RESUMEN
Although there often exists important psychological comorbidity in patients with alopecia areata, few studies have investigated the role of psychotherapeutic interventions. The aim of this prospective cohort study was to investigate the long-term evolution of psychological symptoms in twenty-one patients with refractory alopecia areata. Patients received 10 individual sessions of hypnosis during an approximate 6-month period. Before treatment, patients presented a pathological psychological comorbidity. After treatment, a significant amelioration of alexithymia, anxiety, depression and mental well-being was observed. These improvements were maintained up to 6 months after the end of treatment. Important limitations of this study include the recruitment of highly motivated patients and a non-controlled study design. In summary, hypnotherapy may be effective for significantly improving and maintaining psychological well-being and quality of life in patients with refractory alopecia areata.
Asunto(s)
Alopecia Areata/psicología , Hipnosis , Calidad de Vida , Adolescente , Adulto , Síntomas Afectivos/diagnóstico , Anciano , Emociones , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto JovenAsunto(s)
Alopecia Areata/psicología , Ansiedad/psicología , Depresión/psicología , Cabello/crecimiento & desarrollo , Hipnosis , Calidad de Vida/psicología , Adulto , Alopecia Areata/terapia , Ansiedad/terapia , Estudios de Cohortes , Depresión/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
BACKGROUND: Whether adult alopecia areata (AA) is associated with childhood or total lifetime traumatic events is not known. Previous studies have investigated only the relationship with recent stressful events. OBJECTIVE: We sought to determine whether patients with AA experience more childhood or total lifetime traumatic events, as measured by the Traumatic Experiences Checklist. METHODS: Using a case-control study, data on 90 patients with AA and 91 control subjects were analyzed. RESULTS: Significantly more patients with AA experienced total lifetime and early childhood traumatic events, with an odds ratio of 2.46 (95% confidence interval 1.15-5.28; P = .017) and 2.16 (1.15-4.06; P = .016), respectively. In patients with AA, the global impact score related to their traumatic experiences was significantly higher than in control subjects (P < .001). In addition, patients with AA experienced significantly more emotionally and physically traumatic events. LIMITATION: This case-control study is susceptible to recall bias and to confounding factors associated with stress caused by AA outbreaks or by a traumatic childhood history. CONCLUSION: Our study documents an increased history of childhood trauma in patients with AA compared with control subjects.
Asunto(s)
Alopecia Areata/epidemiología , Alopecia Areata/psicología , Acontecimientos que Cambian la Vida , Estrés Psicológico/epidemiología , Adulto , Estudios de Casos y Controles , Niño , Maltrato a los Niños/estadística & datos numéricos , Abuso Sexual Infantil/estadística & datos numéricos , Violencia Doméstica/estadística & datos numéricos , Salud de la Familia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Encuestas y CuestionariosRESUMEN
BACKGROUND: Alexithymia is a personality trait characterized by difficulties in differentiating and describing feelings. Research indicates that alexithymia acts as a triggering factor for many medical and psychiatric disorders. The interest in alexithymia has increased considerably over the past decade. A state of the art review of recent research on alexithymia in medical and dermatological research is presented. METHODS: We reviewed most relevant publications on alexithymia from the field of clinical research, psychology, psychosomatics, and psycho-neuro-endocrinology. Systematic searches on alexithymia in dermatology were undertaken using the Cochrane Library and PUBMed. RESULTS: Interdisciplinary research, investigating alexithymia, is advancing rapidly into different fields of medicine. Alexithymia has been found to be associated with changes in sympathetic activity, immunity and brain activity. Some researchers link alexithymia with insecure parental attachment and adverse childhood experiences. Although research of alexithymia in dermatology is still scarce and reveals conflicting results, preliminary data show that alexithymia seems to be associated with alopecia areata, psoriasis, atopic dermatitis, vitiligo or chronic urticaria. CONCLUSION: Present research findings on alexithymia in the field of dermatology suggest important implications for the treatment of some specific dermatological disorders. Besides treating comorbid psychological problems such as anxiety and depression, dermatologists should also be aware of alexithymia and its possible association with an underlying dermatologic disease.
Asunto(s)
Síntomas Afectivos/diagnóstico , Síntomas Afectivos/epidemiología , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/epidemiología , Ansiedad/diagnóstico , Ansiedad/epidemiología , Comorbilidad , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/epidemiología , Dermatología , Femenino , Humanos , Incidencia , Masculino , Pronóstico , Trastornos Psicofisiológicos/diagnóstico , Trastornos Psicofisiológicos/epidemiología , Recurrencia , Medición de Riesgo , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Enfermedades de la Piel/prevención & control , Estrés PsicológicoRESUMEN
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.
Asunto(s)
Alopecia Areata/terapia , Hipnosis/métodos , Adulto , Síntomas Afectivos/psicología , Síntomas Afectivos/terapia , Anciano , Alopecia Areata/psicología , Femenino , Humanos , Imaginación , Masculino , Meditación , Trastornos Fóbicos/psicología , Trastornos Fóbicos/terapia , Embarazo , Autoimagen , Estrés Psicológico/complicaciones , SugestiónRESUMEN
BACKGROUND: Only limited data exist on the role of psychotherapy in alopecia areata (AA). OBJECTIVE: We sought to document the influence of hypnotherapy on psychologic well-being and clinical outcome in AA. METHODS: Hypnosis was used in 28 patients with extensive AA who were refractory to previous conventional treatments. It was added as a complementary treatment or used as the only treatment. RESULTS: In all, 21 patients, 9 with alopecia totalis or alopecia universalis and 12 with extensive AA, were analyzed during a 5-year period. After treatment, all patients had a significantly lower score for anxiety and depression. Scalp hair growth of 75% to 100% was seen in 12 patients after 3 to 8 sessions of hypnotherapy. Total growth occurred in 9 of these 12 patients, including 4 patients with alopecia universalis and 2 with ophiasis. In 5 patients, a significant relapse occurred. LIMITATIONS: This is a preliminary study with a limited number of patients. A larger randomized study is necessary. CONCLUSION: Hypnotherapy may enhance the mental well-being of patients with AA and it may improve clinical outcome.
Asunto(s)
Alopecia Areata/psicología , Alopecia Areata/terapia , Hipnosis , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Recurrencia , Resultado del TratamientoRESUMEN
Hypnosis can be a valuable technique in the management of patients who fear medical treatment. Hypnosis leads to a stronger concentration and a more focussed attention, and thus to a better acceptance and greater effectiveness of suggestions. Literature indicates that hypnotherapy can reduce pain and fear in case of dental or medical phobia. After a short review of the existing literature on the topic, the practical aspects of the hypnotic approach are explained.