Patients newly diagnosed with alopecia areata may face a higher risk of developing psychiatric and autoimmune disorders compared with those who don't have the condition, according to a new study.

In the retrospective cohort study, published in JAMA Dermatology, investigators analyzed medical and drug claims from the Merative MarketScan Research Databases, covering data from January 1, 2007, to April 30, 2023. At the start of the study, there were 63,384 patients with alopecia areata, 62.4% of whom were female and 37.6% of whom were male, compared with 3.3 million controls, 52.1% of whom were female and 47.9% of whom were male. The average age at diagnosis was 39.3 years for those with alopecia areata and 39.8 years for the controls. Patients aged 12 to 64 years were matched 1:4 with controls based on sex, age, and geographic region to ensure comparable groups.

The investigators reported that patients newly diagnosed with alopecia areata had a higher likelihood of developing psychiatric and autoimmune comorbidities. At baseline, the prevalence of psychiatric disorders was higher among the patients with alopecia areata compared with controls (30.9% vs 26.8%, P < .001), as was the prevalence of autoimmune disorders (16.1% vs 8.9%, P < .001). During the first year after alopecia areata diagnosis, the incidence of new-onset psychiatric disorders was 10.2% among the patients with alopecia areata compared with 6.8% among controls (P < .001). Similarly, the incidence of new-onset autoimmune disorders was 6.2% among those in the alopecia areata group vs 1.5% among the control group (P < .001).

Further, the patients with alopecia areata were at higher risk of developing psychiatric disorders (adjusted hazard ratio [HR] = 1.3, 95% confidence interval [CI] = 1.3–1.4) and autoimmune disorders (adjusted HR = 2.7, 95% CI = 2.5–2.8) compared with controls. Specific conditions with elevated risk included anxiety, sleep disturbances, depression, atopic dermatitis, vitiligo, and psoriasis. The greatest risks for psychiatric comorbidities were for adjustment disorder (adjusted HR = 1.5, 95% CI = 1.3–1.6), panic disorder (adjusted HR = 1.4, 95% CI = 1.2–1.7), and sexual dysfunction (adjusted HR = 1.4, 95% CI = 1.1–1.8). For autoimmune comorbidities, the highest risks were observed for systemic lupus erythematosus (adjusted HR = 5.7, 95% CI = 4.6–7.2), atopic dermatitis (adjusted HR = 4.3, 95% CI = 3.9–4.8), and vitiligo (adjusted HR = 3.8, 95% CI = 3.2–4.4).

The study suggested an association between alopecia areata and an increased likelihood of developing psychiatric and autoimmune comorbidities. 

Full disclosures can be found in the published study.