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Meta-Analysis
. 2021 May 17:2021:6663646.
doi: 10.1155/2021/6663646. eCollection 2021.

Meta-Analytic Review of High Anxiety Comorbidity among Patients with Vitiligo

Jiani Liu  1 , Rui Tang  2 , Yangfan Xiao  3 , Mei Luo  4 , Yaqian Shi  1 , Qiancheng Deng  1 , Huiming Zhang  1 , Zhoutong Zeng  1 , Zixin Pi  1 , Rong Xiao  1
Affiliations
Meta-Analysis

Meta-Analytic Review of High Anxiety Comorbidity among Patients with Vitiligo

Jiani Liu et al. Biomed Res Int. .

Abstract

Background: Vitiligo is a disfiguring skin disease with profound psychosocial impacts, such as anxiety, but the reported effect sizes of associations vary. We aimed to conduct a meta-analysis to quantify the strength of association between anxiety and vitiligo and to estimate the prevalence of anxiety among individuals with vitiligo.

Methods: A systematic literature search was performed in five online databases (MEDLINE, Embase, Web of Science, Cochrane Library, and PsycINFO) from inception until March 20, 2020. All of the eligible studies were comprehensively reviewed, and all of the available data were analyzed according to our predefined criteria.

Results: Twenty-one studies involving 3259 patients in 11 countries were included in this meta-analysis. Compared with the healthy control group, patients with vitiligo often had concomitant anxiety (OR = 6.14 [95% CI: 3.35-11.24], I 2 = 30.1%). The pooled prevalence of anxiety in female patients was significantly higher than that in males (OR = 2.24 [95% CI: 1.31-3.84], I 2 = 0.0%). Subgroup analysis showed that the pooled prevalence of clinical anxiety disorder and anxiety symptoms was 12% (95% CI: 7%-16%, I 2 = 76.3%) and 34% (95% CI: 21%-46%, I 2 = 94.7%), respectively. No publication bias has been detected by Begg's funnel plot and Egger's test.

Conclusion: Patients with vitiligo have high anxiety comorbidity, with female predominance. Dermatologists and psychiatrists should be vigilant to the presence of anxiety, apply appropriate interventions to reduce the psychological impacts in a timely manner, and thus promote recovery in vitiligo patients. However, due to some objective limitations (poor information about the OR and diversity in assessment tools among included studies), findings should be interpreted with caution.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Flow diagram of literature selection strategy.
Figure 2
Figure 2
The strength of association between anxiety and vitiligo: (a) Forest blot; (b) Begg's funnel plot.
Figure 3
Figure 3
Female predominance of anxiety in patients with vitiligo: (a, c) Forest plot; (b, d) Begg's funnel plot.
Figure 4
Figure 4
The pooled prevalence of anxiety in patients with vitiligo: (a) Forest plot; (b) Begg's funnel plot.
Figure 5
Figure 5
Sensitivity analysis: (a) for the strength of association between anxiety and vitiligo; (b) for the female predominance (OR) of anxiety in patients with vitiligo; (c) for the female predominance (SMD) of anxiety in patients with vitiligo; (d) for the pooled prevalence of anxiety in patients with vitiligo.
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