Chronic medical conditions in children and adolescents have a significant impact on development and quality of life. Children with vitiligo experience depression, anxiety and guilt, body image concerns, and conflicts of acceptance–rejection among peers. Understanding issues of relevance through a developmental perspective is pivotal. Here, we report the experiences of working with an adolescent who presented with depressive symptoms, mood dysregulation, and self-harm, in the background of vitiligo and child sexual abuse. We describe the unique therapeutic challenges, focusing on the interplay between depressive psychopathology, childhood trauma, and normative adolescent development. Therapeutic strategies for patient-centered psychological interventions are discussed. The therapy processes focused on a narrative approach, with the active involvement of the family.

儿童和青少年的慢性疾病对发育和生活质量有重大影响。患有白癜风的儿童会经历抑郁、焦虑和内疚、身体形象问题以及同龄人之间的接受-拒绝冲突。从发展的角度理解相关问题至关重要。在这里，我们报告了在白斑病和儿童性虐待的背景下与出现抑郁症状、情绪失调和自我伤害的青少年一起工作的经历。我们描述了独特的治疗挑战，重点关注抑郁心理病理学、童年创伤和规范的青少年发展之间的相互作用。讨论了以患者为中心的心理干预的治疗策略。治疗过程侧重于叙事方法，