Adjustment Disorders, Anxiety Disorders, Depressive Episode, Overdose, Parasuicide, Recurrent Depressive Disorder, Self-Harm, Deliberate, Social Phobia, Substance Abuse, Suicide, Attempted, Vitiligo
Conditions
Brief summary
This cohort study is a large population-based study in the UK to determine the risks of comorbid mental health conditions (including depression, anxiety and other potential psychological complications of vitiligo) in adults with vitiligo compared to controls and to evaluate whether the relative risks may vary by different ethnicity.
Detailed description
This study has two primary outcomes 1) Prevalence and incidence of mental health condtions in people diagnosed with vitiligo compared to matched controls and 2) Primary care and secondary healthcare utilisation in patients diagnosed with vitiligo and having a prevalent depressive conditon compared to matched controls. In addition, the study examines risk of time off work and unemployment in people diagnosed with vitiligo compared to matched controls.
Interventions
OTHERExposure of mental health condtion of interest
Common mental health conditions consist of depressive episodes, recurrent depressive disorder and anxiety disorder.
Sponsors
Pfizer
Momentum Data
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* All eligible adults ≥18 (as at date of vitiligo diagnosis for cases or start of follow-up for controls) registered with GP practices contributing data to OPCRD between January 1, 2004 and December 31, 2020, were eligible for inclusion in the study.
Exclusion criteria
* People with less than 1 year of follow up available
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Depressive Episodes | At the time of diagnosis in all people diagnosed with vitiligo 2004-2020 inclusive. For matched controls, the date of diagnosis of their matched case. | Prevalence of common mental health conditions (depressive episodes) in adult people diagnosed with vitiligo and matched controls without vitiligo. |
| Risk of Depressive Episodes Within Adult Patients With Vitiligo | Within two years of vitiligo diagnosis. For matched controls, within two years of the date of diagnosis of their matched case. | Adjusted hazard ratio calculated using Cox proportional hazards models |
| Number of Participants With Anxiety Disorder | At the time of diagnosis in all people diagnosed with vitiligo 2004-2020 inclusive. For matched controls, the date of diagnosis of their matched case. | Prevalence of common mental health conditions (Anxiety Disorder) in adult people diagnosed with vitiligo and matched controls without vitiligo. |
| Number of Participants With Recurrent Depressive Disorder | At the time of diagnosis in all people diagnosed with vitiligo 2004-2020 inclusive. For matched controls, the date of diagnosis of their matched case. | Prevalence of common mental health conditions (Recurrent Depressive Disorder) in adult people diagnosed with vitiligo and matched controls without vitiligo. |
| Risk of Anxiety Disorder Within Adult Patients With Vitiligo | Within two years of vitiligo diagnosis. For matched controls, within two years of the date of diagnosis of their matched case. | Adjusted hazard ratio calclulated using Cox Proportional hazard models |
| Risk of Recurrent Depressive Disorder Within Adult Patients With Vitilgo | Within two years of vitiligo diagnosis. For matched controls, within two years of the date of diagnosis of their matched case. | Adjusted hazard ratio calculated using Cox proportional hazards models. Adjusted for age, gender, ethnicity, social deprivation quintile, body mass index, smoking status, alcohol use and comorbidities (hypertension, hyperlipidaemia, type 2 diabetes, atrial fibrillation, angina, myocardial infarction, heart failure, stroke, chronic kidney disease stages 3-5, chronic obstructive pulmonary disease, asthma, chronic liver disease and dementia). |
Countries
United Kingdom
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Cases Patients with a confirmed diagnosis of Vitiligo within the study period will be included as cases for analysis. | 7,224 |
| Controls The controls will be defined by matching cases with people who have never been diagnosed with vitiligo either prior to or during the study period, by age and sex, at General Practice level. | 28,880 |
| Total | 36,104 |
Baseline characteristics
| Characteristic | Cases | Controls | Total |
|---|---|---|---|
| Age, Continuous | 44 years | 44 years | 44 years |
| Age, Customized Age group, years 18-29 | 1377 Participants | 5534 Participants | 6911 Participants |
| Age, Customized Age group, years 30-39 | 1526 Participants | 6087 Participants | 7613 Participants |
| Age, Customized Age group, years 40-49 | 1463 Participants | 5822 Participants | 7285 Participants |
| Age, Customized Age group, years 50-59 | 1251 Participants | 5006 Participants | 6257 Participants |
| Age, Customized Age group, years 60-69 | 918 Participants | 3647 Participants | 4565 Participants |
| Age, Customized Age group, years 70-76 | 534 Participants | 2155 Participants | 2689 Participants |
| Age, Customized Age group, years 80+ | 155 Participants | 629 Participants | 784 Participants |
| Alcohol use, Categorical Alcoholism | 116 Participants | 499 Participants | 615 Participants |
| Alcohol use, Categorical Excess use | 970 Participants | 3604 Participants | 4574 Participants |
| Alcohol use, Categorical Non-drinker | 2438 Participants | 8984 Participants | 11422 Participants |
| Alcohol use, Categorical Not recorded | 901 Participants | 4692 Participants | 5593 Participants |
| Alcohol use, Categorical Safe use | 2799 Participants | 11101 Participants | 13900 Participants |
| Body Mass Index, Categorical 18.5-24.9 Healthy weight | 2129 Participants | 7544 Participants | 9673 Participants |
| Body Mass Index, Categorical <18.5 Underweight | 174 Participants | 670 Participants | 844 Participants |
| Body Mass Index, Categorical 25-29.9 Overweight | 2282 Participants | 8511 Participants | 10793 Participants |
