Psychodermatology U.K.

PS01 The psychological burden of vitiligo: a systematic review and meta-analysis O. Osinubi, M. Grainge, L.L. Hong, A. Ahmed, J. Batchelor, D. Grindlay and S. Ratib University of Nottingham, Nottingham, U.K.; Nottingham University Hospitals NHS Trust, Nottingham, U.K. and Watford General Hospital, Watford, U.K. Vitiligo is an acquired chronic disorder causing depigmentation in up to 1% of people globally. The British Association of Dermatologists recommends assessment of psychological state and quality of life during clinical evaluation of patients with vitiligo. Despite this, the overall psychological burden of vitiligo has not yet been fully synthesized by systematic review. The aim of this study was to describe the prevalence of different psychological disorders in people with vitiligo and to describe the different psychological outcome measures used. In December 2016, a comprehensive search of MEDLINE, Embase, CINAHL and PsycINFO was conducted. Cross-sectional, case–control or cohort studies that assessed the prevalence of depression among patients were included. DerSimonian and Laird random-effects models were utilized to calculate (i) the overall pooled prevalence and (ii) the relative risks of depression and anxiety in those with vitiligo compared with those with psoriasis. In total 29 studies with 2204 people with vitiligo were included. All studies were hospital based. The most commonly diagnosed psychological disorders were depression (n = 25) and anxiety (n = 13). Nine studies provided the prevalence of 11 other psychological disorders: social phobia, sleep disturbances, panic disorder, specific phobia, schizophrenia, adjustment disorder, substance abuse, sexual dysfunction and obsessive compulsive disorder. All studies were hospital based. The Hospital Anxiety and Depression Scale and Centre for Epidemiology Studies Depression Screening Index were the most commonly used tools to diagnose psychological comorbidity. The overall pooled prevalence of depression was 0.26 [95% confidence interval (CI) 0.20– 0.32] when measured by depression-specific questionnaires, 0.29 (95% CI 0.06–0.52) when measured by general health questionnaires and 0.29 (95% CI 0.13–0.45) when clinically examined by a psychiatrist. Compared with people with psoriasis, the relative risk of depression was 0.69 (95% CI 0.52– 0.90; P < 0.01) in people with vitiligo. The overall pooled prevalence of anxiety was 0.26 (95% CI 0.15–0.37) for anxiety-specific questionnaires, 0.21 (95% CI 0.05–0.36) for general health questionnaires and 0.57 (95% CI 0.49–0.65) when clinically examined by a psychiatrist. Compared with people with psoriasis, the relative risk of anxiety was 1.29 (95% CI 0.84–1.98; P = 0.25) in people with vitiligo. Moderate-tohigh heterogeneity was observed between the studies. People living with vitiligo experience a range of psychological disorders. The prevalence of depression did not vary substantially by screening tool, whereas the prevalence of anxiety did, suggesting the need for more robust screening tools in this group of patients. Population-based studies are required in this area to provide more generalizable results.