Abstract
Alopecia areata (AA) is a nonscarring alopecia with an autoimmune etiology, unpredictable course, multiple presentations, and variable psychological distress. We conducted a cross-sectional study which included 126 patients with AA. A complete medical history was documented using the Severity Alopecia Tool (SALT) to assess the severity of the disease, and the following questionnaires were applied to the participants: the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), Plutchik Suicide Risk Scale, and the Perceived Stress Scale (PSS-14) for adults. The Child Dermatology Life Quality Index (cDLQI) and the Birleson Depression Self-Rating Scale questionnaires were applied for children. Quality of life (QoL) disturbance was detected in 77.6% of adult participants, 65.9% of them had signs of depression or anxiety, and 12.8% were at risk of committing suicide. The PSS-14 average score for adults was 24.5. QoL disturbance was detected in 76.7% of children participants, and 6.3% of them showed signs of depression with the Birleson Depression Self-Rating Scale. We conclude that patients with AA could experience changes in their QoL and signs of depression, anxiety, and suicide risk, mainly in the adult population, during the course of the disease.
References
1.
Rajabi
F
, Drake
LA
, Senna
MM
, Rezaei
N
. Alopecia areata: a review of disease pathogenesis
. Br J Dermatol
. 2018
Nov
;179
(5
):1033
–48
.
[PubMed]
0007-09632.
3.
Salazar
NM
, Arias
SS
, Buendia-Eisman
A
. Concepto, epidemiología y etioptogenia de la alopecia areata
. Med Cutan Ibero Lat Am
. 2014
;42
:4
–6
.0210-51874.
Safavi
KH
, Muller
SA
, Suman
VJ
, Moshell
AN
, Melton
LJ
3rd. Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989
. Mayo Clin Proc
. 1995
Jul
;70
(7
):628
–33
.
[PubMed]
0025-61965.
Korta
DZ
, Christiano
AM
, Bergfeld
W
, Duvic
M
, Ellison
A
, Fu
J
, et al. Alopecia areata is a medical disease
. J Am Acad Dermatol
. 2018
Apr
;78
(4
):832
–4
.
[PubMed]
0190-96226.
Tosti
A
, Bellavista
S
, Iorizzo
M
. Alopecia areata: a long term follow-up study of 191 patients
. J Am Acad Dermatol
. 2006
Sep
;55
(3
):438
–41
.
[PubMed]
0190-96227.
Messenger
AG
, McKillop
J
, Farrant
P
, McDonagh
AJ
, Sladden
M
. British Association of Dermatologists’ guidelines for the management of alopecia areata 2012
. Br J Dermatol
. 2012
May
;166
(5
):916
–26
.
[PubMed]
0007-09638.
Gupta
MA
, Gupta
AK
. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis
. Br J Dermatol
. 1998
Nov
;139
(5
):846
–50
.
[PubMed]
0007-09639.
Karia
SB
, De Sousa
A
, Shah
N
, Sonavane
S
, Bharati
A
. Psychiatric morbidity and quality of life in skin diseases: A comparison of alopecia areata and psoriasis
. Ind Psychiatry J
. 2015
Jul-Dec
;24
(2
):125
–8
.
[PubMed]
0972-674810.
Finlay
AY
, Khan
GK
. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use
. Clin Exp Dermatol
. 1994
May
;19
(3
):210
–6
.
[PubMed]
0307-693811.
Zigmond
AS
, Snaith
RP
. The hospital anxiety and depression scale
. Acta Psychiatr Scand
. 1983
Jun
;67
(6
):361
–70
.
[PubMed]
0001-690X12.
Wen
L
, Jiang
G
, Zhang
X
, Lai
R
, Wen
X
. Relationship between acne and psychological burden evaluated by ASLEC and HADS surveys in high school and college students from central China
. Cell Biochem Biophys
. 2015
Mar
;71
(2
):1083
–8
.
[PubMed]
1085-919513.
Ivarsson
T
, Gillberg
C
. Depressive symptoms in Swedish adolescents: normative data using the Birleson Depression Self-Rating Scale (DSRS)
. J Affect Disord
. 1997
Jan
;42
(1
):59
–68
.
[PubMed]
0165-032714.
Tapia
D
, Cruz
C
, Gallardo
I
, Dasso
M
. Adaptación de la escala de percepción global de stress (EPGE) en estudiantes adultos de escasos recursos en Santiago, Chile
. Rev Psiquiatr Salud Ment
. 2007
;24
(1
):109
–19
.1888-989115.
Ramírez
MT
, Hernández
RL
. Factor structure of the Perceived Stress Scale (PSS) in a sample from Mexico
. Span J Psychol
. 2007
May
;10
(1
):199
–206
.
[PubMed]
1138-741616.
You
HR
, Kim
SJ
. Factors Associated with Severity of Alopecia Areata
. Ann Dermatol
. 2017
Oct
;29
(5
):565
–70
.
[PubMed]
1013-908717.
Conic
RZ
, Miller
R
, Piliang
M
, Bergfeld
W
, Atanaskova Mesinkovska
N
. Comorbidities in patients with alopecia areata
. J Am Acad Dermatol
. 2017
Apr
;76
(4
):755
–7
.
[PubMed]
0190-962218.
Liu
LY
, King
BA
, Craiglow
BG
. Alopecia areata is associated with impaired health-related quality of life: A survey of affected adults and children and their families
. J Am Acad Dermatol
. 2018
Sep
;79
(3
):556
–558.e1
.
[PubMed]
0190-962219.
Rencz
F
, Gulácsi
L
, Péntek
M
, Wikonkál
N
, Baji
P
, Brodszky
V
. Alopecia areata and health-related quality of life: a systematic review and meta-analysis
. Br J Dermatol
. 2016
Sep
;175
(3
):561
–71
.
[PubMed]
0007-096320.
Baghestani
S
, Zare
S
, Seddigh
SH
. Severity of depression and anxiety in patients with alopecia areata in Bandar Abbas, Iran
. Dermatol Rep
. 2015
Dec
;7
(3
):6063
.
[PubMed]
2036-739221.
Kim
JM
, Kim
HS
, Ko
HC
, Kim
BS
, Kim
MB
. Analysis of personality trait in patients with alopecia areata
. Ann Dermatol
. 2017
Dec
;29
(6
):815
–6
.
[PubMed]
1013-908722.
Bilgiç
Ö
, Bilgiç
A
, Bahalı
K
, Bahali
AG
, Gürkan
A
, Yılmaz
S
. Psychiatric symptomatology and health-related quality of life in children and adolescents with alopecia areata
. J Eur Acad Dermatol Venereol
. 2014
Nov
;28
(11
):1463
–8
.
[PubMed]
0926-995923.
Christensen
T
, Yang
JS
, Castelo-Soccio
L
. Bullying and quality of life in pediatric alopecia areata
. Skin Appendage Disord
. 2017
Aug
;3
(3
):115
–8
.
[PubMed]
2296-919524.
Sinclair
RD
. Alopecia areata and suicide of children
. Med J Aust
. 2014
Feb
;200
(3
):145
.
[PubMed]
0025-729X25.
Huang
KP
, Mullangi
S
, Guo
Y
, Qureshi
AA
. Autoimmune, atopic, and mental health comorbid conditions associated with alopecia areata in the United States
. JAMA Dermatol
. 2013
Jul
;149
(7
):789
–94
.
[PubMed]
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2019
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