Prevalence and implications of type D personality in patients with alopecia areata: A marker of quality-of-life impairment and mood status disturbances, a comparative study

J Eur Acad Dermatol Venereol. 2023 May;37(5):1064-1070. doi: 10.1111/jdv.18733. Epub 2022 Nov 25.

Abstract

Introduction: Distressed personality (or Type D personality, TDp) is a personality trait that has been associated with poor quality of life in patients suffering from a variety of skin diseases such as psoriasis or urticaria. To date the potential association between Alopecia areata (AA) and TDp has not been studied. The aim of this study was to compare the prevalence of TDp between patients with AA and controls, and to analyse the impact of TDp on patients with AA regarding mood status disturbances, quality of life and sexuality.

Methods: Cross-sectional study includes patients suffering from mild-to-severe AA and sex- and age-matched healthy controls. Socio-demographic and clinical variables, quality of life, sexual disfunction, anxiety, depression and TDp were collected using validated questionnaires.

Results: A total of 120 participants (60 patients and 60 controls) were included. Patients with AA showed higher prevalence of TDp than controls (35% vs. 15% p = 0.01), as well as higher rates of anxiety, depression and sexual dysfunction (p < 0.05). TDp was found to be linked to disease severity (p = 0.04), anxiety and depression scores (p < 0.001) and worse quality of life (p = 0.001). No relationship was found between TDp and sexual dysfunction.

Discussion: Type D personality prevalence is higher in patients with AA than in controls. It is associated with higher rates of anxiety, depression and worse quality of life. Screening for this type of personality could be useful to detect patients who could benefit from additional psychological support as a complement to their medical treatment.

MeSH terms

  • Alopecia Areata* / complications
  • Alopecia Areata* / epidemiology
  • Alopecia Areata* / psychology
  • Cross-Sectional Studies
  • DNA-Binding Proteins
  • Humans
  • Prevalence
  • Quality of Life / psychology
  • Sexual Dysfunction, Physiological*
  • Type D Personality*

Substances

  • DNA-Binding Proteins

Supplementary concepts

  • Diffuse alopecia