Abstract
Background
Vitiligo is a common depigmenting disorder with profound psychosocial impacts. Previous observational studies have suggested a link between vitiligo and psychiatric morbidity such as depression. Variability in study design, however, makes it difficult to accurately quantify the relationship between vitiligo and depression.
Objectives
This study aimed to investigate the underlying prevalence and risk of depression among vitiligo patients.
Methods
A comprehensive search of Medline, Embase, and Cochrane library databases was conducted. Cross-sectional, case-control, or cohort studies that assessed the prevalence of depression among vitiligo patients or the relationship between vitiligo and depression were included. DerSimonian and Lard random-effects models were utilized to calculate the pooled prevalence and relative risks (RRs). Publication bias was evaluated by funnel plots and Egger's tests.
Results
Twenty-five studies with 2,708 cases of vitiligo were included in this meta-analysis.
Based on diagnostic codes, the pooled prevalence of depression among vitiligo patients was 0.253 (95% CI: 0.161 to 0.345, p < 0.001). Using self-reported questionnaire, the pooled prevalence of depressive symptoms was 0.336 (95% CI: 0.248 to 0.424, p < 0.001). The pooled odds ratio of depression among vitiligo patients was 5.05, compared to controls (95% CI: 2.21 to 11.51, p < 0.001). Moderate to high heterogeneity was observed between the studies.
Conclusions
Vitiligo patients were significantly more likely to suffer from depression. Clinical depression or depressive symptoms can be very prevalent, with the actual prevalence differs depending on screening instruments or possibly geographical regions. Clinicians should actively evaluate vitiligo patients for signs/symptoms of depression and provide appropriate referrals to manage their psychiatric symptoms accordingly.
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