Illness perception, psychological distress, and quality of life in patients with alopecia: a cross-sectional study from Riyadh, Saudi Arabia

Abstract

Background

Alopecia, a condition marked by hair loss, includes androgenic alopecia (AGA), alopecia areata (AA), telogen effluvium (TE), and scarring alopecia, each with a unique pathophysiology that profoundly impacts psychological well-being, self-image, and quality of life (QoL), leading to anxiety and depression. Understanding illness perception and its connection to QoL and mental health in comorbid Saudi patients, especially in patients with the simultaneous presence of more than two medical conditions, remains limited. We aimed to assess Saudi patients’ perception of different types of alopecia and explore the relationship between illness perception, QoL, psychological factors, and comorbidities. Methods: A cross-sectional survey was conducted at King Khalid University Hospital, Riyadh, from December 2023 to March 2024. Ninety-nine adults with confirmed alopecia diagnoses completed validated questionnaires, including the Brief Illness Perception Questionnaire (BIPQ), the Dermatology Life Quality Index (DLQI), the Patient Depression Questionnaire (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7). Statistical analysis included regression models to determine predictors of QoL impairment. Results: the most common type of alopecia was AGA (47.5%), followed by AA (30.3%), scarring alopecia (16.2%), and TE (6.1%). Median scores for BIPQ and DLQI were 49.0 and 6.0, respectively, indicating moderate illness perception and QoL impact. Anxiety and depression levels were generally mild, though scarring alopecia patients reported higher emotional distress. Negative illness perception was strongly associated with reduced QoL and higher anxiety and depression scores. Factors such as illness perception, anxiety, and mental health conditions were significant predictors of QoL impairment. Conclusion: Our findings underscore the psychological impact of alopecia and highlight the importance of addressing both physical symptoms and mental health in patient care. Thus, Targeted interventions focusing on illness perception and emotional well-being are crucial for improving outcomes.