Alopecia areata and stress in children

Background The role of psychological factors is conflicting in alopecia areata (AA). Acute as well as chronic stress have been observed in patients with AA. Design A descriptive study of psychological and social factors which may play a role in the pathogenesis and prognosis of childhood AA. Seventeen patients with AA were dermatologically examined and psychosocially studied. Behavioral and emotional problems and possible psychopathology in the child's actual functioning were scored with the Child Behavior Checklist (CBCL) and a life events scale. Fifteen patients with visible atopic dermatitis (AD) formed a reference group. Results Although, on average, children with AA do not have higher behavior problem scores than children in the normative group, more children had scores in the clinical range. However, AA and AD children did not differ in this respect. More AA and AD children than children in the normative group had low social competence scores. Thus, although some AA children differ from children from the normative group, this difference is not specific compared with other children with affected skin, i.e., the AD group. The mean total score and the mean number of life events did not differ significantly from the corresponding data on the international control population. Conclusion A tendency was observed that psychosocial factors play a role in maintaining or inducing AA and AD.