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Oiwoh SO, Enitan AO, Adegbosin OT, Akinboro AO, Onayemi EO. Androgenetic Alopecia: A Review. Niger Postgrad Med J 2024; 31:85-92. [PMID: 38826011 DOI: 10.4103/npmj.npmj_47_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
This study reviewed the current knowledge on the epidemiology, pathophysiology, clinical presentations, diagnosis, treatment, quality-of-life assessment and recent trends in androgenetic alopecia (AGA). Relevant articles on AGA from PubMed, Google Scholar, Medline and Scopus from 1950 to 2024 were obtained and scrutinized.. Key search words included each term like 'androgenetic alopecia', 'androgenic alopecia', 'pattern baldness' and 'pattern hair loss' AND each term like 'epidemiology', 'pathophysiology', 'genetics', 'hormones', 'micronutrient', 'stress and inflammation', 'growth factors', 'clinical features', 'staging', 'cardiovascular associations', 'diagnosis' and 'management' were used in the search. AGA is a non-scarring hair loss that is exemplified by a progressive decline of hair follicles, or non-functional or dead hair follicles in the scalp in a defined pattern. It is the most common hair loss, more common in men but can also present in younger age as premature AGA. Hormones, genetics, micronutrient deficiency, microinflammation and stress have been implicated, while psychosocial distress and cutaneous correlate of cardiovascular diseases have become sources of relentless research. AGA is a patterned hair loss that is more prevalent in Men. It results from the interactions between hormonal, genetic and other factors which determine the extent of hair loss and associated disorders (psychosocial and cardiovascular). As results of more research become available, the extent of AGA, its comorbidities as well as the full spectrum of their manifestations will continue to be sources of health education and more holistic examination by dermatologists and patients.
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Affiliation(s)
- Sebastine Oseghae Oiwoh
- Department of Internal Medicine, Dermatology and Venereology Unit, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ademola Olusegun Enitan
- Department of Dermatology and Venereology, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria
| | | | - Adeolu Oladayo Akinboro
- Department of Medicine, Dermatology and Venereology Unit, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Emmanuel Olaniyi Onayemi
- Department of Dermatology and Venereology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
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Lee JY, Kim CH, Lee WS. Relationship between Illness Behavior and Hair Loss Pattern According to the Basic and Specific (BASP) Classification. Ann Dermatol 2023; 35:318-320. [PMID: 37550233 PMCID: PMC10407333 DOI: 10.5021/ad.21.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/28/2021] [Accepted: 11/23/2021] [Indexed: 08/09/2023] Open
Affiliation(s)
- Ju Yeong Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Chunk Hyeok Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Henne SK, Nöthen MM, Heilmann-Heimbach S. Male-pattern hair loss: Comprehensive identification of the associated genes as a basis for understanding pathophysiology. MED GENET-BERLIN 2023; 35:3-14. [PMID: 38835416 PMCID: PMC10842561 DOI: 10.1515/medgen-2023-2003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Male-pattern hair loss (MPHL) is a highly heritable and prevalent condition that is characterized by progressive hair loss from the frontotemporal and vertex scalp. This androgen-dependent hair loss may commence during puberty, and up to 80 % of European men experience some degree of MPHL during their lifetime. Current treatment options for MPHL have limited efficacy, and improved understanding of the underlying biological causes is required to facilitate novel therapeutic approaches. To date, molecular genetic studies have identified 389 associated genomic regions, have implicated numerous genes in these regions, and suggested pathways that are likely to contribute to key pathophysiological mechanisms in MPHL. This review provides an overview of the current status of MPHL genetic research. We discuss the most significant achievements, current challenges, and anticipated developments in the field, as well as their potential to advance our understanding of hair (loss) biology, and to improve hair loss prediction and treatment.
