Hopelessness, Depression and Alexithymia in Young Turkish Soldiers Suffering from Alopecia areata

Background: There are reports finding high prevalences of psychiatric disorders in patients with alopecia areata (AA), as well as reports refuting this association. The present study was designed to assess the prevalence of depression, anxiety, hopelessness, psychological distress and alexithymia in AA patients compared to a healthy control group. Method: 31 male patients who were soldiers with AA and 40 healthy soldier controls from the same milieu were assessed by the Beck Depression Inventory, the Beck Hopelessness Scale, the State-Trait Anxiety Inventory, the Toronto Alexithymia Scale and the Brief Symptom Inventory. Results: The patients with AA scored significantly higher than normal controls on all of the psychological measures. According to cut-off scores 58% of the patients were alexithymic, 55% were in the range of clinical depression, and 32% displayed hopelessness. AA patients displayed higher levels of psychopathology than normal controls. Conclusions: The alexithymia construct deserves further attention in patients with skin disorders, particularly in AA. State and trait alexithymia can result from deficits induced by severe and persistent stress and they have neurophysiologic causes. Alexithymic individuals who fail to cope with stress and also fail to communicate their feelings, might be more prone to develop AA. Depression, anxiety and hopelessness must be recognized and treated in AA patients for a better response to dermatological therapy.