Abstract
Objective: Present study aims to compare control group patients and patients with diffuse alopecia in order to understand the nature of the relationship between symptoms and level of anger and to see whether patient group has higher number of symptoms than control group. Methods: 43 female patients who were diagnosed diffuse alopecia in dermatology clinic and 52 age-andgender-matched control participants were included in the study. 20% of patients (n=19) with androgenetic alopecia, 10.5% of patients (n=10) with diffuse alopecia areata and 14.7% of patients (n=14) with telogen effluvium participated in study. Hospital Anxiety and Depression Scale (HADS) and The Trait Anger and Anger Expression Scale (TAAES) were filled by the participants. Also patients were followed up by a standard hospital form recording alopecia. Results: It was found that patients with alopecia revealed significantly more depression (p<0,001) and anxiety (p<0,001) scores than control group. Also trait anger (β = 0,216, Wald Z = 3,697, Exp(B)= 1,241, p<0,05) and anxiety (β = -0.466, Wald Z = 5,008, Exp(B)= 0.628, p<0,05) scores significantly predicted alopecia group. Additionally total time period for alopecia significantly and positively correlated with depression (r= 0,402, p<0.01) and anxiety (r=0,393, p<0,01) scores. Comparing patient groups with each other, trait anger and expressed anger were significantly different across groups. Conclusion: Patient group reported more anxiety and depressive symptoms than control group. In treatment of patients with alopecia, bidirectional relationship between alopecia and psychological symptoms should be in consideration. Collaboration with psychiatry is suggested in order to improve treatment efficacy and patients’ life satisfaction. In addition anger management seems essential in treatment of patients with diffuse alopecia
Keywords
References
- Biondo S, Goble D, Sinclair R. Women who present with female pattern hair loss tend to underestimate the severity of their hair loss. Br J Dermatol 2004;150:750-752.
- Wolff H. Diseases of hair. Braun-Falco’s Dermatology. Ed. Burgdorf WHC, Plewig G, Wolff HH, Landthaler M,Braun-Falco O. 3rd ed. Italy, Springer, 2009;1029-1059.
- Firooz A, Firoozabadi MR, Ghazisaidi B, Dowlati Y. Concepts of patients with alopecia areata about their disease. BMC Dermatol 2005;5:1.
- Cash TF, Price VH, Savin RC. Psychological effects of androgenetic
- alopecia on women: comparisons with balding men and with female control subjects. J Am Acad Dermatol 1993;29:568-575.
- Werner B, Mulinari-Brenner F. Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata--part II. An Bras Dermatol 2012;87:884-890.
- Chartier MB, Hoss DM, Kels JMG. Approach to the adult female patient with diffuse nonscarring alopecia. J Am Acad Dermatol 2002;47:809-818.
- Harrison S, Sinclair R. Telogen Effluvium. Clin Exp Dermatol
- ;27:389-395.
- Baranda L, Layseca-Espinosa E, Abud-Mendoza C, Gonzàlez- Amaro R. Severe and unresponsive HIV-associated alopecia areata successfully treated with thalidomide. Acta Derm Venereol 2005;85:277–278.
- Trueb RM. Diffuse hair loss in women. Ther Umsch 2002;59:217–222.
- Price VH. Androgenetic alopecia in women. J Invest Dermatol
- ;8:24-27.
- Trueb RM. Systematic approach to hair loss in women. J Dtsch Dermatol Ges 2010;8:284-297.
- Harth W, Blume-Peytavi U. Psychotrichology: psychosomatic
- aspects of hair diseases. J Dtsch Dermatol Ges 2013;11:125-135.
- Schmidt S, Fischer TW, Chren MM, et al. Strategies of coping and quality of life in women with alopecia. Br J Dermatol 2001;144:1038-1043.
- Ruiz-Doblado S, Carrizosa A, García-Hernández MJ. Alopecia areata: psychiatric comorbidity and adjustment ofilness. Int J Dermatol 2003;42:434-437.
- Camacho FM, Hernandez MJG. Psychological features of androgenetic alopecia. J Eur Acad Dermatol Venereol 2002;16:476-480.
- Hadshiew IM, Foitzik K, Arck PC, Paus R. Burden of hair loss: Stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia. J Invest Dermatol 2004;123:455–457.
