The impact, prevalence, and association of different forms of hair loss among individuals with anxiety disorder: Systematic review and meta-analysis

Abstract

Background: Hair loss is a serious health concern, with individuals having to bear the associated psychological impact of the condition. Alopecia has been linked to emotional and psychological anguish in relationships, career, and personal life. Objective: This study aimed to elucidate the intricate association, prevalence, and impact of hair loss with anxiety disorders, distinguished from other psychological impacts of alopecia. Methods: The current review and meta-analysis were performed in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) framework. A comprehensive search was performed using the Cochrane, PubMed, and Google Scholar electronic databases studies published in English and conducted between January 2014 and September 2024. Statistical analysis was performed using STATA version 16.0 (StataCorp LLC), and the Newcastle-Ottawa Scale and RoB 2 tools were used for critical quality appraisal. Results: A total of 24 eligible articles were included in the current study, with a cumulative of 5553 patients presenting with 1 or more forms of hair loss. Anxiety disorder was significantly prevalent among patients with alopecia event rate (ER) 0.47 (95% CI: 0.39-0.54). Anxiety severity analysis also showed a significant relationship between anxiety and hair loss, with ERs of 0.35 (95% CI: 0.10-0.60), 0.15 (95% CI: 0.01-0.29), and 0.05 (95% CI: 0.03-0.29), respectively. Statistical significance was also demonstrated by a mean HADS-A score of 7.87 (95% CI: 6.85-8.88). However, considerable heterogeneity was observed in various statistical analyses. Conclusion: In summary, our study showed that among people with hair loss-related diseases, alopecia was substantially linked to anxiety disorders, with the frequency of anxiety among those affected being noticeably higher.