“Vitiligo and major depressive disorder: a bidirectional population-based cohort study”

Publication date: Available online 5 December 2018

Source: Journal of the American Academy of Dermatology

Author(s): Isabelle A. Vallerand, Ryan T. Lewinson, Laurie M. Parsons, Jori Hardin, Richard M. Haber, Mark W. Lowerison, Cheryl Barnabe, Scott B. Patten

Abstract

Background

Vitiligo patients often report their mental health has an impact on their skin. However, it is unknown as to whether a common mental disorder such as major depressive disorder (MDD) can also precipitate the onset of vitiligo.

Objective

Evaluate a bidirectional relationship between MDD and vitiligo using The Health Improvement Network (THIN) database.

Methods

Incident MDD and referent cohorts were followed until the development of vitiligo. Additionally, incident vitiligo and referent cohorts were followed until the development of MDD. Cox proportional-hazards models were used, adjusting for numerous covariates.

Results

In adjusted models, MDD patients (n=405,397) were at a 64% increased risk of vitiligo (HR=1.64, 95%CI: 1.43-1.87, p<0.0001) compared to the referent cohort (n=5,739,048). This risk was decreased in patients using antidepressants. Compared to the referent cohort (n=6,137,696), patients with vitiligo (n= 7,104) that were <30 years of age at diagnosis had a higher risk of developing MDD than patients >30 years (HR=1.31; 95%CI: 1.14-1.50, p<0.0001 vs. HR=1.22; 95%CI: 1.08-1.37, p=0.001).

Limitations

This study did not evaluate the severity of MDD or vitiligo on outcome development.

Conclusion

These results highlight the burden of depression in patients with vitiligo and support the possible existence of pathophysiological connections between these two conditions.

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