Alopecia Areata and Its Association With Anxiety and Depression: A Case–Control Study in Patients Referred to Dermatology Clinics Publisher



Kebria A S ; Firouzjah A A ; Khorshidian F ; Ahangar H G
Source: International Journal of Clinical Practice Published:2026

Abstract

Background: Alopecia areata (AA) is an autoimmune disorder characterized by nonscarring hair loss that may present as localized or widespread involvement. Beyond its physical manifestations, AA is associated with considerable psychological distress, particularly anxiety and depression. This study aimed to evaluate the association between anxiety and depression in individuals with AA compared to healthy controls. Methods: In this case–control study, 70 patients were diagnosed with AA and 70 healthy controls completed the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics were reported as mean ± standard deviation for quantitative variables and frequency (percentage) for qualitative variables. Independent t-tests, ANOVA, Pearson’s correlation coefficient, and multivariate linear regression analyses were applied to examine the association between psychological outcomes and clinical variables, including disease duration, severity, stage, treatment modality, and affected area. A p value < 0.05 was considered statistically significant. Results: Patients with AA showed significantly higher levels of anxiety and depression compared to healthy controls (p < 0.001). Anxiety scores were higher in patients with a disease duration longer than six months (p = 0.014). However, anxiety levels were not significantly associated with disease severity, stage, treatment modality, or affected area. In contrast, depression scores were higher in patients with severe AA (p = 0.007), while no significant differences were observed with respect to disease duration, stage, treatment modality, or affected area. Conclusion: Patients with AA experience higher levels of anxiety and depression compared to healthy individuals. Longer disease duration is associated with increased anxiety, while greater disease severity is a significant predictor of depression. These findings highlight the need for routine psychological screening in patients with AA in dermatology practice; however, longitudinal studies are required to establish causality and clarify long-term implications. Copyright © 2026 Azar Shirzadian Kebria et al. International Journal of Clinical Practice published by John Wiley & Sons Ltd.