Vitiligo and major depressive disorder - is there a link?

 

To date, modern literature has focused attention on the problem of mental disorders that occur more often in people with dermatological pathologies, such as vitiligo. Vitiligo is an autoimmune disease that is characterized by skin depigmentation. It is well known that autoimmune diseases, including vitiligo, can have an effect on the mental state of the patient. Thus, given the autoimmune nature of vitiligo, it becomes clear that patients with this pigmentation disorder are at greater risk of developing a depressive disorder.

Reason for the relationship between major depressive disorder and vitiligo
Study results of patients with major depressive disorder and vitiligo
• Conclusion Reason for the relationship between major depressive disorder and vitiligo

Major depressive disorder contributes to systemic inflammation in the body even in the absence of autoimmune pathology, due to the super high level of pro inflammatory cytokines, this phenomenon can act as a provoking factor not only for vitiligo, but also for rheumatoid arthritis and psoriasis. In addition , major depressive disorder has leukocyte antigen features similar to vitiligo. Research confirms similar genetic and inflammatory patterns in depressive disorder and vitiligo. Such a relationship is most likely maintained due to such an axis as: brain-inflammatory process-skin. 

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The presence of serotonin at the neuronal synapse is associated with major depressive disorder, and based on the concept that both neurons and melanocytes are of ectodermal origin, it has been suggested that melanocytes may also produce serotonin in the skin, which plays a cellular modulating role.

Furthermore, experimental evidence suggests that skin serotonin levels may be reduced in vitiligo patients, and high skin serotonin levels may promote hair repigmentation in northern animals during the summer months.

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! Thus, there is a definite relationship between serotonin and melanocytes, which explains the nature of pigmentation disorders in patients with psychiatric disorders.

Study results of patients with major depressive disorder and vitiligo

This study was the largest in the field of dermatopsychology, the analysis used an information base for 26 years of 12 million patients. In order to more clearly link the two disorders, it was decided to investigate both the impact of major depressive disorder on the onset of vitiligo and the impact of vitiligo on the development of major depressive disorder.

 

Analyzing the results of the studies, factors such as age, gender, medication intake and the use of topical agents for the treatment of vitiligo were taken into account.

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The result showed a 64% increase in the risk of vitiligo among patients diagnosed with major depressive disorder. Given that patients with psychiatric disorders are more likely to be treated with antidepressants than the general population, it was also necessary to compare these rates. Patients taking antidepressants had a lower risk of developing vitiligo than people not taking antidepressants.

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It is possible that treatment of depressive disorders reduces the circulation of pro-inflammatory cytokines and thus reduces the risk of an autoimmune response. Another explanation for the positive effect of antidepressants is the fact that this group of drugs has an immunomodulatory effect on the skin, namely: antidepressants affect the balance of T helpers, which in turn are associated with vitiligo.  

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Thus, younger patients (under 30 years of age) had a higher risk of developing mental disorders - 31%, while the risk rate in people after 30 years was 22%. 

Conclusion

This study confirms the fact that mental health has a very significant impact on the dermatological component, which is especially important in the context of autoimmune manifestations among young patients. Dermatologists and cosmetologists should take this point into account in the management of patients with vitiligo. Further study of this issue will be devoted to methods of treatment and correction, since from the above it follows that vitiligo and major depressive disorder have a similar developmental pathogenesis.

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