Anxiety, depression and low self-esteem among people with alopecia

OBJECTIVES: To assess the frequency of anxiety and depression symptoms among individuals with alopecia and to assess the self-esteem levels of alopecia patients in a hair restorative treatment center of Karachi, Pakistan. METHODS: This cross-sectional study was conducted on 84 consecutive patients of alopecia by conducting interviews. Sample size was calculated using the prevalence rate of alopecia of 2% at confidence level of 95% and precision of 3%. Hospital Anxiety and Depression Scale (HADS) was used to quantify depression and anxiety, and Rosenberg Self-esteem Scale (RSES) was used for selfesteem levels. Scores were calculated. Test of correlation and Chi square test were applied. RESULTS: Median (inter-quartile range) HADS score for Anxiety and Depression in 84 study participants was 11 (7-14) and 11 (8-14) respectively. Regarding depression and anxiety, 52.4% (n=44) and 53.6% (n=45) fell into the abnormal category (score 11-21) respectively. For self-esteem, 48.8% (n=41) had low self-esteem (score 0-14). Positive correlation was found between age of participants and their selfesteem score (p-value=0.001). The older participants achieved higher scores. There was an inverse relation between age at onset of alopecia and self-esteem score (p-value= 0.03). People with early onset of alopecia had lower self-esteem scores. There was no significant difference between male and females and the anxiety, depression and self-esteem levels. CONCLUSION: Our study reveals significant prevalence of depression, anxiety, and low self-esteem among alopecia patients seeking hair restoration, highlighting the urgent need for targeted psychological interventions.