Saraswat Neerja, Shankar Pooja, Chopra Ajay, Kumar Sushil, Mitra Debdeep, Agarwal Reetu
Department of Dermatology, Base Hospital, Delhi Cantt, India.
Department of Community Medicine, ADH, Jabalpur Cantt, India.
Indian J Dermatol. 2020 May-Jun;65(3):183-186. doi: 10.4103/ijd.IJD_378_18.
Alopecia areata (AA) is a common form of nonscarring alopecia characterized by patchy loss of hair from the scalp and body. It is a complex outcome of factors such as autoimmunity, genetic factors, infectious diseases, as well as psychological factors, such as stress, personality type, familial conditions. Around 20% of patients are in the pediatric age group, and 60% of the patients develop AA before the age of 20 years.
The present study looked into the impact of psychosocial factors in AA.
This was a case-control study conducted over a period of 1 year. One hundred and two patients and age and gender-matched control group between the ages of 2 and 14 years were included. A questionnaire was administered to identify the stress arising due to personal or familial conditions, school-related issues, psychotrauma or illness, and accidents prior to developing AA. Age and gender-matched patients with other dermatoses with low psychosomatic component to it and unlikely to be influenced by stress were selected as control.
Fifty-three patients (52 %) were male and 49 were female (48 %). Fifty-five (53.9%) patients were in the age group of 10 to 14 years. Forty (39.2%) children had multiple patches. Onset was <5 months in 30 patients (29.4%). Forty-nine (48%) children reported stress due to school-related issues compared to 13 (12.7%) in the control group. Eighteen (17.6%) children had familial issues compared to 6 (0.05%) in the control group. Nineteen children (18.6%) had multiple stressors. Sixty-nine (67.6%) patients related their disease to a stress component compared to 33 (32.3%) who could not relate to any stress. A significant association was noted between examination pressure and academic performance with onset of AA compared to control ( < 0.05%), which was stronger among female compared to male.
The psychological profile and comorbidities have a significant impact on the onset or recidivism of AA. Impact of a stressful personal or family life, parental pressure to perform better in school, and psychological vulnerability can significantly contribute to the onset or exacerbation of AA.
斑秃（AA）是一种常见的非瘢痕性脱发，其特征为头皮和身体出现斑片状脱发。它是自身免疫、遗传因素、传染病以及心理因素（如压力、性格类型、家庭状况）等多种因素共同作用的复杂结果。约20%的患者为儿童年龄组，60%的患者在20岁之前发病。
本研究探讨心理社会因素对斑秃的影响。
这是一项为期1年的病例对照研究。纳入了102例年龄在2至14岁之间的患者以及年龄和性别匹配的对照组。通过问卷调查来确定在患斑秃之前因个人或家庭状况、学校相关问题、心理创伤或疾病以及意外事故所产生的压力。选择年龄和性别匹配的、心身因素较低且不太可能受压力影响的其他皮肤病患者作为对照。
53例（52%）患者为男性，49例（48%）为女性。55例（53.9%）患者年龄在10至14岁之间。40例（39.2%）儿童有多处脱发斑。30例（29.4%）患者发病时间小于5个月。49例（48%）儿童报告因学校相关问题感到压力，而对照组为13例（12.7%）。18例（17.6%）儿童有家庭问题，而对照组为6例（0.05%）。19例儿童（18.6%）有多种压力源。69例（67.6%）患者将其疾病与压力因素相关联，而33例（32.3%）患者认为与任何压力无关。与对照组相比，考试压力和学业成绩与斑秃发病之间存在显著关联（<0.05%），女性比男性更明显。
心理状况和合并症对斑秃的发病或复发有显著影响。紧张的个人或家庭生活、父母对在学校取得更好成绩的压力以及心理易损性对斑秃的发病或加重有显著影响。
