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The relation between illness perceptions and psychiatric morbidity among patients with vitiligo, in Al-Madinah, Saudi Arabia

Mokhtar Mahfouz Shatla, Israa Abdulhadi AlSofyani, Samira Waslullah Almitairi, Ahmad Saud Alrahili, Amani Wasal Alsolami.

Abstract
Background: Vitiligo is a prevalent macular skin depigmentation that can impose significant psychiatric morbidity in terms of depression and anxiety. Patients with vitiligo, as well as other chronic diseases, react to their illness by developing their own beliefs and perceptions that might affect their health and well-being.

Objective: This study aimed to assess the rate of depression and anxiety among patients with vitiligo, and to evaluate the relation between patients’ perceptions regarding vitiligo and the increased likelihood of depression and anxiety.

Materials and Methods: This cross-sectional study included consecutive adult patients with vitiligo who attended the Laser and Skin Clinic in King Fahd Hospital, in Al-Madinah, Saudi Arabia. Participants were invited to respond to the Arabic versions of the Hospital Anxiety and Depression Scale (HADS), and the Revised-Illness Perceptions Questionnaire (IPQ-R). Patients’ sociodemographic characteristics were recorded.

Results: Out of 132 patients, 49 (37.1%) had depression and 56 (42.4%) had anxiety. Pearson’s correlation showed significant association between depression and anxiety, and various dimensions of the patients’ poor illness perceptions (P < 0.05). Multivariate logistic regression analysis revealed that poor personal control over illness was the most significant independent variable associated with psychiatric morbidity (OR = 11.7; 95% CI, 2.9–48.2 for depression; and OR = 17.6; 95% CI 3.7–84.6 for anxiety), followed by patients’ beliefs in serious consequences, more perceived severity, and less trust in treatment effect. The risk of psychiatric morbidity was associated with patient’s younger age, female gender, being unmarried, and unemployed.

Conclusion: Poor illness perceptions were clearly adversely affecting the psychological well-being of patients with vitiligo with a resulting increased rate of depression and anxiety.

Key words: Illness perceptions, psychiatric morbidity, depression, anxiety, vitiligo



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