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Affiliation(s)
- Sabrina K. Henne
- University Hospital of Bonn & University of BonnInstitute of Human GeneticsBonnGermany
| | - Markus M. Nöthen
- University Hospital of Bonn & University of BonnInstitute of Human GeneticsBonnGermany
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Lauron S, Plasse C, Vaysset M, Pereira B, D’Incan M, Rondepierre F, Jalenques I. Prevalence and Odds of Depressive and Anxiety Disorders and Symptoms in Children and Adults With Alopecia Areata: A Systematic Review and Meta-analysis. JAMA Dermatol 2023; 159:281-288. [PMID: 36696123 PMCID: PMC9878435 DOI: 10.1001/jamadermatol.2022.6085] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/23/2022] [Indexed: 01/26/2023]
Abstract
Importance Two recent meta-analyses reported a high prevalence of both anxiety and depression in patients with alopecia areata (AA), as well as a positive association of AA with anxiety and depression, without distinguishing between disorders and symptoms. Yet, depression and anxiety can manifest either as symptoms identified in questionnaires or as specific diagnoses defined by Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision criteria. Objective To perform a large meta-analysis separating the prevalence of depressive and anxiety disorders from that of depressive and anxiety symptoms in patients with AA. Data Sources PubMed, ScienceDirect, the Cochrane Library, Embase, and PsycINFO databases were searched from inception through August 1, 2020. Study Selection Studies that contained data on the prevalence of depressive or anxiety disorders or symptoms were included. Data Extraction and Synthesis The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines were used. Pooled prevalence was calculated with a random effects model meta-analysis that took into account between- and within-study variability. Meta-regressions were used to study the association between variations in prevalence and study characteristics. Main Outcomes and Measures The prevalence of depressive and anxiety disorders and symptoms in patients with AA. Results Thirty-seven articles (29 on depression and 26 on anxiety) that met the inclusion criteria were identified. By distinguishing between disorders and symptoms, the prevalence of both depressive disorders (9%) and unspecified anxiety disorders (13%) in patients with AA was shown to be greater than that in the general population. The prevalence and odds ratio (OR) of depressive disorders (prevalence, 9%; OR, 1.38) and anxiety disorders of which each category had been specifically studied (prevalence, 7%-17%; OR, 1.51-1.69) were markedly lower than that of depressive symptoms (prevalence, 37%; OR, 2.70) and anxiety symptoms (prevalence, 34%; OR, 3.07). Meta-regressions showed that variations in prevalence were mainly associated with methodological differences between studies. Conclusions and Relevance In this systematic review and meta-analysis, the separate analyses showed that 7% to 17% of patients with AA had depressive or anxiety disorders that require psychiatric care, including specific medication. Additionally, more than one-third of patients had symptoms that are warning signs and that need monitoring because they can develop into disorders.
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Affiliation(s)
- Sophie Lauron
- Pascal Institut, Adult Psychiatry and Medical Psychology Department, CNRS, CHU Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Camille Plasse
- Pascal Institut, Adult Psychiatry and Medical Psychology Department, CNRS, CHU Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Marion Vaysset
- Pascal Institut, Adult Psychiatry and Medical Psychology Department, CNRS, CHU Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Bruno Pereira
- Department of Clinical Research and Innovation, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Michel D’Incan
- Dermatology Department, Clermont Auvergne University, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Fabien Rondepierre
- Adult Psychiatry and Medical Psychology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Isabelle Jalenques
- Clermont Auvergne INP, Pascal Institut, Adult Psychiatry and Medical Psychology Department, CNRS, CHU Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
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Muntyanu A, Gabrielli S, Donovan J, Gooderham M, Guenther L, Hanna S, Lynde C, Prajapati VH, Wiseman M, Netchiporouk E. The burden of alopecia areata: A scoping review focusing on quality of life, mental health and work productivity. J Eur Acad Dermatol Venereol 2023; 37:1490-1520. [PMID: 36708097 DOI: 10.1111/jdv.18926] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/16/2023] [Indexed: 01/29/2023]
Abstract
Alopecia areata (AA) is a common inflammatory autoimmune disease of the hair which can have a significant negative impact on quality of life (QoL), mental health and productivity. The aim of this scoping review is to elucidate the burden of AA focusing on these three realms. Inclusion criteria included all original manuscripts with no restriction on study type or statistical method written in English (or having an English abstract). For QoL 40 articles were included, 85 for psychiatric comorbidities, and 9 for work/school absenteeism/presenteeism mostly consisting of cross-sectional and observational cohort studies. QoL impairment was detected in over 75% of patients and up to one-third reported extremely severe QoL impairments. Specific QoL dimensions with the greatest impact were embarrassment, social functioning, as well as shopping and/or housework. Cross-sectional studies assessing the psychological burden of adult patients with AA found that the presence of signs of anxiety and/or depression ranged from 30% to 68% and affected all age groups. Rates of work absenteeism and unemployment were significantly higher in AA patients compared to healthy controls. Up to 62% reported making major life decisions including relationships, education and career based on their AA. Additionally, the extensive camouflage techniques and time lost from work led to a strong financial burden for patients and the numerous physician visits added to the healthcare costs. The overall impact of AA stretches much further than simply being an aesthetic concern and can negatively impact every part of an individual's life. An individualized approach and effective treatments will help reduce the psychosocial consequences and distress and return patients to their normal state of health.
