A recent study published in the Journal of the American Medical Association (JAMA Dermatology) found that patients with newly diagnosed alopecia areata (AA) have a higher prevalence and incidence of developing psychiatric and autoimmune comorbidities.
The study set out to evaluate the prevalence and new-onset incidence of psychiatric and autoimmune comorbidities in patients with AA in the US. It used data collected from the Merative MarketScan Research Databases from the period Jan. 1, 2007, to Apr. 30, 2023. This data included medical and drug claims data from more than 46 million patients in the US from adolescent and adult patients aged 12-64 years diagnosed with AA and patients without AA (controls).
At baseline, 63,384 patients with AA and 3,309,107 patients without AA were identified. After matching, there were 16, 512 and 66, 048 patients in the AA and control groups, respectively. The mean age was 36.9 years and 50.6% were female.
The results of the study showed that compared with unmatched controls, patients with AA had a greater prevalence of psychiatric (30.9% vs 26.8%) and autoimmune (16.1% vs 8.9%) comorbidities at AA diagnosis. Additionally, for those without a history of these comorbidities, the incidence was also higher in patients with AA compared to the matched control group.
The study highlights the ongoing challenges faced by patients with AA and the importance of understanding the impact of the disease alongside the associated conditions. Furthermore, the findings emphasize the need for a comprehensive approach to the care, treatment, and management of AA.
According to Arash Mostaghimi, MD, MPH, FAAD, vice chair of clinical trials and innovation, director of dermatology inpatient services and co-director of the complex medical dermatology fellowship program at Brigham and Women’s Hospital and associate professor at Harvard Medical School, “The association of alopecia areata with different autoimmune and psychiatric conditions has been well established. What this study adds to the literature is the idea that many of these psychiatric comorbidities and autoimmune diseases are identified after the diagnosis of alopecia areata.” He adds, “It’s not just that they are associated, but that the alopecia areata came first.”
Dr. Mostaghimi therefore recommends providers conduct psychiatric screenings and physical examinations with their patients newly diagnosed with AA in order to specifically look for other signs of autoimmune disorders.
Sources:
Sources:
- Mostaghimi A, Soliman AM, Li C, Barqawi YK, Grada A. Immune-Mediated and Psychiatric Comorbidities Among Patients Newly Diagnosed With Alopecia Areata. JAMA Dermatol. 2024;160(9):945–952. doi:10.1001/jamadermatol.2024.2404
- ‘Order matters’: Alopecia diagnoses precede onset of psychiatric, autoimmune comorbidities