Psychological Morbidity and Quality of Life in Shwitra (Vitiligo) Patients

Abstract

Background: Diseases affecting the skin are visible to others; therefore, patients with skin diseases not only cope with the effect of the disease, but also with the reaction of people to their disease. Skin colour plays an important role in an individual’s perception of health, desirability, worth and wealth. Vitiligo presents as milky – white patches in the skin which can result in psychological morbidity, social stigmatization and hampered quality of life. According to modern dermatology, Shwitra can be correlated with Vitiligo. Aim: To study Effect of Shwitra (Vitiligo) On Quality Of Life and Depression. Methods: Trial group includes previously diagnosed 200 patients of Shwitra. For the assessment of dermatology life quality index DLQI questionnaire was used, level of depression was assessed with Hamilton Depression Rating Scale (HAM-D) and to estimate the baseline percentage of Vitiligo involvement in each body region Vitiligo Area Scoring Index (VASI) scale was used. Results: patients had a range of concerns regarding their disease such as physical appearance, progression of white patches on to exposed skin and the whole body, social restriction, dietary restrictions, difficulty in getting jobs and major concern about difficulty to getting married. Mild to moderate Depression was common. The condition was perceived to be a serious illness. Multiple medical consultations at various system of medicine were frequent. Complete repigmentation was strongly desired. The diseased imposed a significant financial burden. The problems were more severe in females. Conclusion: an empathetic and supportive doctor – patient interaction, information regarding Vitiligo, early diagnosis, prompt treatment, good social especially family support and psychotherapeutic interventions can help the patient to live with their disease, and to manage the associated psychosocial and psychiatric comorbidity.