Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Division of Dermatology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
J Am Acad Dermatol. 2019 May;80(5):1371-1379. doi: 10.1016/j.jaad.2018.11.047. Epub 2018 Dec 5.
Vitiligo patients often report their mental health has an effect 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.
Evaluate a bidirectional relationship between MDD and vitiligo using The Health Improvement Network database.
Incident MDD and referent cohorts were followed until the development of vitiligo. Also, incident vitiligo and referent cohorts were followed until the development of MDD. Cox proportional hazards models were used, and numerous covariates were adjusted for.
In adjusted models, MDD patients (n = 405,397) were at a 64% increased risk for vitiligo (hazard ratio 1.64, 95% confidence interval [CI] 1.43-1.87, P < .0001) compared with the referent cohort (n = 5,739,048). This risk was decreased in patients using antidepressants. Compared with the referent cohort (n = 6,137,696), patients with vitiligo (n = 7104) that were <30 years of age at diagnosis had a higher risk of developing MDD than patients ≥30 years of age (hazard ratio 1.31, 95% CI 1.14-1.50, P < .0001 vs 1.22, 95% CI 1.08-1.37, P = .001, respectively).
This study did not evaluate the severity of MDD or vitiligo on outcome development.
These results highlight the burden of depression in patients with vitiligo and support the possible existence of pathophysiological connections between these 2 conditions.
白癜风患者常报告其心理健康状况会影响皮肤。然而，目前尚不清楚常见的精神障碍，如重度抑郁症（MDD），是否也会引发白癜风。
利用健康改善网络数据库评估 MDD 与白癜风之间的双向关系。
对 MDD 发病队列和参照队列进行随访，直至发生白癜风；同时对白癜风发病队列和参照队列进行随访，直至发生 MDD。采用 Cox 比例风险模型，并对多个协变量进行调整。
在调整后的模型中，与参照队列（n=5739048）相比，MDD 患者（n=405397）发生白癜风的风险增加了 64%（风险比 1.64，95%置信区间[CI] 1.43-1.87，P<.0001）。使用抗抑郁药的患者风险降低。与参照队列（n=6137696）相比，诊断时年龄<30 岁的白癜风患者（n=7104）发生 MDD 的风险高于年龄≥30 岁的患者（风险比 1.31，95%CI 1.14-1.50，P<.0001 与 1.22，95%CI 1.08-1.37，P=.001）。
本研究未评估 MDD 或白癜风严重程度对结局发展的影响。
这些结果突出了抑郁症在白癜风患者中的负担，并支持这两种疾病之间可能存在病理生理联系。