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Affiliation(s)
| | | | - Jeffrey Donovan
- Donovan Hair Clinic, Whistler, British Columbia, Canada
- Department of Dermatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melinda Gooderham
- SKiN Centre for Dermatology, Peterborough, Ontario, Canada
- Probity Medical Research Inc., Waterloo, Ontario, Canada
- Queen's University, Kingston, Ontario, Canada
- Division of Dermatology, Western University, London, Ontario, Canada
| | - Lyn Guenther
- Division of Dermatology, Western University, London, Ontario, Canada
- Guenther Research Inc., London, Ontario, Canada
| | - Sameh Hanna
- Probity Medical Research Inc., Waterloo, Ontario, Canada
- Dermatology on Bloor, Toronto, Ontario, Canada
| | - Charles Lynde
- Probity Medical Research Inc., Waterloo, Ontario, Canada
- Division of Dermatology, Western University, London, Ontario, Canada
- Lynde Institute for Dermatology, Markham, Ontario, Canada
| | - Vimal H Prajapati
- Probity Medical Research Inc., Waterloo, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Sections of Community Pediatrics and Pediatric Rheumatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Dermatology Research Institute, Calgary, Alberta, Canada
- Skin Health & Wellness Centre, Calgary, Alberta, Canada
| | - Marni Wiseman
- Section of Dermatology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- SKiNWISE Dermatology, Winnipeg, Manitoba, Canada
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Nazli EC, Avcı C, Akarsu S. The effect of patient characteristics on illness perception and sun protection behaviors in melasma. J Cosmet Dermatol 2022; 21:7107-7115. [PMID: 36136352 DOI: 10.1111/jocd.15401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/16/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND/AIM Melasma, a significant cosmetic problem, has been accepted by some authors as a photoaging illness in recent times. There is no published study evaluating the effects of the clinical and sociodemographic findings on illness perception and sun protection behaviors (SPBs) in patients with melasma. PATIENTS/METHODS Sociodemographic data, personal characteristics, and clinical features of 150 patients with melasma were recorded in this cross-sectional study. They were analyzed for their SPBs in three groups as "never," "rarely/sometimes," and "often/always." Patients completed the Melasma Quality of Life (QoL) Scale and Revised-Illness Perception Questionnaire. RESULTS Melasma patients with higher clinical severity and Qol scores, lower education level, concomitant chronic illness, and a history of previous melasma treatment thought more frequently that melasma had negative serious consequences. Majority of the patients blamed sun exposure as the cause of the melasma. However, SPBs were more frequent only in patients with higher socioeconomic and educational levels, a previous history of melasma treatment, and evaluating their disease as a chronic condition. Neither Qol nor clinical severity score had a significant effect on sun exposure causal attribution or SPBs. No significant effect of patients' perception of melasma was determined on the use of sunscreen or protective hat. CONCLUSION Being aware of the factors affecting the perception of melasma and QoL of patients might be helpful in making persistent individual recommendations for the regulation of SPBs.
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Affiliation(s)
- Ecem Cantürk Nazli
- Department of Dermatology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
| | - Ceylan Avcı
- Department of Dermatology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
| | - Sevgi Akarsu
- Department of Dermatology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
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van Dalen M, Muller KS, Kasperkovitz-Oosterloo JM, Okkerse JME, Pasmans SGMA. Anxiety, depression, and quality of life in children and adults with alopecia areata: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:1054898. [PMID: 36523776 PMCID: PMC9745337 DOI: 10.3389/fmed.2022.1054898] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/11/2022] [Indexed: 09/14/2023] Open
Abstract
Introduction Alopecia areata (AA) is a non-scarring hair loss condition, subclassified into AA, alopecia universalis, and alopecia totalis. There are indications that people with AA experience adverse psychosocial outcomes, but previous studies have not included a thorough meta-analysis and did not compare people with AA to people with other dermatological diagnoses. Therefore, the aim of this systematic review and meta-analysis was to update and expand previous systematic reviews, as well as describing and quantifying levels of anxiety, depression, and quality of life (QoL) in children and adults with AA. Methods A search was conducted, yielding 1,249 unique records of which 93 were included. Results Review results showed that people with AA have higher chances of being diagnosed with anxiety and/or depression and experience impaired QoL. Their psychosocial outcomes are often similar to other people with a dermatological condition. Meta-analytic results showed significantly more symptoms of anxiety and depression in adults with AA compared to healthy controls. Results also showed a moderate impact on QoL. These results further highlight that AA, despite causing little physical impairments, can have a significant amount on patients' well-being. Discussion Future studies should examine the influence of disease severity, disease duration, remission and relapse, and medication use to shed light on at-risk groups in need of referral to psychological care. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022323174].
