The associated burden of mental health conditions in alopecia areata: A population-based study in UK primary care

Macbeth, Abby E., Holmes, Susan, Harries, Matthew, Chiu, Wing Sin, Tziotzios, Christos, de Lusignan, Simon, Messenger, Andrew G. and Thompson, Andrew R. ORCID: https://orcid.org/0000-0001-6788-7222 2022. The associated burden of mental health conditions in alopecia areata: A population-based study in UK primary care. British Journal of Dermatology 187 (1) , pp. 73-81. 10.1111/bjd.21055

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Abstract

Background Alopecia areata (AA) is a common cause of non-scarring hair loss that can have a profound psychological impact. Objective To assess the co-occurrence of depression and anxiety in adults with AA compared to the general population, and evaluate the mental health treatment burden and impact on time-off work and unemployment. Methods 5,435 people with newly-diagnosed AA in UK primary care were identified from the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database, and matched to 21,740 controls. In cases and controls, we compared prevalence and incidence of depressive episodes (DE), recurrent depressive disorder (RDD) and anxiety disorder (AD), rates of time off work and unemployment, and, in those with pre-existing mental health conditions, rates of mental health related prescribing and referral rates. Results Depression and anxiety were more prevalent in people diagnosed with AA compared to controls (p<0.001). People with AA were also more likely to subsequently develop new onset depression and anxiety (adjusted hazard ratio [aHR] DE 1.38 [95%CI 1.13-1.69], RDD aHR 1.30 [95%CI 1.04-1.62], AD aHR 1.33 [95%CI 1.09-1.63]), be issued time-off work certificates (aHR 1.56, 95%CI 1.43-1.71), and be recorded as unemployed (aHR 1.82, 95%CI 1.33-2.49). Higher rates of antidepressant prescribing were also seen in people with AA. Conclusion People with AA have higher rates of depression and anxiety than those without AA. This impacts deleteriously on mental health treatment burden, time-off work, and unemployment. Evidence-based mental health treatment programs are needed for people with AA.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Psychology
Publisher:	Wiley
ISSN:	0007-0963
Date of First Compliant Deposit:	10 February 2022
Date of Acceptance:	8 February 2022
Last Modified:	03 May 2023 11:10
URI:	https://orca.cardiff.ac.uk/id/eprint/147376

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