title: Objective vs. subjective factors in the psychological impact of vitiligo: the experience from a French referral centre.
abstract: BACKGROUND
  Vitiligo affects around 0.5% of the population. The burden of disease perceived by patients seems to be underestimated by the medical community.
  
  
  OBJECTIVE
  To analyse the impact of objective and psychological factors on the quality of life (QoL) and self-body image of patients with vitiligo.
  
  
  METHODS
  Demographic data, medical information and psychological factors (perceived severity, trait anxiety, trait depression, trait self-esteem, body image and QoL) were prospectively collected for all patients.
  
  
  RESULTS
  Forty-eight patients with a mean age of 43.9 years were included in the study. Vitiligo caused overall a moderate effect on patients' QoL with a 7.17 Dermatology Life Quality Index (DLQI) mean score (out of 30) without correlation with gender. According to distribution, no or minimal (DLQI 0-1), mild (2-5), moderate (6-11) and severe (12-20) impairment of QoL was found in five (10%), 14 (29%), 18 (38%) and 11 (23%) patients, respectively. The mean perceived severity evaluated by the patients was 4.91 based on visual analogue scale from 0 to 10. The self-body image was influenced by gender, perceived severity and disease characteristics. Perceived severity and patient personality were predictors of QoL impairment. Perceived severity of vitiligo was explained mainly by the patients' personality and less significantly by objective criteria.
  
  
  CONCLUSIONS
  Subjective as well as objective factors should be included in the assessment of disease severity and follow-up of patients with vitiligo. A simple perceived severity scale is useful in clinical practice.
authors.affiliation: Centre de Référence des Maladies Rares de la Peau, Service de Dermatologie, Hôpital Saint André, Bordeaux 33075, France.
authors.forename: P
authors.initials: P
authors.lastname: Kostopoulou
authors.forename: T
authors.initials: T
authors.lastname: Jouary
authors.forename: B
authors.initials: B
authors.lastname: Quintard
authors.forename: K
authors.initials: K
authors.lastname: Ezzedine
authors.forename: S
authors.initials: S
authors.lastname: Marques
authors.forename: S
authors.initials: S
authors.lastname: Boutchnei
authors.forename: A
authors.initials: A
authors.lastname: Taieb
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014820:Vitiligo / Q000523:psychology*; D055815:Young Adult