- Altınöz AE, Taşkıntuna N, Altınöz ST, Ceran S. A cohort study of the relationship between anger and chronic spontaneous urticaria. Adv Ther 2014;31:1000-1007.
- Bağcıoğlu E. Akne vulgariste psikolojik faktörlerin rolü,hastalığın yaşam kalitesi üzerine etkisi. Yayımlanmamış Uzmanlık Tezi, Sütçü İmam Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, ahramanmaraş, 2008.
- Koh KB. Anger and somatization. Journal of Psychosomatic Research 2003;55:113.
- Sifneos PE. Alexithymia and its relationship to hemispheric specialization, affect, and creativity. Psychiatr Clin North Am 1988;11:287-292.
- Alfani S, Antinone V, Mozzetta A, et al. Psychological status of patients with alopecia areata. Acta Derm Venereol 2012;92:304-306.
- Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-370.
- Aydemir Ö. Hastane anksiyete ve depresyon ölçeği türkçe formunun geçerlilik ve güvenilirlik çalışması. Türk Psikiyatri Dergisi 1997;8:280-287.
- Spielberger CD, Jacobs GA, Russell SF, Crane RJ. Assessment of anger: The state-trait anger scale. Advances in personality assessment. Ed. Butcher JN, Spielberger CD. Hillsdale NJ, Erlbaum, 1983; 159-187.
- Özer AK. Sürekli öfke ve öfke ifade tarzı ölçekleri ön çalışması. Türk Psikoloji Dergisi 1994;31:26-35.
- Cash TF. The psychology of hair loss and its implications for patient care. Clin Dermatol 2001;19:161-166.
- Cartwright T, Endean N, Porter A. Illness perceptions, coping and quality of life in patients with alopecia. Br J Dermatol 2009;160:1034-1039.
- Gupta MA, Gupta AK, Wattell GN. Stress and alopecia areata: psychodermatologic study. Acta Derm Venereol 1997;77:296-298.
- Mercan S, Altunay İK. Psikiyatri ve dermatolojinin ortak çalışma alanı: Psikodermatoloji. Türk Psikiyatri Dergisi 2006;17:305-313.
- Colon EA, Popkin MK, Callies AL, et al. Lifetime prevalence of psychiatric disorders in patients with alopecia areata. Comprehensive Psychiatry 1991;32:245-251.
- Çalıkoğlu E, Alpay FB. Pruri universalis, alopecia areata, psoriasis ulgaris ve kronik ürtikerde Beck depresyon,durumluluk ve süreklilik aygı envanterlerinin değerlendirilmesi. T Klin Dermatol 2000;10:229-232.
- Yazıcı AC, Başterzi A, Tot Acar Ş, et al. Alopesi Areata ve Aleksitimi. Türk Psikiyatri Dergisi 2006;17:101-106.
- Tabolli S, Sampogna F, di Pietro C, et al. Health status, coping strategies and alexithymia in subjects with androgenetic alopecia: a questionnaire study. Am J Clin Dermatol 2013;14:139-145.
- Doruk A, Tunca M, Koç E, ve ark. Psöriyazis ve alopesi areatali erkek olgularda aleksitimi, öfke-öfke ifade tarzi ve mizaç-karakter özellikleri. Turkiye Klinikleri J Med Sci 2009;29:1503-1509.
- Greenberg SI. Alopecia areata: a psychiatric survey. Arch Dermatol 1995;72:454-457.
Abstract
Amaç: Bu çalışmada diffüz alopesili hastalarda psikiyatrik belirti sıklığının sağlıklı kontrollere göre daha fazla olup olmadığının belirlenmesi ve bunların öfke düzeyleriyle ilişkisinin araştırılması amaçlanmıştır.
