Patients With Vitiligo Suffer Heightened Stigma, Mental Health Risks

This content was produced independently by The American Journal of Managed Care^® and is not endorsed by the American Academy of Dermatology.

Two posters presented at the 2024 American Academy of Dermatology Annual Meeting show that patients with vitiligo have a heightened risk of stigma and subsequent mental health issues, demonstrating the need for integrated medical and psychological care.

The first poster¹ described a systemic review and meta-analysis of the association of vitiligo and mental health outcomes. According to the poster, the relationship between vitiligo and psychiatric disorders had not yet been explored, so the researchers aimed to systemically review the literature regarding the risk of mental health outcomes in patients with vitiligo.

Children with vitiligo suffer heightened stigma and subsequent mental health risks. | Image Credit: Liga Cerina - stock.adobe.com

To do so, they searched electronic databases Scopus, Web of Science, Cochrane, and Embase for relevant studies until June 2023. The researchers considered eligible studies as those that compared the incidence of various mental health outcomes between patients with and without vitiligo. Consequently, they included 14 eligible studies in their meta-analysis, which involved 200,595 patients with vitiligo and 94,060,402 non-vitiligo controls.

Through a pooled analysis from cross-sectional and case-control studies, the researchers found that patients with vitiligo were significantly more likely to have anxiety (OR, 1.64; 95% CI, 1.31-2.04), depression (OR, 1.65; 95% CI, 1.33-2.04), and obsessive-compulsive disorder (OR, 3.51; 95% CI, 2.13-5.76) compared to matched controls. However, they noted that associations with substance-related disorders (P = .62), suicidal tendencies (P = .50), attention-deficit/hyperactivity disorder (P = .12), schizophrenia (P = .47), and adjustment disorder (P = .62) were not statistically conclusive.

Due to the significant link between vitiligo and heightened psychiatric disorder risk, the researchers concluded that recognizing these associations is “crucial” for holistic patient care and emphasized the need for integrated medical and psychological care in patients with vitiligo.

The second poster featured a cross-sectional survey to assess vitiligo-related stigma and the psychological repercussions.² The researchers explained that skin diseases with high visibility and severity, like vitiligo, can have profound psychosocial effects. Therefore, children with vitiligo experience stigma, affecting psychosocial development. However, research about vitiligo’s impact on children is sparse.

Because of this, the researchers conducted a study to both evaluate the social and mental health repercussions of vitiligo-related stigma and correlate vitiligo severity and visibility with stigma and psychosocial impacts. To do so, they surveyed 56 patients with vitiligo between the ages of 8 and 17.

Compared to children with chronic diseases, 39.2% of the study population reported no-minimal stigma (T score < 40), 32.1% reported mild stigma (T score ≥ 40 and < 45), 25% reported moderate stigma (T score ≥ 45 and < 55), and 3.6% reported high stigma (T score ≥ 55). Additionally, of the study population, 3.6%, 3.6%, and 14.3% reported at least moderate depression (T score ≥ 60), anxiety (T score ≥ 60), and impaired peer relationships (T scores < 40), respectively.

Overall, the researchers found that the stigma faced by children and adolescents with vitiligo majorly influences their quality of life and risk of mental health issues. They noted that greater vitiligo severity and visibility increased patients' stigma risk. Conversely, patients with less severe and visible vitiligo may still experience stigma.

Similar to the first poster, the researchers concluded by emphasizing the need for both new therapeutic interventions for vitiligo and strategies to mitigate vitiligo-related stigma and help improve the mental well-being of this population.

References

1. Abdi P, Manzar D, Suntres E, Maibach HI. Association of vitiligo and mental health outcomes: a systemic review and meta-analysis. Presented at American Academy of Dermatology Annual Meeting; March 8-12, 2024; San Diego, CA. Poster 50526.

2. Yang L, Rangel S, Griffith J, et al. Stigma drives mental health issues in children and adolescents with vitiligo. Presented at American Academy of Dermatology Annual Meeting; March 8-12, 2024; San Diego, CA. Poster 53614.