Roles of Stress, Stress Perception and Trait‐Anxiety in the Onset and Course of Alopecia Areata

Abstract

Clinical observations suggest that the nervous system, including psychological factors, can influence the onset and course of alopecia areata (AA). The aim of this study was to determine whether stressful life events, stress perception, and trait-anxiety are risk factors in the onset and course of AA. A group of 45 patients diagnosed with AA and a group of 45 healthy controls were participants in the study. The patients with AA were divided into two subgroups: patients with a first episode of AA and patients with recidivism of the disease. All participants completed questionnaires addressing sociodemographic, clinical and psychological aspects of their disorder. The frequency and types of stressful life events experienced over the previous six months were recorded. Lemyre and Tessier's Mesure de Stress Psychologique was used to measure emotional, cognitive, behavioral, and physiological aspects of distress. Anxiety was evaluated by the Spielberg's Trait Anxiety Inventory. The subgroups of AA and the control group, using the same numbers of subjects matched for age and sex, education level, marital and employment status, were statistically compared. The number of patients with four stressful life events over the previous 6 months was significantly higher in the group of AA patients with recidivism of disease compared to the control group (P=0.004). There were no differences among the other groups with respect to the frequency of life events. Examination of the relationships between the two groups regarding anxiety, as well as perceived distress, revealed that the groups differed significantly with respect to psychosocial variables studied. A significantly higher degree of trait-anxiety and perceived distress were observed among patients in both AA subgroups (first onset and recidivism of AA) than in the healthy control group. The highest scores for anxiety and stress perception among examined groups were obtained in the group with recidivism of AA (33.42 +/- 12.71 and 90.32 +/- 50.74, respectively). Trait-anxiety and stress perception constitutes risk factors that may influence the onset and exacerbation of AA. The present study does not provide evidence of a significant role of stress in the onset of AA. Life events may play an important role in triggering of some episodes.

Impact of Androgenic Alopecia on the Quality of Life in Male Subjects: Results of an Observational Study from Tertiary Care Hospital

“…However, a study by Brajac in 2003. 8 was unable to establish causal relationship between alopecia areata with stressful life events. 8 Positive family history of alopecia was given by 51% subjects.…”

“…8 was unable to establish causal relationship between alopecia areata with stressful life events. 8 Positive family history of alopecia was given by 51% subjects. Twin studies in males indicate that susceptibility, age of onset, pattern and rate of progression of male pattern baldness are under genetic influence.…”

Physiology, pharmacology, and therapeutic relevance of urocortins in mammals: Ancient CRF paralogs

“…Finally hair follicles are both sources and targets of CRF/Ucn 1 lineage peptides with resulting effects on pigmentation [122,138]. Thus, it has been suggested that disorders such as atopic dermatitis, psoriasis [270], alopecia areata [31,136], and chronic urticaria [200] involve a stress-related precipitation or exacerbation of skin mast cell activation (and possibly other resident skin cells) via local CRF/Ucn 1-CRF receptor signaling.…”

La Alopecia Areata

“…Sin embargo, en la AA estas evidencias han sido circunstanciales (43). Hay autores que muestran relación entre estrés y AA (8,44), y otros que no le conceden significación (45). Existe un volumen importante de trabajos que se ocupa del estrés psicosocial como desencadenante de los brotes.…”