ArticlePostepy dermatologii i alergologii2026
Psychological distress statistically mediates the association between vitiligo severity and health-related quality of life: a cross-sectional study from Kandahar, Afghanistan.
Article in Postepy dermatologii i alergologii, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Vitiligo substantially impairs health-related quality of life (HRQoL). However, mechanisms linking disease severity to HRQoL in low-resource and conflict-affected settings remain insufficiently understood. Aim: To assess whether psychological distress mediates the association between vitiligo severity and HRQoL among patients in Kandahar, Afghanistan. Material and methods: In this cross-sectional study, 402 adult patients with vitiligo were recruited from eight dermatology clinics between September 2024 and July 2025. Disease severity was measured using the Vitiligo Area Severity Index (VASI); psychological distress using the General Health Questionnaire-12 (GHQ-12); anxiety using the Hamilton Anxiety Rating Scale (HAM-A); depression using the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16); and HRQoL using the Dermatology Life Quality Index (DLQI). Mediation analysis was performed using a regression-based framework, with indirect effects assessed by the Sobel test. Results: Mean age of the patients was 30.4 ±10.5 years; 59.5% of them screened positive for psychological distress. Vitiligo severity showed a weak correlation with DLQI ( Conclusions: Psychological distress substantially mediates the relationship between vitiligo severity and HRQoL. Integrating routine psychological assessment into dermatologic care may improve patient outcomes in low-resource settings.
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