K. Phan, M. Gupta
Introduction: Vitiligo is an autoimmune skin disorder characterized by patches of depigmentation due to loss of melanocytes. Vitiligo associated with signiﬁcant psychoso- cial burden, with prior studies showing links with psychi- atric comorbidities such as depression. Few studies have evaluated the relationship between vitiligo and suicidal ideation and suicide attempts.
Objective: We aimed to investigate the underlying preva- lence and risk of suicidal ideation or suicide attempts among patients with vitiligo.
Methods: A systematic search of PubMed, MEDLINE, Embase and the Cochrane Library was conducted. Cross- sectional, case–control or cohort studies that assessed the prevalence of suicidal ideation or suicide attempts among patients with vitiligo were included. DerSimonian and Laird random-effects models were utilized to calculate the pooled prevalence and odds ratios.
Results: From systematic review, we identiﬁed 7 studies included for analysis. A total of 12,043 vitiligo cases were compared with 87,053,333 controls. The pooled proportion of suicidal ideation in vitiligo was 15.2% compared to
2.0% in the control group (P < 0.001). The proportion of suicide attempts/suicides were also higher for vitiligo com- pared to controls (3.2% vs 2.1%, P < 0.001). Moderate-to- high heterogeneity was observed between the studies. Conclusions: Our data further provides evidence of the signiﬁcant impact vitiligo has on self-esteem and psycho- logical burden. Patients with vitiligo were signiﬁcantly more likely to have suicidal ideation. Clinicians should actively evaluate patients with vitiligo for signs/symptoms of suicidal ideation and provide appropriate referrals to manage their psychiatric symptoms accordingly.