title: Quantification and comparison of psychiatric distress in African patients with albinism and vitiligo: a 5-year prospective study.
abstract: BACKGROUND
  Vitiligo and albinism are two disorders of pigmentation that make the affected African highly visible and strikingly different from their peers. Both pose considerable management challenges, attract significant stigma and profound impairment of quality of life.
  
  
  OBJECTIVE
  To determine and compare psychiatric distress in vitiligo and albinism using the Hospital Anxiety and Depression Scale (HADS). Participants were 87 albinos and 102 vitiligo adult patients seen at an urban tertiary hospital in Nigeria between 2004 and 2009.
  
  
  RESULTS
  Prevalence of psycho morbidity was 59% (60/102) in vitiligo compared with 26% (23/87) in the albinos. The mean anxiety score was estimated to be 2.55 points lower for albino patients (95% CI: 1.47 to 3.64), and the mean depression score 2.76 points lower (95% CI: 1.84 to 3.68), after adjustment for age, sex and marital status. However, significant differences were not observed when comparing the vitiligo patients with the subset of albino patients with skin cancer. Older patients had significantly higher anxiety and depression scores. Females had significantly higher anxiety scores (but not depression scores) compared to males. Genital involvement in vitiligo was significantly associated with anxiety but not depression.
  
  
  CONCLUSIONS
  We found that the African with vitiligo suffers significantly higher psychiatric distress than the African albino on average. Clinical evaluation of these patients would be incomplete without assessment of their psycho morbidity. There is need for increased focus on cancer prevention strategies in the African albino.
authors.affiliation: Consultant Physician Dermatologist, Department of Medicine, Lagos State University College of Medicine, Ikeja LAGOS Nigeria, Lagos, Nigeria.
authors.forename: F O A
authors.initials: FO
authors.lastname: Ajose
authors.forename: R A
authors.initials: RA
authors.lastname: Parker
authors.forename: E L C
authors.initials: EL
authors.lastname: Merrall
authors.forename: A O
authors.initials: AO
authors.lastname: Adewuya
authors.forename: M P
authors.initials: MP
authors.lastname: Zachariah
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000417:Albinism / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011584:Psychology; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D014820:Vitiligo / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D055815:Young Adult