{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:12:11Z","timestamp":1790993531515,"version":"4.1.0"},"reference-count":28,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"funder":[{"DOI":"10.13039\/100009032","name":"Pfizer UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009032","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec id=\"S2056472422005919_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Vitiligo is an acquired, autoimmune depigmenting skin disorder that may affect psychological well-being.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472422005919_sec_a2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To determine the risk and impact of psychological comorbidity in people with new-onset vitiligo.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472422005919_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We conducted a retrospective observational study, using UK general practice data (2004\u20132020). Adults diagnosed with vitiligo (<jats:italic>n<\/jats:italic> = 7224) were matched 1:4 with controls (<jats:italic>n<\/jats:italic> = 28 880). Associations within 2 years of diagnosis were assessed for psychological conditions: recurrent depressive disorder (RDD), depressive episodes, non-phobia-related anxiety disorder, social phobia, adjustment disorder, substance misuse, self-harm and suicide attempts. Healthcare utilisation, time off work and unemployment within 1 year were compared in those with and without a mental health condition at vitiligo diagnosis.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472422005919_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>At diagnosis, people with vitiligo had a similar prevalence of mental health conditions as controls, except for anxiety disorder (cases 7.9%, controls 7.0%; <jats:italic>P<\/jats:italic> = 0.014). Incident RDD and anxiety disorder were more common in people with vitiligo (RDD: adjusted hazard ratio (aHR) 1.25, 95% CI 1.01\u20131.55; anxiety disorder: aHR 1.23, 95% CI 1.00\u20131.51). Risk was highest in Black and minority ethnic individuals (RDD: aHR 1.72, 95% CI 1.06\u20132.79; depressive episodes: aHR 1.56, 95% CI 1.03\u20132.37). No association was found with other mental health conditions. People with vitiligo and psychological comorbidity had more primary care encounters, more time off workand higher unemployment.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472422005919_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>People with vitiligo have a higher incidence of RDD and anxiety disorder than controls, and this risk increase may be greatest in Black and minority ethnic populations.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2022.591","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T11:01:48Z","timestamp":1666350108000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":21,"title":["The mental health associations of vitiligo: UK population-based cohort study"],"prefix":"10.1192","volume":"8","author":[{"given":"Andrew R.","family":"Thompson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Eleftheriadou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2685-4373","authenticated-orcid":false,"given":"John","family":"Nesnas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"S2056472422005919_ref12","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1001\/archpsyc.62.6.617","article-title":"Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication","volume":"62","author":"Kessler","year":"2005","journal-title":"Arch Gen Psychiatry"},{"key":"S2056472422005919_ref20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001885","article-title":"The Reporting of studies conducted using observational routinely-collected health data (RECORD) statement","volume":"12","author":"Benchimol","year":"2015","journal-title":"PLoS Med"},{"key":"S2056472422005919_ref19","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1002\/pds.1934","article-title":"Issues in multiple imputation of missing data for large general practice clinical databases","volume":"19","author":"Marston","year":"2010","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"S2056472422005919_ref1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1590\/S0365-05962004000300010","article-title":"Vitiligo","volume":"79","author":"Steiner","year":"2004","journal-title":"An Bras Dermatol"},{"key":"S2056472422005919_ref3","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s40257-021-00631-6","article-title":"Psychosocial effects of vitiligo: a systematic literature review","volume":"22","author":"Ezzedine","year":"2021","journal-title":"Am J Clin Dermatol"},{"key":"S2056472422005919_ref6","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1111\/jdv.14739","article-title":"The prevalence and odds of depression in patients with vitiligo: a meta-analysis","volume":"32","author":"Wang","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"S2056472422005919_ref13","volume-title":"ICD-10: International Statistical Classification of Diseases and Related Health Problems","year":"2011"},{"key":"S2056472422005919_ref18","doi-asserted-by":"crossref","first-page":"920","DOI":"10.14236\/jhi.v23i4.920","article-title":"Ethnicity recording in primary care computerised medical record systems: an ontological approach","volume":"23","author":"Tippu","year":"2017","journal-title":"J Innov Health Inform"},{"key":"S2056472422005919_ref8","first-page":"6663646","article-title":"Meta-analytic review of high anxiety comorbidity among patients with vitiligo","volume":"2021","author":"Liu","year":"2021","journal-title":"Biomed Res Int"},{"key":"S2056472422005919_ref5","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1111\/bjd.15199","article-title":"Vitiligo and depression: a systematic review and meta-analysis of observational studies","volume":"177","author":"Lai","year":"2017","journal-title":"Br