episodes: aHR 1.56, 95% CI 1.03–2.37). No association was found with other mental health conditions. People with vitiligo and psychological comorbidity had more primary care encounters, more time off workand higher unemployment. Conclusions: People with vitiligo have a higher incidence of RDD and anxiety disorder than controls, and this risk increase may be greatest in Black and minority ethnic populations. 202319390 (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Source: journal abstract)