Alopecia Areata Is Associated with Posttraumatic Stress Disorder and Alcohol Use in a Case-Control Study of 4,785 Patients

Abstract

<b><i>Introduction:</i></b> Previous studies have demonstrated association of alopecia areata (AA) with anxiety and depression. However, few case-control studies have evaluated AA association with posttraumatic stress disorder and lifestyle factors, including alcohol use. We aimed to assess associations of AA with psychiatric disorders and lifestyle factors using a national database. <b><i>Methods:</i></b> A nested case-control study using the National Institutes of Health <i>All of Us</i> database was conducted analyzing patients ≥18 years with AA diagnosis and controls matched 1:4 by age, sex at birth, and self-reported ethnicity/race. <b><i>Results:</i></b> There were 957 AA patients and 3,828 controls included in the final analysis. AA patients versus controls had higher odds of depression, posttraumatic stress disorder, anxiety, and alcohol use. AA patients had decreased odds of smoking. <b><i>Conclusion:</i></b> Our study demonstrates previously understudied AA associations with posttraumatic stress disorder, obesity, and alcohol use, and corroborates high burden of anxiety and depression among AA patients. We recommend screening AA patients for psychiatric disorders and alcohol use and appropriate referrals to psychiatry.