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Affiliation(s)
- Marije van Dalen
- Department of Pediatric Gastroenterology, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Kirsten S. Muller
- Department of Pediatric Gastroenterology, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
| | | | - Jolanda M. E. Okkerse
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Suzanne G. M. A. Pasmans
- Department of Dermatology, Center of Pediatric Dermatology, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
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Legiawati L, Suseno LS, Sitohang IBS, Pratama AI. Hair disorder in cosmetic dermatology venereology outpatient clinic of dr. Cipto Mangunkusumo Jakarta: socio-demographic and clinical evaluation. Dermatol Reports 2022; 14:9341. [PMID: 36199901 PMCID: PMC9527679 DOI: 10.4081/dr.2022.9341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022] Open
Abstract
Hair disorder has a significant impact on sociopsychology. In Indonesia, there are currently few and out-of-date studies on hair disorders. Our study aimed to provide an update on the epidemiology of hair loss, which is common in Indonesia. This is a retrospective study of hair disorder cases seen at Dr. Cipto Mangunkusumo’s Cosmetic Dermatology Outpatient Clinic at the National Central General Hospital from January 2017 to December 2019. Each patient’s age, gender, family history, education, occupation, body mass index (BMI), comorbidities, and diagnosis were recorded. Hair disorders were found to be more prevalent in males (54.6 percent) with a mean age of 26.41 ± 12.8 years old and the highest age group of 18-39 years old (59.4 percent) among the 64 patients who were eligible for the study. There were 32 cases (50.0%) of alopecia areata (AA), 20 cases (31.2%) of alopecia androgenetic (AGA), 9 cases (14.0%) of telogen effluvium (TE), 2 cases of cicatricial alopecia (CA) due to lupus erythematosus (DLE), and 1 case of trichotillomania (TTM). Female patients had significantly more TE cases. Cases of AGA in the study, mainly early-onset AGA (mean age 29.45 ± 10.29 years old, 39.5% in 18-39 years old) showed a significant positive familial history. At dr Cipto Mangunkusumo National General Hospital Jakarta, the most common types of hair disorders were AA, AGA, and TE, with each disease having a unique socio-demographic and clinical profile.
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Huang Y, Yan S, Xie H, Wang B, Zhao Z, Huang Y, Li J. Health Related Quality of Life of Rosacea Patients in China Assessed by Dermatology Life Quality Index and Willingness to Pay. Patient Prefer Adherence 2022; 16:659-670. [PMID: 35283624 PMCID: PMC8910444 DOI: 10.2147/ppa.s345258] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/21/2022] [Indexed: 12/04/2022] Open
Abstract
PURPOSE Rosacea is a chronic inflammatory dermatosis mainly involving facial skin, leading to physical and emotional problems, which greatly affect the quality of life (QoL) of patients. Dermatology Life Quality Index (DLQI) and willingness to pay (WTP) are well-established instruments assessing the health-related quality of life (HRQoL), while very few studies have been focused on this topic about rosacea in China. The present study investigated HRQoL in Chinese rosacea patients. PATIENTS AND METHODS This cross-sectional study was conducted on 973 patients with rosacea. Sociodemographic data, clinical features and DLQI were collected, and WTP was assessed by three standardized items. Multivariable logistic analysis was performed to investigate independent factors influencing QoL. RESULTS A total of 921 questionnaires were accomplished by participants. The mean DLQI score was 11.6 (median 11). Patients were willing to pay an average of € 896.2 (median € 368.1) for complete cure. 33.3% would like to pay more than 20% of their monthly income to achieve sustainable control. There were positive correlations between WTP with DLQI (P < 0.05). DLQI could be independently impacted by age (21-30 and 31-40 relative to > 50, OR = 3.242 and 3.617, respectively), the occupational requirement of appearance (high, OR = 4.410), disease duration (< 2 years, OR = 1.582), edema (OR = 1.844) and severity of flushing, burning, stinging and pruritus (severe, OR = 2.003, 1.981, 2.491, 2.249, respectively). There were no significant associations between WTP and most of the clinical factors. CONCLUSION The QoL was greatly impaired and should not be ignored among rosacea patients in China. Patients aged 21-40y, having occupational requirement of appearance, with the disease duration less than 2 years, and suffering severe flushing and related sensitive symptoms were more likely to have severe or very severe limitation of QoL.
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Affiliation(s)
- Yaqun Huang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Sha Yan
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Hongfu Xie
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Ben Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Zhixiang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Yingxue Huang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Correspondence: Ji Li; Yingxue Huang, Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People’s Republic of China, Tel +86 731 8432 7472, Fax +86 731 8432 7128, Email ;
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Nasimi M, Abedini R, Ghandi N, Manuchehr F, Kazemzadeh Houjaghan A, Shakoei S. Illness perception in patients with Alopecia areata under topical immunotherapy. Dermatol Ther 2021; 34:e14748. [PMID: 33403745 DOI: 10.1111/dth.14748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 11/29/2022]
Abstract
Alopecia areata (AA) is a chronic autoimmune-mediated disorder. There is little research on how AA patients conceptualize their disease. The purpose of this study was to investigate the perception and attitude of patients with AA about their illness. The cross-sectional study was performed on 102 patients with AA referred to our alopecia clinic. Patients between 16 and 60 years were enrolled in the study. A questionnaire including demographic and clinical characteristics and Illness Perception Questionnaire-Revised (IPQ-R) was administered to each patient. More than half of patients (55%) experienced their illness as a long-lasting (17.3 ± 5.5, median reference score = 18), and timely variable (13.4 ± 2.8, median reference score = 12) disorder. Patients perceived that their illness negatively affects their lives (18.9 ± 4.8, median reference score = 18) and are considered an effective role for themselves in controlling disease (20.3 ± 4.9, median reference score = 18). Moreover, patients had a fairly good accepting of their illness (13.4 ± 2.8, median reference score = 15). We observed significant negative effects of illness on the patient's emotions (21.5 ± 5.5, median reference score = 18). We also found that men had a stronger belief in personal control compared with women (21.5 ± 4.8 vs 19.5 ± 4.8; P = .03). A positive correlation was observed between educational status and illness coherence (r = .21; P = .03). Most patients with AA considered undesirable consequences of their illness. High scores of negative affective symptoms indicate the harmful effects of this disease on patients' lives leading to problems of mental health.
