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Objective: To accurately quantify the relationship between the presence of depression or depressive symptoms in patients with vitiligo. Design: Systematic review and meta-analysis.Data sources: A search Of PubMed, Web of Science, and Embase database was performed. Eligibility criteria for selection of studies: Prospective or retrospective cohort or population studies that provide data related to depressive symptoms in normal and vitiligo patients of all ages during the study period. We included English studies published after 2000 to reflect the contemporary real-life situation of depression rates among vitiligo patients.Data extraction and synthesis: Two reviewers independently screened the retrieved citationsand extracted data. Results: A total of 786 articles were included, the full texts of 30 articles were assessed for eligibility (13 case-control, and 17 cross-sectional). Most of these articles are from India, a few from Europe. and the pooled prevalence of depression or depressive symptoms among vitiligo patients was 0.31 (I2=95.0%, p <0.001). The pooled prevalence of depression was higher in patients with vitiligo compared with health control ((OR 10.25 SMD 0.60). Conclusions: Vitiligo patients are more likely to suffer from depression or depressive symptoms, thus clinicians need to manage physical illnesses along with psychiatric issues.

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