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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with a 7-year history of depression relapsed after self-discontinuation of antidepressant drugs. He was admitted to our hospital and re-administered amoxapine 150 mg. p.o. per day, and further given haloperidol 5 mg i.m. or p.o. per day because he was suicidal and excited. One month later, an area of alopecia was found on the back of his head. Immediately, he received dermatological treatment. The psychotropic drugs were continued, but the hair loss was unchanged after one month. So, haloperidol alone was discontinued. One week later, the hair loss had stopped and a month later alopecia had virtually disappeared. We suggest that alopecia areata is associated with haloperidol.
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PMID:Alopecia areata associated with haloperidol. 789 21

Alopecia areata (AA) is a dermatologic disease whose onset is significantly associated to life events. Its course may often be characterized by high levels of anxiety and depression. These observations suggested a rationale for using an antidepressant in AA. Thirteen patients were enrolled in a double-blind, placebo-controlled study of efficacy of imipramine in alopecia. After six months clinically significant hair regrowth occurred in 5 of the 7 patients on imipramine, whereas no response was observed in the placebo group. An improvement in psychic symptomatology was present in both groups. Our preliminary results indicate the potential efficacy of imipramine in patients with AA, not acting directly through a reduction of anxiety or depression.
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PMID:Imipramine in alopecia areata. A double-blind, placebo-controlled study. 806 57

Psychosocial stress has been reported to play a role in the onset and/or exacerbation of alopecia areata. Little is known about the clinical characteristics of alopecia areata patients whose alopecia is stress-reactive. We examined the relation between the stress reactivity of alopecia areata and a wide range of psychosocial measures among 16 patients with alopecia areata/totalis and 28 patients with alopecia universalis. The degree to which the alopecia was exacerbated by stress was measured by patient ratings on a 10-point scale. A wide range of psychologic measures correlated (p<0.05) with the stress reactivity score. Stepwise logistic regression analysis revealed that patients with higher depression scores were more likely to be in the high-stress reactor group. Patients whose alopecia is stress-reactive may suffer from depressive illness, a potentially important consideration in the overall management of such patients.
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PMID:Stress and alopecia areata: a psychodermatologic study. 922 23

We examined the prevalence of depression (measured by the Carroll Rating Scale for Depression, CRSD), wishes to be dead and acute suicidal ideation among 480 patients with dermatological disorders that may be cosmetically disfiguring, i.e. non-cystic facial acne (n = 72; 5.6% suicidal ideation), alopecia areata (n = 45; 0% suicidal ideation), atopic dermatitis (n = 146; 2.1% suicidal ideation) and psoriasis (79 outpatients, 2.5% suicidal ideation and 138 inpatients, 7.2% suicidal ideation). Analysis of variance revealed that the severely affected psoriasis inpatients (mean +/- SD total body surface area affected: 52 +/- 23.4%) had the highest (P < 0.05) CRSD score, followed by the patients with mild to moderate acne; both scores were in the range for clinical depression (CRSD score > 10). The 5.6-7.2% prevalence of active suicidal ideation among the psoriasis and acne patients was higher than the 2.4-3.3% prevalence reported among general medical patients. Our findings highlight the importance of recognizing psychiatric comorbidity, especially depression, among dermatology patients and indicate that in some instances even clinically mild to moderate disease such as non-cystic facial acne can be associated with significant depression and suicidal ideation.
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PMID:Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. 989 52

Although the results of some studies have proven negative, the influence of psychological factors in the development, evolution and therapeutic management of alopecia areata is, in general, well documented. Life events and intrapsychically generated stress can play an important role in triggering of some episodes. The comorbidity of psychiatric disorders, mainly generalized anxiety disorder, depression, and phobic states, is high. The role of treatment of concomitant psychopathological disorders is a vital one. Indeed this treatment can positively affect how the patient adapts to his/her alopecia and social setting and perhaps can even lead to a better dermatological evolution of the alopecia. Therefore, controlled studies analyzing the possible links between psychiatric symptoms, treatment with antidepressants or benzodiacepines, evolution of alopecia, medium term prognosis, and immune function are necessary. Basic psychotherapeutic support may prove to be of use in many cases and can be carried out by the dermatologist, although a subgroup of patients may need psychopharmacological or psychotherapeutic specialized treatments. Studies using operative diagnostic criteria and structured interviews are still scarce. Therefore, it seems necessary to design studies using modern psychiatric methodology. Controlled clinical trials to test the efficiency of psychoactive drugs and psychotherapy in the disease are also needed. By studying in depth these and other related aspects, we may improve the clinical management of our patients.
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PMID:Alopecia areata, stress and psychiatric disorders: a review. 1055 27

