Anxiety, depression, and quality of life in children and adults with alopecia areata: A systematic review and meta-analysis

Abstract

IntroductionAlopecia areata (AA) is a non-scarring hair loss condition, subclassified into AA, alopecia universalis, and alopecia totalis. There are indications that people with AA experience adverse psychosocial outcomes, but previous studies have not included a thorough meta-analysis and did not compare people with AA to people with other dermatological diagnoses. Therefore, the aim of this systematic review and meta-analysis was to update and expand previous systematic reviews, as well as describing and quantifying levels of anxiety, depression, and quality of life (QoL) in children and adults with AA.MethodsA search was conducted, yielding 1,249 unique records of which 93 were included.ResultsReview results showed that people with AA have higher chances of being diagnosed with anxiety and/or depression and experience impaired QoL. Their psychosocial outcomes are often similar to other people with a dermatological condition. Meta-analytic results showed significantly more symptoms of anxiety and depression in adults with AA compared to healthy controls. Results also showed a moderate impact on QoL. These results further highlight that AA, despite causing little physical impairments, can have a significant amount on patients’ well-being.DiscussionFuture studies should examine the influence of disease severity, disease duration, remission and relapse, and medication use to shed light on at-risk groups in need of referral to psychological care.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022323174].

Comparing quality of life, anxiety, depression, sleep disturbance, and associated factors in vitiligo and alopecia areata patients

“…Despite the fact that previous studies have suggested that women with vitiligo or AA experience lower QoL than men, 28,29 we did not find any gender‐related differences in QoL in either vitiligo or AA subjects. Notably, our finding is compatible with the results of van Dalen et al 23 . research on AA and Al‐Shammari et al 24 .…”

Establishing the financial burden of alopecia areata and its predictors

“…Living with AA can also have deleterious consequences on psychosocial wellbeing, owing predominantly to its visible impact on appearance. 3 To manage the change in appearance, many use strategies to conceal or camouflage their hair loss. Wigs, for example, can reduce fear of negative evaluation from others and improve social confidence, 4 and can therefore be considered an orthotic for those choosing to use them.…”

“…Hair loss from AA typically begins with small patches on the scalp but can progress to its more severe forms involving total scalp (alopecia totalis) and body (alopecia universalis) hair loss. Living with AA can also have deleterious consequences on psychosocial wellbeing, owing predominantly to its visible impact on appearance 3 …”

“…Living with AA can also have deleterious consequences on psychosocial wellbeing, owing predominantly to its visible impact on appearance. 3 …”

Peer-Recommended Coping Strategies for Individuals Living With Alopecia Areata

“…However, an "it's just hair" perspective fails to consider the elevated levels of suffering and significant impact on quality of life (QOL) reported by many living with AA (Rencz et al, 2016). The existing research has shown that people with AA are at a significantly high risk of experiencing stigma (Schielein et al, 2020) and developing complex psychological problems, including self-esteem issues, anxiety, depression, and an increased risk of suicidality (e.g., Davey et al, 2019;Layegh et al, 2010;Hunt & McHale, 2005;van Dalen et al, 2022). For instance, Lee et al (2019) found that among people living with AA, 27.1% reported the presence of anxiety and 18.9% reported a diagnosis of depression.…”