Background:
Alopecia areata (AA) may be related to stress and has been reported to be
associated with psychiatric disorders. Nevertheless, a nationwide study of the
relationship between AA and comorbid psychiatric diseases has not been
conducted, and the effect of onset age has rarely been reported.
Objectives:
The aim of this study is to analyze the associations between AA and various
psychiatric disorders using a nationwide database in Taiwan.
Methods:
Data were obtained from the National Health Insurance Research Database of
Taiwan from 2000 to 2009. A total of 5,117 AA patients and 20,468 age-,
gender-matched controls were enrolled. Results: Patients with AA tended to have
more coexisting anxiety and less comorbid schizophrenia. Differences in ages of
onset revealed differences in comorbidities.
Increased risk of depression (odds ratio [OR] = 2.23, 95% confidence interval
[CI]1.09-4.54) was found in AA patients aged less than 20 years. Increased rate
of anxiety (OR = 1.43, CI 1.15-1.77) was observed with AA onset between the ages
of 20 and 39.
The highest odds of obsessive-compulsive disorder (OR = 3.00, CI 1.11-8.12) and
anxiety (OR = 2.05, CI 1.56-2.68) were observed in AA patients aged 40 to 59.
Moreover, about 50 percent of psychiatric disorders occurred earlier than AA.
Conclusions:
AA is related to various psychiatric disorders. Onset age of AA is an important
factor in the association with different comorbid psychiatric diseases. In
addition to cosmetic impact which may bring about anxiety or depression, stress-neuroendocrine-immunology
may play an important role in the pathogenesis of both AA and psychiatric
disorders.
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