Yöntemler: Bu çalışmaya dermatoloji polikliniğinde diffüz alopesi tanısı konulan 43 kadın hasta ile cinsiyet ve yaş açısından uyumlu sağlıklı 52 gönüllü dâhil edildi. Dermatolojik tanı olarak diffüz alopesi alt tiplerinden androgenetik alopesi tanısı alan 19 (%20,0), diffüz alopesia areata tanısı alan 10 (%10,5), telogen effluvium tanısı alan 14 (%14,7) kişi çalışmaya dâhil edildi. Hastalara ve kontrol grubuna Hastane Anksiyete ve Depresyon Ölçeği (HAD) ve Sürekli Öfke ve Öfke Tarz Ölçeği (SÖÖTÖ) uygulandı. Standart hazırlanan “Saç Dökülmesi Hasta Takip Formu”na hastaların kayıtları yapıldı.
Bulgular: Alopesili hasta grubunda sağlıklı kontrollere göre anksiyete (p<0.001) ve depresyon (p<0.001) puanları anlamlı olarak yüksek bulunmuştur. Ayrıca sürekli öfke (β = 0,216, Wald Z = 3,697, Exp(B)= 1,241, p<0,05) ve anksiyete (β = -0.466, Wald Z = 5,008, Exp(B)= 0.628, p<0,05) puanlarının tanı grubunu anlamlı derecede öngördüğü ve ayırt edici olduğu belirlendi. Saç dökülme süresinin, anlamlı ölçüde depresyon (r= 0,402, p<0.01) ve anksiyete (r=0,393, p<0.01) puanları ile pozitif korelasyon gösterdiği bulundu. Dermatolojik tanılar birbirleriyle karşılaştırıldığında, sürekli öfke ve öfke dışa alt ölçekleri arasında anlamlı derecede farklılıklar saptandı.
Sonuç: Alopesili hastalarda sağlıklı kontrollere göre anksiyete ve depresif belirtilerin daha fazla olduğu tespit edilmiştir. Bu hastalara bu tür psikiyatrik rahatsızlıklar sıklıkla eşlik ettiği için psikiyatri kliniği ile işbirliği yapılması; hem tedavinin başarısını, hem de hastanın yaşam kalitesini olumlu yönde etkileyecektir. Ayrıca bu hastalarda öfke ve öfke ifade tarzı üzerinde de dikkatle durulmalıdır. Bu ilişkinin farkında olmak diffüz alopesi hastalarının tedavisine katkı sağlayacaktır.
Anahtar kelimeler: Diffüz alopesi, depresyon, anksiyete, öfke
Keywords
References
- Biondo S, Goble D, Sinclair R. Women who present with female pattern hair loss tend to underestimate the severity of their hair loss. Br J Dermatol 2004;150:750-752.
- Wolff H. Diseases of hair. Braun-Falco’s Dermatology. Ed. Burgdorf WHC, Plewig G, Wolff HH, Landthaler M,Braun-Falco O. 3rd ed. Italy, Springer, 2009;1029-1059.
- Firooz A, Firoozabadi MR, Ghazisaidi B, Dowlati Y. Concepts of patients with alopecia areata about their disease. BMC Dermatol 2005;5:1.
- Cash TF, Price VH, Savin RC. Psychological effects of androgenetic
- alopecia on women: comparisons with balding men and with female control subjects. J Am Acad Dermatol 1993;29:568-575.
- Werner B, Mulinari-Brenner F. Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata--part II. An Bras Dermatol 2012;87:884-890.
- Chartier MB, Hoss DM, Kels JMG. Approach to the adult female patient with diffuse nonscarring alopecia. J Am Acad Dermatol 2002;47:809-818.
- Harrison S, Sinclair R. Telogen Effluvium. Clin Exp Dermatol
- ;27:389-395.
- Baranda L, Layseca-Espinosa E, Abud-Mendoza C, Gonzàlez- Amaro R. Severe and unresponsive HIV-associated alopecia areata successfully treated with thalidomide. Acta Derm Venereol 2005;85:277–278.
- Trueb RM. Diffuse hair loss in women. Ther Umsch 2002;59:217–222.
- Price VH. Androgenetic alopecia in women. J Invest Dermatol
- ;8:24-27.
- Trueb RM. Systematic approach to hair loss in women. J Dtsch Dermatol Ges 2010;8:284-297.
- Harth W, Blume-Peytavi U. Psychotrichology: psychosomatic
- aspects of hair diseases. J Dtsch Dermatol Ges 2013;11:125-135.