| Body Mass Index, Categorical 30-34.9 Class I obesity | 1080 Participants | 4316 Participants | 5396 Participants |
| Body Mass Index, Categorical 35-39.9 Class II obesity | 367 Participants | 1674 Participants | 2041 Participants |
| Body Mass Index, Categorical >40 Class III obesity | 211 Participants | 1013 Participants | 1224 Participants |
| Body Mass Index, Categorical Not recorded | 981 Participants | 5152 Participants | 6133 Participants |
| Race/Ethnicity, Customized Asian or Asian British | 1060 Participants | 3200 Participants | 4260 Participants |
| Race/Ethnicity, Customized Black, African, Caribbean or Black British | 170 Participants | 556 Participants | 726 Participants |
| Race/Ethnicity, Customized Missing | 1966 Participants | 8769 Participants | 10735 Participants |
| Race/Ethnicity, Customized Mixed | 66 Participants | 238 Participants | 304 Participants |
| Race/Ethnicity, Customized Not stated | 199 Participants | 949 Participants | 1148 Participants |
| Race/Ethnicity, Customized Other | 259 Participants | 1155 Participants | 1414 Participants |
| Race/Ethnicity, Customized White | 3504 Participants | 14013 Participants | 17517 Participants |
| Sex: Female, Male Female | 3828 Participants | 15304 Participants | 19132 Participants |
| Sex: Female, Male Male | 3396 Participants | 13576 Participants | 16972 Participants |
| Smoking Status, Categorical Current smoker | 1147 Participants | 5881 Participants | 7028 Participants |
| Smoking Status, Categorical Ex-smoker | 3521 Participants | 12862 Participants | 16383 Participants |
| Smoking Status, Categorical Non-smoker | 2357 Participants | 8629 Participants | 10986 Participants |
| Smoking Status, Categorical Not recorded | 169 Participants | 1431 Participants | 1600 Participants |
| Smoking Status, Categorical Passive smoker | 30 Participants | 77 Participants | 107 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Number of Participants With Anxiety Disorder
Prevalence of common mental health conditions (Anxiety Disorder) in adult people diagnosed with vitiligo and matched controls without vitiligo.
Time frame: At the time of diagnosis in all people diagnosed with vitiligo 2004-2020 inclusive. For matched controls, the date of diagnosis of their matched case.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Cases | Number of Participants With Anxiety Disorder | 569 Participants |
| Controls | Number of Participants With Anxiety Disorder | 2031 Participants |
Primary
Number of Participants With Depressive Episodes
Prevalence of common mental health conditions (depressive episodes) in adult people diagnosed with vitiligo and matched controls without vitiligo.
Time frame: At the time of diagnosis in all people diagnosed with vitiligo 2004-2020 inclusive. For matched controls, the date of diagnosis of their matched case.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Cases | Number of Participants With Depressive Episodes | 1018 Participants |
| Controls | Number of Participants With Depressive Episodes | 4007 Participants |
Primary
Number of Participants With Recurrent Depressive Disorder
Prevalence of common mental health conditions (Recurrent Depressive Disorder) in adult people diagnosed with vitiligo and matched controls without vitiligo.
Time frame: At the time of diagnosis in all people diagnosed with vitiligo 2004-2020 inclusive. For matched controls, the date of diagnosis of their matched case.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Cases | Number of Participants With Recurrent Depressive Disorder | 1093 Participants |
| Controls | Number of Participants With Recurrent Depressive Disorder | 4305 Participants |
Primary
Risk of Anxiety Disorder Within Adult Patients With Vitiligo
Adjusted hazard ratio calclulated using Cox Proportional hazard models
Time frame: Within two years of vitiligo diagnosis. For matched controls, within two years of the date of diagnosis of their matched case.
Population: Patients with a pre-existing diagnosis of anxiety disorder were excluded from the analysis
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Cases | Risk of Anxiety Disorder Within Adult Patients With Vitiligo | 122 Participants |
| Controls | Risk of Anxiety Disorder Within Adult Patients With Vitiligo | 382 Participants |
95% CI: [1.01, 1.51]
Primary
Risk of Depressive Episodes Within Adult Patients With Vitiligo
Adjusted hazard ratio calculated using Cox proportional hazards models
Time frame: Within two years of vitiligo diagnosis. For matched controls, within two years of the date of diagnosis of their matched case.
Population: Patients with a pre-existing diagnosis of depressive episodes were excluded from this analysis
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Cases | Risk of Depressive Episodes Within Adult Patients With Vitiligo | 157 Participants |
| Controls | Risk of Depressive Episodes Within Adult Patients With Vitiligo | 501 Participants |
95% CI: [0.92, 1.32]
Primary
Risk of Recurrent Depressive Disorder Within Adult Patients With Vitilgo
Adjusted hazard ratio calculated using Cox proportional hazards models. Adjusted for age, gender, ethnicity, social deprivation quintile, body mass index, smoking status, alcohol use and comorbidities (hypertension, hyperlipidaemia, type 2 diabetes, atrial fibrillation, angina, myocardial infarction, heart failure, stroke, chronic kidney disease stages 3-5, chronic obstructive pulmonary disease, asthma, chronic liver disease and dementia).
Time frame: Within two years of vitiligo diagnosis. For matched controls, within two years of the date of diagnosis of their matched case.
Population: Patients with a pre-existing diagnosis of recurrent depressive disorder were excluded from the analysis
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Cases | Risk of Recurrent Depressive Disorder Within Adult Patients With Vitilgo | 113 Participants |
| Controls | Risk of Recurrent Depressive Disorder Within Adult Patients With Vitilgo | 312 Participants |
95% CI: [1.01, 1.56]