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Affiliation(s)
- Maryam Nasimi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Robabeh Abedini
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Narges Ghandi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fatememasume Manuchehr
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Safoura Shakoei
- Department of Dermatology, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Huang CH, Fu Y, Chi CC. Health-Related Quality of Life, Depression, and Self-esteem in Patients With Androgenetic Alopecia: A Systematic Review and Meta-analysis. JAMA Dermatol 2021; 157:963-970. [PMID: 34232264 DOI: 10.1001/jamadermatol.2021.2196] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Androgenetic alopecia (AGA) is associated with trichodynia, anxiety, low self-esteem, and depression, which have implications for quality of life. However, no systematic evaluation has been performed on the association of AGA with health-related quality of life (HRQOL). Objective To systematically examine the association of AGA with HRQOL and psychiatric disorders. Data Sources Cochrane Library, PubMed, Embase, and WanFang databases were searched from inception through January 24, 2021. Study Selection Case series, case-control studies, cross-sectional studies, cohort studies, and randomized clinical trials that examined either HRQOL or psychiatric disorders in patients with AGA were included. Studies published in languages other than English and Mandarin were excluded. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was used. The risk of bias in included studies was assessed with the Risk of Bias in Non-randomized Studies of Intervention (ROBINS-I) tool. A random-effects model meta-analysis was performed to calculate the pooled effect on HRQOL. A subgroup analysis according to sex and geographic regions was also conducted. Main Outcomes and Measures The outcome was HRQOL of patients with AGA. Results A total of 41 studies involving 7995 patients was included. The pooled Dermatology Life Quality Index score was 8.16 (95% CI, 5.62-10.71). The pooled Hair-Specific Skindex-29 score indicated moderate impairment of emotions, with the meta-analysis showing a score of 29.22 (95% CI, 24.17-34.28) in the emotion dimension. The pooled Center for Epidemiologic Studies Depression Scale score did not indicate depression, with the meta-analysis showing a score of 14.98 (95% CI, 14.28-15.68). Factors that had a direct association with HRQOL included married or coupled status and receipt of medical treatments, whereas factors that had an inverse association with HRQOL included higher self-rated hair loss severity, lower visual analog scale score, and higher educational level. Conclusions and Relevance This systematic review and meta-analysis found a significant association of AGA with moderate impairment of HRQOL and emotions, but no association was found with depressive symptoms. The findings suggest that patients with AGA may need psychological and psychosocial support.
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Affiliation(s)
- Chun-Hsien Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yun Fu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Chernyshov PV, Tomas-Aragones L, Finlay AY, Manolache L, Marron SE, Sampogna F, Spillekom-van Koulil S, Pustisek N, Suru A, Evers AWM, Salavastru C, Svensson A, Abeni D, Blome C, Poot F, Jemec GBE, Linder D, Augustin M, Bewley A, Salek SS, Szepietowski JC. Quality of life measurement in alopecia areata. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes. J Eur Acad Dermatol Venereol 2021; 35:1614-1621. [PMID: 34107093 DOI: 10.1111/jdv.17370] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/28/2021] [Indexed: 12/13/2022]
Abstract
New treatment options may lead to an increased interest in using reliable and sensitive instruments to assess health-related quality of life in people with alopecia areata (AA). The purpose of this paper is to present current knowledge about quality of life assessment in AA. The dermatology-specific Dermatology Life Quality Index (DLQI) was the most widely reported health-related quality of life instrument used in AA. Three AA-specific (Alopecia Areata Symptom Impact Scale, Alopecia Areata Quality of Life Index and Alopecia Areata Patients' Quality of Life) and three hair disease-specific instruments (Hairdex, Scalpdex and 'hair-specific Skindex-29') were identified with a range of content and validation characteristics: there is little evidence yet of the actual use of these measures in AA. Scalpdex is the best-validated hair disease-specific instrument. Further extensive validation is needed for all of the AA-specific instruments. The European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes recommends the use of the dermatology-specific DLQI questionnaire, hair disease-specific Scalpdex and the alopecia areata-specific instruments the Alopecia Areata Symptom Impact Scale or Alopecia Areata Quality of Life Index, despite the limited experience of their use. We hope that new treatment methods will be able to improve both clinical signs and health-related quality of life in patients with AA. In order to assess the outcomes of trials on these new treatment methods, it would be helpful when further development and validation of AA-specific instruments is being encouraged and also conducted.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - S E Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University Hospital Miguel Servet, Zaragoza, Spain
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - S Spillekom-van Koulil
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N Pustisek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - A Suru
- Paediatric Dermatology Discipline, 'Carol Davila' University of Medicine and Pharmacy, Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - A W M Evers
- Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health and Medical Sciences Faulty, University of Copenhagen, Copenhagen, Denmark
| | - D Linder
