Heterogeneity in Depression and Suicidality Risk Among Vitiligo Patients: A Meta‐Analysis of Adolescent Complexity and Subgroup Stratification

ABSTRACT

Patients with vitiligo are known to have a markedly increased burden of psychological comorbidities compared with the general population. However, a comprehensive and up‐to‐date assessment of the association between vitiligo, depression, and suicidality is lacking. This study aimed to quantitatively evaluate the association between vitiligo and the risks of depression and suicidality. A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted from inception to 25 July 2025. Pooled odds ratios (ORs) and standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were calculated. Seventy‐three studies were included. The pooled prevalence of depression among patients with vitiligo was 0.37 (95% CI, 0.30–0.45). Compared with non‐vitiligo controls, vitiligo patients exhibited significantly higher risks of depression (OR = 1.60, 95% CI [1.05, 2.43]) and suicide‐related outcomes (OR = 1.22, 95% CI [1.05, 1.41]), with suicidal ideation showing the greatest increase (OR = 2.05, 95% CI [1.08, 3.90]). However, the unadjusted preliminary analysis of continuous depression scores showed an increase, but it was not significant after publication bias correction. Female patients represented a particularly vulnerable subgroup, whereas adolescent patients showed a dual risk profile depending on the reference group: compared with age‐matched non‐vitiligo controls, adolescents with vitiligo had a significantly higher risk of depression (OR = 2.84); however, within the vitiligo patient population, adolescents showed a lower depression risk than adult patients (OR = 0.20). The risk of depression was higher than that in the general population but lower than that observed in psoriasis. Vitiligo is significantly associated with elevated risks of depression and suicidality. These findings highlight the need for heightened clinical awareness and integrated psychological care to improve patients' overall well‐being and quality of life.