A recent case-control study found that African American pediatric patients with vitiligo were over seven times more likely to develop disruptive behavior disorders and nearly three times more likely to experience suicidal ideation compared to matched controls without vitiligo.

The retrospective, single-center study, conducted at Texas Children’s Hospital, included 327 African American pediatric patients with vitiligo, each matched to three controls without vitiligo by age, race, and sex. The study revealed a higher prevalence of psychiatric comorbidities, including depression, disruptive behavior disorders (DBDs), eating disorders (EDs), generalized anxiety disorder (GAD), substance abuse (SA), and suicidal ideation (SI) in the vitiligo cohort compared with controls.

African American pediatric patients with vitiligo had a 7.68-fold higher likelihood of being diagnosed with DBDs (odds ratio [OR] 7.68, 95% confidence interval [CI] 4.28-13.78, p<0.001) and were 2.88 times more likely to have SI (OR 2.88, 95% CI 1.38-6.03, p=0.005). Patients with vitiligo were also 3.63 times more likely to be diagnosed with depression (OR 3.63, 95% CI 2.19-6.03, p<0.001) and 2.61 times more likely to have GAD (OR 2.61, 95% CI 1.67-4.09, p<0.001).

Patients with depression, DBDs, and EDs demonstrated the highest rates of treatment initiation (76.5%, 82.1%, and 100%, respectively), while those diagnosed with GAD and SA had lower treatment initiation rates (55.3% and 61.5%, respectively). Nearly 15% of patients with SI did not initiate psychiatric treatment.

This study, in-press at JAAD International, highlights the psychosocial burden faced by African American pediatric patients with vitiligo due to the condition's visibility and social stigma. The findings underscore the need for heightened clinical awareness of psychiatric comorbidities in this population. However, as this was a retrospective study, causality between vitiligo and psychiatric comorbidities cannot be determined. The study's single-center nature and relatively small sample size may also limit generalizability.

The authors declared no conflicts of interest.