- Unit of Dermatology, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,The Royal London Hospital, London, UK
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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Patient Perspectives of the Social, Emotional and Functional Impact of Alopecia Areata: A Systematic Literature Review. Dermatol Ther (Heidelb) 2021; 11:867-883. [PMID: 33770385 PMCID: PMC8163950 DOI: 10.1007/s13555-021-00512-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/27/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction Alopecia areata (AA) is a chronic, autoimmune disease of hair loss, which can significantly affect the emotional and psychological well-being of patients. A systematic literature review was conducted to better understand the burden of AA from the patient perspective. Methods Embase, MEDLINE and Cochrane databases were searched for published studies (2008–2018) reporting on assessments of health-related quality of life (HRQoL) for patients with AA. Qualitative, and quantitative data were collected. Results The review included 37 studies encompassing a range of clinical outcome assessment (COA) tools. None of the COA tools were specific for AA, and only one study used the Hairdex scale, which was designed to evaluate HRQoL in patients with disorders of the hair and scalp. All studies reported substantial impact on HRQoL due to AA, both overall and in domains related to personality (i.e. temperament and character), emotions and social functioning. Acute stress was also noted, and several studies identified lack of emotional awareness (alexithymia) in 23–50% of the patients with AA. Conclusions Although it is well-established that patients with AA experience anxiety and depression, they also experience a decrease in HRQoL in many other areas, including personality, emotions, behaviors and social functioning, and these changes may be accompanied by acute stress and alexithymia. There is a need to achieve consensus on a core set of measures for AA and to develop and validate AA-specific measurement tools for use in future studies, to attain a clearer understanding of the impact of AA on patients. Trial Registration PROSPERO registration number; CRD42019118646. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00512-0. Alopecia areata (AA) is a disease in which a person’s immune system attacks their hair follicles, from which hairs grow, causing hair loss. Studies have shown that people with AA may have a lower quality of life, and studies have reported higher rates of depression and anxiety in people with AA than in people without AA. Study design: We reviewed published studies to better understand how AA affected people socially, emotionally and in their day-to-day functioning. We also looked at how healthcare providers measured these social, emotional and day-to-day effects on people with AA. Our review included 37 published studies that used several evaluation tools to measure the impacts of AA. These included a variety of questionnaires that were answered by people with AA. Results: The studies reported that AA negatively affected the personality, emotions, behaviors and/or social functioning of many people with AA. However, none of the evaluation tools that were used in those studies were specific for AA, and most of the evaluation tools did not include questions about the hair or scalp. Conclusions: We recommend that a group of people familiar with AA (practitioners, researchers and patients) work together to develop an evaluation tool that is designed specifically for people with AA. This evaluation tool can then be used in future studies to better understand how AA affects people socially, emotionally and in their day-to-day functioning.
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Yu N, Hu T, Yang H, Zhang L, Song Q, Xiang F, Yang X, Li Y. Twist1 Contributes to the Maintenance of Some Biological Properties of Dermal Papilla Cells in vitro by Forming a Complex With Tcf4 and β-Catenin. Front Cell Dev Biol 2020; 8:824. [PMID: 32974352 PMCID: PMC7466560 DOI: 10.3389/fcell.2020.00824] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE During hair follicle regeneration, hair follicle stem cells (HFSCs) are regulated by signals from dermal papilla cells (DPCs). Previously we found that Tcf4 could promote the proliferation of DPCs. In this study, we focused on whether and how the biological properties of Tcf4-induced DPCs were regulated by Twist1. METHODS Twist1 was overexpressed or knocked down in DPCs following different adenovirus or lentivirus infection. Phase-contrast microscopy was used to observe the agglutinative growth of DPCs. The CCK-8 assay was used to test the proliferation of DPCs. Western blot and qPCR experiments were used to determine the expression of HGF, IGF-1, VEGF, c-myc, survivin, and CyclinD1 in DPCs. ELISAs were used to test the growth factors secreted by DPCs. Conditional medium culture was used to detect the inductive ability of DPCs. Co-immunoprecipitation and immunofluorescence were used to test the binding of Twist1, Tcf4, and β-catenin in DPCs. Immunofluorescence was also used to test the expression of Twist1, Tcf4, and KRT15 in hair follicles. RESULTS Twist1 induced DPC agglutinative growth and proliferation. Twist1 upregulated the expression of downstream target genes downstream of Tcf4, c-myc, survivin, in Tcf4-induced DPCs, as well as the expression and secretion of growth factors HGF, IGF-1, VEGF, which had the ability to induce hair follicle growth. The conditional medium from Twist1-treated DPCs increased the expression of KRT40 and MSX2 in HaCaT cells. Twist1 and Tcf4 co-localized in DPCs both in vitro and in vivo. Anti-Twist1 precipitated Tcf4 and β-catenin. CONCLUSION These results indicate that Tcf4 and Twist1 play a synergistic role in regulating the hair follicle induction ability of DPCs. Twist1 functions by forming a ternary complex with Tcf4 and β-catenin. Thus, we report new data that elucidate whether and how Twist1 regulates some biological properties of DPCs.