Turner's syndrome is a sex chromosomal abnormality characterized by gonadal failure, short stature, skeletal and medical anomalies due to structural defects or monosomy of the X chromosome. The association between this syndrome and autoimmune diseases has been reported in the literature. This case report highlights the finding of two immunological skin diseases, alopecia areata and psoriasis, in an 18-year-old girl with Turner's syndrome. By the time of her referral to the Department of Dermatology, Verona University (Italy) the girl had suffered from psoriasis on the scalp for 5 years and alopecia for 6 months; the diagnoses were confirmed by histological evaluation. Topical therapy was useful for the treatment of the psoriatic lesions but not for the alopecia areata. Alopecia areata and psoriasis occurring together in Turner's syndrome may indicate some genetic relationship and could support the concept that these patients have the tendency to develop autoimmune or immunological diseases. Anxiety, depression and unsatisfactory relationships could have been important trigger factors in our patient. Multidisciplinary management, including psychological, educational and behavioural techniques, in addition to other therapies, could be useful in treating these conditions.
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PMID:Turner's syndrome associated with psoriasis and alopecia areata. 1260 69

Disturbed body image and negative self-referent cognitions caused by the postural disfigurement of the head are regarded as the main reason for elevated depression scores in spasmodic torticollis (ST), but this factor was never controlled for. We therefore compared 48 patients with ST and 48 patients with alopecia areata (AA) who were matched for age, sex, and body image dissatisfaction. Psychiatric diagnoses were based on a structured psychiatric interview (SCID-I). Results of patients with ST and AA were compared with a matched sample of the representative German population. Odds ratios to develop psychiatric comorbidity for patients with ST compared with patients with AA were significantly increased throughout nearly all assessed DSM-IV categories. Logistic regression analysis showed that (1) depressive coping and (2) belonging to the group of patients with ST correlated with a significantly higher rate of current psychiatric diagnosis. We conclude that high psychiatric comorbidity in ST is unlikely to be a mere consequence of chronic disease and disfigurement.
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PMID:High psychiatric comorbidity in spasmodic torticollis: a controlled study. 1289 Oct 94

Hair loss in children encompasses a wide range of conditions that can be congenital or acquired. A congenital hair abnormality may be an isolated finding in an otherwise healthy child or may exist as a feature of a clinical syndrome. A thorough understanding of basic hair biology and normal hair development enables accurate assessment of the child with hair loss. Knowledge of the normal range and variation observed in children's hair additionally enhances this assessment. Social and cultural factors also influence these norms. The psychological and cosmetic importance of hair is immense in our society. The clinical presentation of pediatric hair disorders ranges from subtle to disfiguring. Management of hair disorders requires a holistic approach to the child and family. Young children usually lack self-awareness and it may be the parent who, projecting their own concerns onto the child, most acutely feels any associated anxiety. In addition, parents of a child with an inherited hair condition often feel guilt, and siblings can develop unsupported fears that they may be affected. Hair loss for the older child can lead to low self-esteem, depression and humiliation. Congenital and hereditary hypotrichosis and hair shaft abnormalities often have no effective treatment. There is a variety of treatment options for alopecia areata and telogen effluvium, but no single treatment is 100% effective. Tinea capitis is an infective condition of the hair that responds readily to the appropriate medical therapy. If no effective treatment for the hair loss exists, cosmetic camouflage with wigs is the best option.
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PMID:Optimal management of hair loss (alopecia) in children. 1457 98

The author is looking to the psychological consequences of chronic hair diseases through a review of the recent literature. In general those consequences are depending on the coping skills and on the personality traits. The effect of hair loss on the quality of life is similar to that of a severe psoriasis. The most important effect is a loss of self-confidence. This is enhanced by an insecure or ambivalent attachment pattern. The coping skills will therefore be different and less flexibles. Two psychiatric syndromes are first mentioned: the body dysmorphic syndrome (very slight or imaginary defect in appearance) and trichotillomania. Androgenetic alopecia leads to an important suffering in women mostly. Alopecia induced by cancer chemotherapy has been reported to cause changes in self-concept and body image. This does not return to the previous state after regrowth of hair for a majority of patients. A cosmeto-oncologic care strategy is developed in our department to improve the quality of life of the patients during this difficult coping period. Alopecia areata has an important psychiatric comorbidity: mostly anxiety and depression. Old stressful life events are frequently reported at the onset of the disease revealing a chronic stress. Those patients have difficulties to express their feelings (what is called alexithymia). With a systemic vision this is interpreted as an unconscious task of avoiding family conflicts. This conflicts are raising the anxiety of family splitting coming from early loss or death in the previous generations. A cautious family therapy helps to change those unconscious myths.
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PMID:[Psychological consequences of chronic hair diseases]. 1551 58

Alopecia areata (AA) is an autoimmune disease leading to loss of scalp hairs. The disease seems triggered by stress. Data on the possibility of using hypnotherapy in the treatment of AA are very limited. Twenty-eight patients with extensive AA, all refractory to previous conventional treatment, were treated with hypnosis at the Academic Hospital UZ Brussel, Brussels, Belgium. This paper describes in detail the authors' hypnotherapeutic approach combining symptom-oriented suggestions with suggestions to improve self-esteem. Twelve out of 21 patients, including 4 with total loss of scalp hair, presented a significant hair growth. All patients presented a significant decrease in scores for anxiety and depression. Although the exact mechanism of hypnotic interventions has not been elucidated, the authors' results demonstrate that hypnotic interventions may ameliorate the clinical outcome of patients with AA and may improve their psychological well-being.
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PMID:Hypnotic approaches for alopecia areata. 1856 42


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