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- Title
Mental Health and Psychosocial Quality-of-Life Burden Among Patients With Vitiligo: Findings From the Global VALIANT Study.
- Authors
Bibeau, Kristen; Ezzedine, Khaled; Harris, John E.; van Geel, Nanja; Grimes, Pearl; Parsad, Davinder; Tulpule, Mukta; Gardner, Jackie; Valle, Yan; Tlhong Matewa, Gaone; LaFiura, Christine; Lindley, Anouk; Ren, Haobo; Hamzavi, Iltefat H.
- Abstract
Key Points: Question: What is the association of vitiligo with patient-reported quality of life and psychosocial health globally? Findings: In this population-based qualitative study, 3541 patients with vitiligo across 17 countries reported substantial burden on quality of life, emotional well-being, daily life, and psychosocial health, with greater burden noted among patients with more than 5% affected body surface area, Fitzpatrick skin types IV to VI (ie, darker skin), facial involvement, or hand involvement vs their counterparts. Meaning: Findings suggest that improvement in the psychosocial health of patients should be prioritized in the management and treatment of vitiligo. Importance: Patients with vitiligo often have impaired quality of life (QOL) and experience substantial psychosocial burden. Objective: To explore the global association of vitiligo with QOL and mental health from the patient perspective. Design, Setting, and Participants: This qualitative study of the cross-sectional population-based Vitiligo and Life Impact Among International Communities (VALIANT) study was conducted from May 6, 2021, to June 21, 2021. Potential participants for this qualitative study were recruited from an online panel in 17 countries. Of 5859 surveyed adults (aged ≥18 years) who reported a vitiligo diagnosis, 3919 (66.9%) completed the survey, and 3541 (60.4%) were included in the analysis. Exposures: Patients were asked questions regarding their emotional well-being, including QOL and mental health. Main Outcomes and Measures: Reported analyses are descriptive and hypothesis generating. Vitiligo Impact Patient scale (VIPs) scores ranged from 0 to 60, with higher scores indicating more psychosocial burden. Results: The median age of the 3541 patients was 38 years (range, 18-95 years), and 1933 (54.6%) were male; 1602 patients (45.2%) had more than 5% affected body surface area (BSA; Self-Assessment Vitiligo Extent Score assessed), and 1445 patients (40.8%) had Fitzpatrick skin types IV to VI (ie, darker skin). The mean (SD) global short-form VIPs score was 27.3 (15.6) overall; patients from India (mean [SD], 40.2 [14.1]) reported the highest scores (ie, most burden). The QOL burden according to the scale was profound for patients with more than 5% affected BSA (mean [SD] score, 32.6 [14.2]), darker skin (mean [SD] score, 31.2 [15.6]), and lesions on the face (mean [SD] score, 30.0 [14.9]) or hands (mean [SD], 29.2 [15.2]). At least 40% of patients globally reported that vitiligo frequently affected aspects of their daily lives, including choosing clothes to wear (1956 of 3541 [55.2%]). Most patients (2103 of 3541 [59.4%]) reported concealing their vitiligo frequently. More than half of patients (2078 of 3541 [58.7%]) reported diagnosed mental health conditions, including anxiety (1019 of 3541 [28.8%]) and depression (866 of 3541 [24.5%]). The Patient Health Questionnaire–9 depression screener showed that 55.0% of patients (1948 of 3541) had moderate to severe depressive symptoms; the highest rates were in India (271 of 303 [89.4%]) and among patients with more than 5% affected BSA (1154 of 1602 [72.0%]) and darker skin (987 of 1445 [68.3%]). Conclusions and Relevance: This qualitative study found that, globally, patients with vitiligo reported being substantially affected in their emotional well-being, daily lives, and psychosocial health; the burden was typically greatest among patients with more than 5% affected BSA, darker skin types, and lesions on the face or hands. Survey findings suggest that patients reported having altered their behavior, expressed clear discontent, and have symptoms consistent with depression, which may be underdiagnosed. This qualitative study investigates the mental health and psychosocial quality-of-life burden worldwide among patients with vitiligo.
- Publication
JAMA Dermatology, 2023, Vol 159, Issue 10, p1124
- ISSN
2168-6068
- Publication type
Article
- DOI
10.1001/jamadermatol.2023.2787