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Affiliation(s)
- Nanlan Yu
- Department of Dermatology, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Tianxing Hu
- Department of Dermatology, The First Affiliated Hospital of the Army Medical University, Chongqing, China
- Department of Cell Biology, Army Medical University, Chongqing, China
| | - Haichao Yang
- Department of Dermatology, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Lian Zhang
- Department of Dermatology, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Qin Song
- Department of Dermatology, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Fei Xiang
- State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Institute of Burn Research, Army Medical University, Chongqing, China
| | - Xichuan Yang
- Department of Dermatology, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Yuhong Li
- Department of Cell Biology, Army Medical University, Chongqing, China
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Toussi A, Barton VR, Le ST, Agbai ON, Kiuru M. Psychosocial and psychiatric comorbidities and health-related quality of life in alopecia areata: A systematic review. J Am Acad Dermatol 2020; 85:162-175. [PMID: 32561373 DOI: 10.1016/j.jaad.2020.06.047] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/14/2020] [Accepted: 06/11/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alopecia areata (AA) is an immune-mediated disease resulting in nonscarring hair loss. Systematic reviews on the psychosocial and psychiatric comorbidities, health-related quality of life, and interventions targeting psychosocial well-being are limited. OBJECTIVE To conduct a systematic review of the psychosocial comorbidities, health-related quality of life, and treatment options targeting psychosocial well-being in adult and pediatric AA patients. METHODS A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines within the PubMed database. Specific search terms included, but were not limited to, alopecia areata, psychosocial, psychiatry, and quality of life. Studies were then evaluated for their design and categorized into corresponding levels of evidence according to the guidelines adapted from the Oxford Center for Evidence Based Medicine. FINDINGS Seventy-three reports met inclusion criteria, involving approximately 414,319 unique participants. AA patients were found to have psychiatric comorbidities, particularly anxiety and depression. Health-related quality of life is reduced in AA patients, but data on pediatric AA quality of life are limited. Psychotherapy is often recommended as adjuvant treatment. CONCLUSION AA has substantial psychosocial impact on patients and results in reduced health-related quality of life. Addressing this should be an active part of treatment.
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Affiliation(s)
- Atrin Toussi
- Department of Dermatology, University of California, Davis, Sacramento, California; School of Medicine, University of California, Davis, Sacramento, California
| | - Virginia R Barton
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Stephanie T Le
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Oma N Agbai
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, California; Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, California.
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Ahluwalia J, Fabi SG. The psychological and aesthetic impact of age-related hair changes in females. J Cosmet Dermatol 2019; 18:1161-1169. [PMID: 31012988 DOI: 10.1111/jocd.12960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/14/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND While dermatologists focus on practices to promote anti-aging, thinning hair that frames a more rejuvenated face can affect age perception and cosmesis. OBJECTIVES To characterize the effects of age-related hair changes on age determination and perceived attractiveness. METHODS A search was conducted for articles on intrinsic and extrinsic aging as it relates to hair. Key studies on the hair aging process and its effects on self-perception, confidence, and anti-aging were reviewed. RESULTS According to several studies, hair density peaks about 27 years of age or earlier and then decreases from the mid-thirties onward. This serves as an opportunity to prevent or treat hair loss in a similar way we treat aging skin. Without optimizing appearance of hair, overall cosmesis to foster self-perception can be curtailed despite multiple efforts to rejuvenate and restore the aging face. CONCLUSION The discrepancy between rejuvenated faces and thinner appearing hair that frames the face highlights the importance of a holistic approach to the anti-aging consultation. To more comprehensively address the aesthetic patient, we need to promote awareness of the onset of these hair changes in order to incorporate prevention and therapeutic strategies to preserve hair to complement overall appearance.