- Schmidt S, Fischer TW, Chren MM, et al. Strategies of coping and quality of life in women with alopecia. Br J Dermatol 2001;144:1038-1043.
- Ruiz-Doblado S, Carrizosa A, García-Hernández MJ. Alopecia areata: psychiatric comorbidity and adjustment ofilness. Int J Dermatol 2003;42:434-437.
- Camacho FM, Hernandez MJG. Psychological features of androgenetic alopecia. J Eur Acad Dermatol Venereol 2002;16:476-480.
- Hadshiew IM, Foitzik K, Arck PC, Paus R. Burden of hair loss: Stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia. J Invest Dermatol 2004;123:455–457.
- Altınöz AE, Taşkıntuna N, Altınöz ST, Ceran S. A cohort study of the relationship between anger and chronic spontaneous urticaria. Adv Ther 2014;31:1000-1007.
- Bağcıoğlu E. Akne vulgariste psikolojik faktörlerin rolü,hastalığın yaşam kalitesi üzerine etkisi. Yayımlanmamış Uzmanlık Tezi, Sütçü İmam Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, ahramanmaraş, 2008.
- Koh KB. Anger and somatization. Journal of Psychosomatic Research 2003;55:113.
- Sifneos PE. Alexithymia and its relationship to hemispheric specialization, affect, and creativity. Psychiatr Clin North Am 1988;11:287-292.
- Alfani S, Antinone V, Mozzetta A, et al. Psychological status of patients with alopecia areata. Acta Derm Venereol 2012;92:304-306.
- Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-370.
- Aydemir Ö. Hastane anksiyete ve depresyon ölçeği türkçe formunun geçerlilik ve güvenilirlik çalışması. Türk Psikiyatri Dergisi 1997;8:280-287.
- Spielberger CD, Jacobs GA, Russell SF, Crane RJ. Assessment of anger: The state-trait anger scale. Advances in personality assessment. Ed. Butcher JN, Spielberger CD. Hillsdale NJ, Erlbaum, 1983; 159-187.
- Özer AK. Sürekli öfke ve öfke ifade tarzı ölçekleri ön çalışması. Türk Psikoloji Dergisi 1994;31:26-35.
- Cash TF. The psychology of hair loss and its implications for patient care. Clin Dermatol 2001;19:161-166.
- Cartwright T, Endean N, Porter A. Illness perceptions, coping and quality of life in patients with alopecia. Br J Dermatol 2009;160:1034-1039.
- Gupta MA, Gupta AK, Wattell GN. Stress and alopecia areata: psychodermatologic study. Acta Derm Venereol 1997;77:296-298.
- Mercan S, Altunay İK. Psikiyatri ve dermatolojinin ortak çalışma alanı: Psikodermatoloji. Türk Psikiyatri Dergisi 2006;17:305-313.
- Colon EA, Popkin MK, Callies AL, et al. Lifetime prevalence of psychiatric disorders in patients with alopecia areata. Comprehensive Psychiatry 1991;32:245-251.
- Çalıkoğlu E, Alpay FB. Pruri universalis, alopecia areata, psoriasis ulgaris ve kronik ürtikerde Beck depresyon,durumluluk ve süreklilik aygı envanterlerinin değerlendirilmesi. T Klin Dermatol 2000;10:229-232.
- Yazıcı AC, Başterzi A, Tot Acar Ş, et al. Alopesi Areata ve Aleksitimi. Türk Psikiyatri Dergisi 2006;17:101-106.
- Tabolli S, Sampogna F, di Pietro C, et al. Health status, coping strategies and alexithymia in subjects with androgenetic alopecia: a questionnaire study. Am J Clin Dermatol 2013;14:139-145.
- Doruk A, Tunca M, Koç E, ve ark. Psöriyazis ve alopesi areatali erkek olgularda aleksitimi, öfke-öfke ifade tarzi ve mizaç-karakter özellikleri. Turkiye Klinikleri J Med Sci 2009;29:1503-1509.
- Greenberg SI. Alopecia areata: a psychiatric survey. Arch Dermatol 1995;72:454-457.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Articles |
| Authors | |
| Publication Date | October 24, 2015 |
| Submission Date | October 24, 2015 |
| Published in Issue | Year 2015 Volume: 42 Issue: 3 |