Cao Cheng, Lin Fuquan, Jin Rong, Lei Jindi, Zheng Yujie, Sheng Anqi, Xu Wen, Xu Aie, Zhou Miaoni
Department of Dermatology, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
Front Psychol. 2024 Sep 20;15:1454947. doi: 10.3389/fpsyg.2024.1454947. eCollection 2024.
To clarify the causal relationship between anxiety-depression and the progression and outcomes of vitiligo, providing a basis for enhancing psychological interventions in the treatment of vitiligo.
A two-sample Mendelian randomization analysis was used to validate the causal relationship between anxiety, depression, and vitiligo. The Hospital Anxiety and Depression Scale (HADS) assessed the psychiatric condition of vitiligo patients. Fisher's chi-square tests and rank sum tests analyzed the differences in clinical characteristics among vitiligo patients with different HADS scores. Regression analysis assessed the correlation between anxiety-depression and disease progression and treatment outcomes.
Mendelian randomization analysis showed that depression significantly increases the risk of vitiligo (OR = 4.46, 95% CI: 1.16-17.18, = 0.03). According to the HADS scores, clinical characteristics differed significantly among the groups ( < 0.05). Univariate regression analysis demonstrated that both HADS ( = -1.168, < 0.001, 95% CI: -1.532 to -0.804) and VIDA ( = -2.157, < 0.001, 95% CI: -3.464 to -0.887) were significantly negative associated factors for disease outcomes. However, HADS ( = -1.006, < 0.001, 95% CI: -1.475 to -0.657) emerged as the only factor influencing therapeutic efficacy in multivariate regression analysis. A restricted cubic spline graph illustrates a U-shaped relationship between HADS and clinical efficacy, with the most significant impact on therapeutic efficacy occurring when HADS equals 15.
Anxiety-depression exhibit a bidirectional positive causal relationship with vitiligo. Moderate to severe anxiety-depression significantly influences the clinical efficacy of vitiligo treatment.
阐明焦虑抑郁与白癜风进展及结局之间的因果关系，为加强白癜风治疗中的心理干预提供依据。
采用两样本孟德尔随机化分析来验证焦虑、抑郁与白癜风之间的因果关系。医院焦虑抑郁量表（HADS）评估白癜风患者的精神状况。Fisher卡方检验和秩和检验分析不同HADS评分的白癜风患者临床特征的差异。回归分析评估焦虑抑郁与疾病进展及治疗结局之间的相关性。
孟德尔随机化分析表明，抑郁显著增加白癜风风险（OR = 4.46，95%CI：1.16 - 17.18，P = 0.03）。根据HADS评分，各组临床特征差异显著（P < 0.05）。单因素回归分析表明，HADS（β = -1.168，P < 0.001，95%CI：-1.532至-0.804）和VIDA（β = -2.157，P < 0.001，95%CI：-3.464至-0.887）均为疾病结局的显著负相关因素。然而，在多因素回归分析中，HADS（β = -1.006，P < 0.001，95%CI：-1.475至-0.657）是影响治疗效果的唯一因素。限制立方样条图显示HADS与临床疗效之间呈U形关系，当HADS等于15时对治疗效果的影响最为显著。
焦虑抑郁与白癜风呈现双向正因果关系。中度至重度焦虑抑郁显著影响白癜风治疗的临床疗效。