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Affiliation(s)
- Jusleen Ahluwalia
- Department of Dermatology, San Diego School of Medicine, University of California, La Jolla, California
| | - Sabrina G Fabi
- Department of Dermatology, San Diego School of Medicine, University of California, La Jolla, California.,Cosmetic Laser Dermatology, San Diego, California
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Lau JTF, Wu X, Wu AMS, Wang Z, Mo PKH. Relationships Between Illness Perception and Post-traumatic Growth Among Newly Diagnosed HIV-Positive Men Who have Sex with Men in China. AIDS Behav 2018; 22:1885-1898. [PMID: 28852886 DOI: 10.1007/s10461-017-1874-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Newly diagnosed HIV-positive men who have sex with men (NHMSM) are at high risk of mental health problems but may also develop post-traumatic growth (PTG). According to the Common Sense Model, illness perception (including both cognitive representation and emotional representation) affects coping and health-related outcomes. A cross-sectional survey was conducted to examine the associations between illness perception and PTG among 225 NHMSM in Chengdu, China. Linear regression analyses indicated that the constructs of emotional representation subscale (β = -0.49) and five cognitive representation subscales (timeline, consequence, identity, attribution to god's punishment/will, and attribution to chance/luck) (β = -0.13 to -0.37) were negative correlates of PTG, while four other constructs of cognitive representation (coherence, treatment control, personal control, and attribution to carelessness) were positive correlates (β = 0.15 to 0.51). No moderating effects were observed. The associations between five cognitive representation subscales and PTG were fully-mediated via emotional representation. The results indicate that interventions promoting PTG among NHMSM are warranted and should alter illness perception, emotional representation in particular. Future studies should clarify relationships between cognitive representation and emotional representation, and extend similar research to other health-related outcomes and HIV-positive populations.
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Zhang L, Schwarz J, Kleinstäuber M, Fritzsche K, Hannig W, Wei J, Yang J, Zhang L. Confirmatory factor analysis of the causal illness attribution scale in Chinese patients with multiple somatic symptoms. PSYCHOL HEALTH MED 2018; 23:1056-1070. [PMID: 29770714 DOI: 10.1080/13548506.2018.1455983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Causal illness attributions influence how individuals cope with somatic symptoms and illnesses. Dimensions of causal symptom attributions have been examined in Western cultures with the subscale 'causes' of the revised Illness Perception Questionnaire (IPQ-R). Some previous studies have identified a stronger somatic attribution style in Asian patients. In this study it was examined if the factorial structure of causal attributions identified in Western populations can be identified in a large Chinese sample of patients presenting with somatic symptoms. We recruited 665 patients aged at least 18 who were visiting the hospital for reasons of treatment from departments of traditional Chinese medicine (TCM), neurology (Biomedicine), and psychosomatic medicine in six hospitals across China. All subjects completed the Patient Health Questionnaire (PHQ) and the causes subscale of the IPQ-R. We split the data-set by chance in two parts. On the first subsample, we conducted a confirmatory factor analysis (CFA) to check the fit of the originally proposed 4-factor structure and an exploratory factor analysis (EFA). The factor structure indentified in the EFA was rechecked with a CFA in the second subsample. The originally proposed 4-factor-model of the IPQ-R subscale causes showed no adequate fit in the first subsample. The EFA revealed two factors, psychological attributions and risk factors. The CFA in the second sample showed mediocre fit indices (RMSEA = .098, CFI = .923). For the Chinese sample we propose a two-factor structure for IPQ-R causes scale. As in other studies, we identified the relatively stable factor psychological attributions, indicating no fundamental differences in illness attributions between Western and Chinese samples.
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Affiliation(s)
- Ling Zhang
- Mental Health Centre , West China Hospital, Sichuan University , Chengdu , China.,Suzhou Psychiatric Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jeanine Schwarz
- Division of Clinical Psychology and Psychotherapy , Philipps University of Marburg , Marburg , Germany
| | - Maria Kleinstäuber
- Division of Clinical Psychology and Psychotherapy , Philipps University of Marburg , Marburg , Germany
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy , University Medical Centre Freiburg , Freiburg , Germany
| | - Wiebke Hannig
- Division of Clinical Psychology and Psychotherapy , Philipps University of Marburg , Marburg , Germany
| | - Jing Wei
- Department of Psychological Medicine , Peking Union Medical College Hospital , Peking , China
| | | | - Lan Zhang
- Mental Health Centre , West China Hospital, Sichuan University , Chengdu , China
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Meta-analysis identifies novel risk loci and yields systematic insights into the biology of male-pattern baldness. Nat Commun 2017; 8:14694. [PMID: 28272467 PMCID: PMC5344973 DOI: 10.1038/ncomms14694] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/23/2017] [Indexed: 02/06/2023] Open
Abstract
Male-pattern baldness (MPB) is a common and highly heritable trait characterized by androgen-dependent, progressive hair loss from the scalp. Here, we carry out the largest GWAS meta-analysis of MPB to date, comprising 10,846 early-onset cases and 11,672 controls from eight independent cohorts. We identify 63 MPB-associated loci (P<5 × 10-8, METAL) of which 23 have not been reported previously. The 63 loci explain ∼39% of the phenotypic variance in MPB and highlight several plausible candidate genes (FGF5, IRF4, DKK2) and pathways (melatonin signalling, adipogenesis) that are likely to be implicated in the key-pathophysiological features of MPB and may represent promising targets for the development of novel therapeutic options. The data provide molecular evidence that rather than being an isolated trait, MPB shares a substantial biological basis with numerous other human phenotypes and may deserve evaluation as an early prognostic marker, for example, for prostate cancer, sudden cardiac arrest and neurodegenerative disorders.
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