Comparison of Quality of Life, Depression and Self-Esteem in Patients of Vitiligo and Melasma

Title: Comparison of Quality of Life, Depression and Self-Esteem in Patients of Vitiligo and Melasma

Authors: Dr Suyog V. Jaiswal, Dr Chitra S. Nayak, Dr Henal R. Shah, Dr Ravindra M. Kamath, Dr Khushboo Kadri

DOI: https://dx.doi.org/10.18535/jmscr/v4i11.26

Abstract

Background: Skin is an important interface ofa human being with the world. Pigmentary disorders have psychological impact as well as impact on well-being and body image. The quality of life is affected adversely in both vitiligo and melasma patients, but psychosocial factors at work are different,

Aim: To assess and compare quality of life, self-esteem, depression and socio-demographic variables in patients of vitiligo and melasma.

Methodology: 50 consecutive patients each of vitiligo and melasma were interviewed in the Dermatology clinic. WHO QOL-BREF, Hamilton Depression Rating Scale & Rosenberg Self Esteem Scale were used for interview. Data obtained was analysed using statistical tests.

Results: The mean age was 34.8 (±13.34) & 39.78 (±7.65) years for patients of vitiligo & melasma respectively. The mean duration of illness was 8.04 (±7.95) years in Vitiligo and 4.36 (±4.15) years in melasma. 36% of vitiligo patients had changed their physician more than twice when compared to only 8% patients of melasma. Only 40% Melasma patients perceived it to be a major ailment, whilst 70% of Vitiligo patients reported it to be a major ailment and the difference was statistically significant (P-0.03). Female patients of vitiligo had significantly worse quality of life and self-esteem than female melasma patients. Depression was significantly worse in vitiligo patients.

Conclusion: Vitiligo has a more negative psychological impact especially on female patients than melasma.

Keywords: Vitiligo, Melasma, Quality of life, Depression, Self-esteem.

References

1. Owoeye OA, Aina OF, omoluabi PF, Olumide YM. An assessment of emotional pain among subjects with chronic dermatological problems in Lagos, Nigeria. Int J Psychiatry Med. 2007; 37(2): 129-38.

2. Korabel H, Dudek D, Jaworek A, Wojas-Pelc A. Psychodermatology: psychological and psychiatrical aspects of dermatology. PrzeglLek. 2008; 65(5):244-8.

3. Kosaraju SK, Reddy KS, Vadlamani N, Sandhya L, Kalasapati L, Maganti S, Mary A. Psychological Morbidity Among Dermatological Patients in a Rural Setting.Indian J Dermatol. 2015 Nov-Dec;60(6):635.

4. Taylor A, Pawaskar M, Taylor SL, Balkrishnan R, Feldman SR. Prevalence of pigmentary disorders and their impact on quality of life: a prospective cohort study. J CosmetDermatol. 2008Sep; 7(3): 164-8.

5. Davinder Prasad, Sunil Dogra, AmrinderJitKanwar. Quality of life in patients with vitiligo. Health Qual Outcomes. 2003; 1: 58. Published online 2003 October 23. doi: 10.1186/1477-7525-1-58.

6. Kent G, Al’aAbadie M. Physiologic effect of vitiligo: a critical incident analysis. J Am AcadDermatol. 1996 Dec;35(6):895-8.

7. Rigopoulos D, Gregoriou S, Katsambas A. Hyperpigmentation and Melasma. J CosmetDermatol. 2007 Sep;6(3):195-202.

8. Cash TF, Pruzinsky T. Body Images: Development, Deviance and Change. New York: Guilford; 1997.

9. Kellet S. Shame-focused acne: A biopsychosocial conceptualization and treatment rationale. In: Gilbert P, Miles J, eds: Body Shame: Conceptulization, Research and Treatment. East Sussex: Brunner-Routledge; 2002;135.

10. Skevington SM, Lotfy M, O'Connell KA. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of life Research. 2004 Mar 1;13(2):299-310.

11. Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, et. al. The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDSSR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry 2003; 54:573–83.

