British Journal of Dermatology

<jats:title>Abstract</jats:title>
               <jats:sec>
                  <jats:title>Background</jats:title>
                  <jats:p>Alopecia areata (AA) can significantly impact patients’ quality of life (QoL) and mental health, leading to increased levels of anxiety and depression. It is unclear whether this impact is more strongly associated with disease severity or patients’ disease perception, and which patients are more likely to have a greater psychological burden.</jats:p>
               </jats:sec>
               <jats:sec>
                  <jats:title>Objectives</jats:title>
                  <jats:p>To examine the psychosocial impact of AA, while focusing on illness perceptions and stigma, aiming to identify high-risk subgroups and key perceptions linked to worse QoL, anxiety and depression.</jats:p>
               </jats:sec>
               <jats:sec>
                  <jats:title>Methods</jats:title>
                  <jats:p>This was a UK cross-sectional online study. It comprised 596 patients with AA who self-reported disease severity and completed the Dermatology Life Quality Index (DLQI), EuroQol 5-Dimensional 5-Level (EQ-5D-5L), Hospital Anxiety and Depression Scale (HADS), Stigma Scale for Chronic Illnesses 8-Item (SSCI-8) and Brief Illness Perception Questionnaire (BIPQ).</jats:p>
               </jats:sec>
               <jats:sec>
                  <jats:title>Results</jats:title>
                  <jats:p>Patients with AA perceived their condition as chronic and life-impacting, with limited personal or treatment control, significant emotional effects and high concern. Many patients reported high levels of anxiety, depression, stigma and impaired QoL, all strongly associated with illness perceptions. Hierarchical regression analyses showed that illness perceptions and stigma explained a higher proportion of variance in QoL, anxiety and depression than disease severity. Cluster analysis identified two distinct patient groups based on illness perceptions, with different levels of QoL, anxiety, depression and stigma.</jats:p>
               </jats:sec>
               <jats:sec>
                  <jats:title>Conclusions</jats:title>
                  <jats:p>AA has a severe psychosocial impact, more strongly linked to patients’ illness perceptions and stigma than disease severity. The identification of two distinct patient profiles based on illness perceptions reveals differences in psychosocial burden, highlighting those at risk of worse outcomes and underscoring the value of evaluating illness perceptions along with stigma in clinical practice to improve patient outcomes.</jats:p>
               </jats:sec>

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Alopecia areata (AA) can significantly impact patients' quality of life (QoL) and mental health, leading to increased levels of anxiety and depression. It is unclear whether this impact is more strongly associated with disease severity or patients' disease perception, and which patients are more likely to have a greater psychological burden.
To examine the psychosocial impact of AA, while focusing on illness perceptions and stigma, aiming to identify high-risk subgroups and key perceptions linked to worse QoL, anxiety and depression.
This was a UK cross-sectional online study. It comprised 596 patients with AA who self-reported disease severity and completed the Dermatology Life Quality Index (DLQI), EuroQol 5-Dimensional 5-Level (EQ-5D-5L), Hospital Anxiety and Depression Scale (HADS), Stigma Scale for Chronic Illnesses 8-Item (SSCI-8) and Brief Illness Perception Questionnaire (BIPQ).
Patients with AA perceived their condition as chronic and life-impacting, with limited personal or treatment control, significant emotional effects and high concern. Many patients reported high levels of anxiety, depression, stigma and impaired QoL, all strongly associated with illness perceptions. Hierarchical regression analyses showed that illness perceptions and stigma explained a higher proportion of variance in QoL, anxiety and depression than disease severity. Cluster analysis identified two distinct patient groups based on illness perceptions, with different levels of QoL, anxiety, depression and stigma.
AA has a severe psychosocial impact, more strongly linked to patients' illness perceptions and stigma than disease severity. The identification of two distinct patient profiles based on illness perceptions reveals differences in psychosocial burden, highlighting those at risk of worse outcomes and underscoring the value of evaluating illness perceptions along with stigma in clinical practice to improve patient outcomes.
Alopecia areata (AA) is an autoimmune skin disease. It causes unpredictable nonscarring hair loss on the scalp and other parts of the body. AA affects about 2.1% of people over their lifetime. Our UK-based online study looked at how AA impacts a person’s mental health and quality of life (QoL). We wanted to study whether these effects relate more to disease severity or a person’s perceptions. We analysed responses from 596 patients with AA. They rated their disease severity and completed several questionnaires. We found that patients with AA view their condition as a chronic, life-impacting condition. They also believed they had limited control over its progression. Many people reported high levels of anxiety, depression and stigma, and reduced QoL. These findings were strongly linked with their personal views of the condition. We found that people's perceptions of AA and stigma had a stronger effect on their mental health and QoL than disease severity. We also identified two distinct patient groups based on their personal views of the illness. These groups differed in their levels of anxiety, depression, stigma and QoL. Our study findings suggest that healthcare professionals should assess patients’ illness perceptions and stigma when treating AA. This could help reduce the psychosocial impact of AA and improve patient outcomes.

Psychosocial burden and the impact of illness perceptions and stigma on quality of life, anxiety and depression in alopecia areata: results from the Alopecia + Me study.

Psychosocial burden and the impact of illness perceptions and stigma on quality of life, anxiety and depression in alopecia areata: results from the Alopecia + Me study

Psychosocial burden and the impact of illness perceptions and stigma on quality of life, anxiety and depression in alopecia areata: results from the Alopecia + Me study

Clinical Summary

What was studied

Key findings

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