J Dermatol"},{"key":"S2056472422005919_ref7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0241445","article-title":"Vitiligo and anxiety: a systematic review and meta-analysis","volume":"15","author":"Kussainova","year":"2020","journal-title":"PLoS One"},{"key":"S2056472422005919_ref23","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.jaad.2009.03.022","article-title":"The burden of vitiligo: patient characteristics associated with quality of life","volume":"61","author":"Homan","year":"2009","journal-title":"J Am Acad Dermatol"},{"key":"S2056472422005919_ref15","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-045718","article-title":"Epidemiology, management and the associated burden of mental health illness, atopic and autoimmune conditions, and common infections in alopecia areata: protocol for an observational study series","volume":"11","author":"Harries","year":"2021","journal-title":"BMJ Open"},{"key":"S2056472422005919_ref28","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1111\/j.1365-2133.2005.06456.x","article-title":"Effect of vitiligo on self-reported health-related quality of life","volume":"152","author":"Ongenae","year":"2005","journal-title":"Br J Dermatol"},{"key":"S2056472422005919_ref26","doi-asserted-by":"crossref","first-page":"104","DOI":"10.4103\/2349-5847.219684","article-title":"Quality of life in vitiligo: relationship to clinical severity and demographic data","volume":"4","author":"Patvekar","year":"2017","journal-title":"Pigment Int"},{"key":"S2056472422005919_ref11","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1111\/1346-8138.15290","article-title":"Increased risk of psychiatric disorders in adult patients with vitiligo: a nationwide, population-based cohort study in Taiwan","volume":"47","author":"Chen","year":"2020","journal-title":"J Dermatol"},{"key":"S2056472422005919_ref17","unstructured":"17 Office for National Statistics. Ethnicity. Office for National Statistics, 2018 (https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/culturalidentity\/ethnicity)."},{"key":"S2056472422005919_ref21","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/j.1365-2133.2010.09828.x","article-title":"Vitiligo linked to stigmatization in British South Asian women: a qualitative study of the experiences of living with vitiligo","volume":"163","author":"Thompson","year":"2010","journal-title":"Br J Dermatol"},{"key":"S2056472422005919_ref25","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/bjd.15560","article-title":"Factors affecting quality of life in patients with vitiligo: a nationwide study","volume":"178","author":"Bae","year":"2018","journal-title":"Br J Dermatol"},{"key":"S2056472422005919_ref4","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.clindermatol.2017.01.001","article-title":"Psychosomatic aspects of vitiligo","volume":"35","author":"Cupertino","year":"2017","journal-title":"Clin Dermatol"},{"key":"S2056472422005919_ref9","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1111\/bjd.16049","article-title":"The prevalence of psychological comorbidity in people with vitiligo: a systematic review and meta-analysis","volume":"178","author":"Osinubi","year":"2018","journal-title":"Br J Dermatol"},{"key":"S2056472422005919_ref2","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1093\/oxfordhb\/9780199580521.013.0010","volume-title":"Oxford Handbook of the Psychology of Appearance","author":"Thompson","year":"2012"},{"key":"S2056472422005919_ref10","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/j.jaad.2018.11.047","article-title":"Vitiligo and major depressive disorder: a bidirectional population-based cohort study","volume":"80","author":"Vallerand","year":"2019","journal-title":"J Am Acad Dermatol"},{"key":"S2056472422005919_ref22","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1111\/bjd.12990","article-title":"Starting to develop self-help for social anxiety associated with vitiligo: using clinical significance to measure the potential effectiveness of enhanced psychological self-help","volume":"171","author":"Shah","year":"2014","journal-title":"Br J Dermatol"},{"key":"S2056472422005919_ref24","doi-asserted-by":"crossref","first-page":"700","DOI":"10.4103\/0378-6323.45141","article-title":"Life quality assessment among patients with vitiligo: comparison of married and single patients in Iran","volume":"74","author":"Dolatshahi","year":"2008","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"S2056472422005919_ref16","unstructured":"16 Ministry of Housing, Communities & Local Government. English Indices of Deprivation 2015. The Stationery Office, 2015 (https:\/\/www.gov.uk\/government\/statistics\/english-indices-of-deprivation-2015)."},{"key":"S2056472422005919_ref14","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12911-016-0274-7","article-title":"Case-finding for common mental disorders of anxiety and depression in primary care: an external validation of routinely collected data","volume":"16","author":"John","year":"2016","journal-title":"BMC Med Inform Decis Mak"},{"key":"S2056472422005919_ref27","article-title":"Quality of life of adult vitiligo patients using camouflage: a survey in a Chinese vitiligo community","volume":"14","author":"Chen","year":"2019","journal-title":"PLoS One"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472422005919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T11:02:44Z","timestamp":1666350164000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472422005919\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,21]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["S2056472422005919"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2022.591","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,21]]},"assertion":[{"value":"Copyright \u00a9 Pfizer Limited, 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e190"}}