Psychological Morbidity and Quality of Life in Patients with Shwitra (Vitiligo): A Comparative Cross-Sectional study with Healthy Controls

Abstract

Background:  Shwitra [Vitiligo] may become a psychologically devastating disorder. The present study focuses on the assessment of quality of life and level of depression in patients with Shwitra [Vitiligo] and compares them with a matched control population. Methods: A hospital-based, comparative, cross-sectional, case-control study was conducted at Parul Ayurved Hospital, Vadodara, Gujarat [IEC approval PU/PIA/IECHR/2019/88; CTRI/2019/12/022567]. Convenience sampling technique was used. 200 previously diagnosed patients of Shwitra and 200 apparently healthy, age-matched volunteers were enrolled. The age range was 20–59 years [mean age 34.9 years in each group]; 120/200 participants were female and 80/200 male in each group. Depression was measured using the Hamilton Depression Rating Scale [HAM-D], quality of life using the Dermatology Life Quality Index [DLQI], and disease extent using the Vitiligo Area Scoring Index [VASI]. Group comparisons used the independent-samples t-test for mean HAM-D scores, and the chi-square test of independence for categorical associations. Results: HAM-D scores were normal in 13/200, mild in 96/200 and moderate in 91/200 patients, while normal in 191/200, mild in 6/200 and moderate in 3/200 controls. DLQI was unaffected in 3/200, small effect in 91/200, moderate effect in 95/200, and large effect in 11/200 patients. Mean HAM-D scores were significantly higher in patients than in controls [p = .000]. HAM-D and DLQI were strongly associated [Cramer's V = 0.571, p =.000]. Conclusion: Vitiligo is associated with substantially higher depression and poorer quality of life than in matched healthy controls.