Psychological interventions

Abstract

Although vitiligo does not lead to severe physical illness, patients experience a variable degree of psychosocial impairment. The psychological impact of vitiligo has been shown in different studies all over the world. Patients with vitiligo suffer from poor body image, low self-esteem, and social isolation, caused by feelings of embarrassment, and they experience a considerable level of disability [1-7]. The prevalence of psychiatric morbidity associated with vitiligo ranges from 25 to 30% in western Europe [2, 8] and from 56 to 75% in India [3, 9, 10]. A low self-esteem and high levels of perceived stigma seem to be important factors for quality of life impairment in vitiligo patients [9, 11-16] (Part 1.5). The majority of patients with vitiligo found their disfigurement moderately or severely intolerable [14], and most of them said that vitiligo had affected their lives recently [9]. Psychological interviews with patients at our department confirm that vitiligo has an important impact on their daily lives. Visible or not directly visible lesions influence not only their personal relationships, their professional career, but also their social life. Patients said they avoided daily activities and different social events in order to protect themselves from embarrassing comments [17]. In the same study, we found that perceived severity of the disease and patient's personality are important factors to consider when assessing the psychological impact of vitiligo. If self-body image is more influenced by gender, perceived severity is more influenced by patient's personality than by objective criteria of the disease (Fig. 3.13.1) [17] © 2010 Springer-Verlag Berlin Heidelberg.