Alopecia areata is a form of non-scarring hair loss resulting possibly from genetic, environmental or autoimmune factors. Some believe it can be precipitated by stressful life events as well. Indeed, some researchers believe that it can be grouped among primary dermatologic disorders with psychiatric comorbidities or even as a primary psychiatric disorder with dermatologic problem. Citalopram supports this suggestion since it tends to have an antidepressant effect on those with the disease who have major depressive disorder. This medication also enhanced the effectiveness of the dermatological treatment.
Furthermore, there is a very high comorbidity rate when it comes to its association with a psychiatric disorder; approximately 78 percent, with 50 percent of major depressive disorder, as well as a high rate of obsessive-compulsive disorder. On study suggested a 39 percent lifetime prevalence o major depression in those witht he disease. Approximately 25.5 percent of those with AA exhibited high rates of both depression and anxiety over a period of 11 years in this study.
Interestingly enough, studies on alopecia areata suggest that such patients exhibit an unusually high rate of alexithymia, which is defined as difficulty processing and regulating emotions:
“Alexithymia is thought to be a cognitive deficit in processing and regulation of emotions characterized by difficulty identifying and describing feelings, externally oriented thinking and impaired imaginary capacity.[23] Despite the conflicting results of studies, research data have shown that there is an association between dermatological conditions and alexithymia.[14] AA has also been specifically reported to be associated with alexithymic characteristics. There is a higher prevalence of alexithymia in AA patients than in general population. According to the research data, dermatologists should be aware of alexithymia while evaluating their patients’ psychological status.”