12. Hamilton M. Hamilton rating scale for Depression (Ham-D). In: Handbook of psychiatric measures. Washington DC: APA; 2000. p. 526–8.

13. Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press;1965. p.326.

14. Jadotte YT, Schwartz RA. Melasma: insights and perspectives. ActaDermatovenerol Croat. 2010 Jul; 18(3): 124-9.

15. Salman A, Kurt E, Topcuoglu V, Demircay Z. Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study. Am J ClinDermatol. 2016 Jun;17(3):305-11.

16. Mattoo SK, Handa S, Kaur I, Gupta N, Malhotra R. Psychiatric morbidity in vitiligo: prevalence and correlates in India. J EurDermatolVenerol 2002;16:573-78

17. Pawaskar MD, Parikh P, Markowski T, McMicheal AJ, Feldman SR, Balkrisnan R. Melasma and its impact on health related quality of life in Hispanic women. J Dermatog Treat. 2007;18(1):5-9.

18. Borimnejad L, ParsaYekta Z, Nisbakht-Nasrabadi A, Firooz A. Quality of Life with vitiligo: comparison of male and female muslim patients in Iran. Gend Med. 2006 Jun;3(2):124-30.

19. Ongenae K, Van Geel N, De Schepper S, Naeyaert JM. Effect of vitiligo on self-reported health-related quality of life. Br J Dermatol. 2005 Jun;152(6):1165-72.

20. Mattoo SK, Handa S, Kaur I, Gupta N, Malhotra R. Psychiatric morbidity in vitiligo and psoriasis: a comparative study from India. J Dermatol. 2001 Aug;28(8):424-32.

21. Sampogna F, Raskovic D, Guerra L, Pedicelli C, Tabolli S &Leoni L. Identification of categories at risk for high quality of life impairment in patients with vitiligo. British Journal of Dermatology. 2008; 159, 351–359.

22. Firooz A, Bouzari N, Fallah N, Ghazisaidi B, Firoozabadi MR &Dowlati Y. What patients with vitiligo believe about their condition. International Journal of Dermatology.2004; 43, 811–814.

23. Schmid-Ott G, Kunsebeck HW, Jecht E, Shimshoni R, Lazaroff I &Schallmayer S. Stigmatization experience, coping and sense of coherence in Vitiligo patients. Journal of the European Academy of Dermatology Venereology.2007;21, 456–461.

24. Ahmed I, Ahmed S, Nasreen S. J Ayub Med Coll Abbottabad. 2007 Jul-Sep;19(3):19-21.

25. Bashir K, Dar NR, SibghatUllahRao. Depression in adult dermatology outpatients. J Coll Physicians Surg Pak. 2010 Dec;20(12):811-3.

26. Cayce KA, McMichael AJ, Feldman SR. Hyperpigmentation: an overview of the common afflictions.. DermatolNurs. 2004 Oct;16(5):401-6, 413-6; quiz 417.

27. Freitag FM, Cestari TF, Leopoldo LR, Paludo P, Boza JC. Effect of melasma on quality of life in a sample of women living in southern Brazil. J EurAcad Dermatol Venereol. 2008 Jun;22(6):655-62.

28. Tsintsadze N, Beridze L, Tsintsadze N, Krichun Y, Tsivadze N, Tsintsadze M.Psychosomatic aspects in patients with dermatologic diseases. Georgian Med News. 2015 Jun;(243):70-5.

29. Bolton MA, Lobben I, Stern TA. The Impact of Body Image on Patient Care.Prim Care Companion J Clin Psychiatry. 2010; 12(2): PCC.10r00947.

30. Bonotis K, Pantelis K, Karaoulanis S, Katsimaglis C, Papaliaga M, Zafiriou E, Tsogas P. Investigation of factors associated with health-related quality of life and psychological distress in vitiligo. J DtschDermatolGes. 2016 Jan;14(1):45-9.

Corresponding Author

Dr Suyog V. Jaiswal

Assistant Professor, Department of Psychiatry

H.B.T. Medical College & Dr. R.N. Cooper Mun Gen. Hospital, Mumbai

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile No. +91 9970850212