Clinical correlates of vitiligo with depression and anxiety: A comparative study in patients and their caregivers.

Background: Vitiligo is a chronic depigmentation disorder with an incidence of approximately 0.5% of the general population. Although physical discomfort due to vitiligo is rare, the disease affects the patient’s personal and social life, producing a negative self-image and social stigmatization. Patients with vitiligo have been shown to have higher rates of depression, anxiety and impaired quality of life in adulthood. Objectives: The aim of this study was to determine the pattern of psychiatric morbidity in vitiligo patients treated at the dermatology outpatient clinic and to investigate the relation between anxiety, depression, social anxiety levels, and self esteem and disability in these patients. Material and Methods: Fifty patients with vitiligo were assessed in dermatology outpatient department of Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIM &HS), Dehradun with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Hospital Anxiety Depression Scale (HADS), Rosenberg Self-Esteem Scale (RSES), Liebowitz Social Anxiety Scale (LSAS) and Sheehan Disability Scale (SDS). Control group included caregivers who were matched to patients in terms of age, sex and education level. Results: In comparison to healthy controls, the rate of psychiatric morbidity was found to be higher and mean self-esteem score was found to be lower in the vitiligo group. There was no significant difference between groups in terms of social anxiety. Majority of the patients were mildly disabled. Among the vitiligo cases, psychiatric morbidity was found more frequent in female and young participants. Anxiety and social avoidance scores negatively correlated with age. Conclusion: These findings suggest that the rate of psychiatric morbidity is higher in patients with vitiligo than healthy control subjects. Patients with vitiligo treated at dermatology clinics should be assessed in terms of psychiatric disorders and psychiatric interventions may become necessary in the course of illness.