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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 30 janvier 2020
Doi : 10.1016/j.jaad.2019.11.064
accepted : 25 November 2019
Bidirectional association between alopecia areata and major depressive disorder among probands and unaffected siblings: A nationwide population-based study
 

Ying-Xiu Dai, MD a, b, Ying-Hsuan Tai, MD, MSc b, c, d, Chih-Chiang Chen, MD, PhD a, b, e, Yun-Ting Chang, MD, PhD a, b, Tzeng-Ji Chen, MD, PhD b, f, Mu-Hong Chen, MD, PhD b, g,
a Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan 
b School of Medicine, National Yang-Ming University, Taipei, Taiwan 
c Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan 
d Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan 
e Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan 
f Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan 
g Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan 

Correspondence to: Mu-Hong Chen, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei City, Taiwan 11217, ROC.Department of PsychiatryTaipei Veterans General HospitalNo. 201, Sec. 2, Shipai Rd, Beitou DistrictTaipei CityTaiwan11217ROC
Abstract
Background

Alopecia areata (AA) has long been associated with major depressive disorder (MDD). However, most evidence to date has derived from cross-sectional or case-control studies.

Objective

To investigate the bidirectional association between AA and MDD among probands and unaffected siblings.

Methods

Study participants were recruited from the National Health Insurance Research Database in Taiwan. We included 2123 probands with AA, 2298 unaffected siblings, and 9192 matched controls to assess the risk of MDD. We included 16,543 probands with MDD, 17,352 unaffected siblings, and 69,408 matched controls to assess the risk of AA. The Breslow-Cox model was used to calculate the adjusted relative risk.

Results

Compared with controls, AA probands and unaffected siblings had adjusted relative risks of 8.22 (95% confidence interval [CI], 6.41-10.54) and 2.55 (95% CI, 1.91-3.40), respectively, for MDD. MDD probands and unaffected siblings had adjusted relative risks for AA of 1.66 (95% CI, 1.24-2.22) and 1.64 (95% CI, 1.27-2.12), respectively.

Limitation

The National Health Insurance Research Database lacked information on disease severity, body mass index, smoking habit, alcohol consumption, and stressful life events.

Conclusion

Our study demonstrated a bidirectional association between AA and MDD among probands and unaffected siblings, thus suggesting shared familial mechanisms underlying AA and MDD.

The full text of this article is available in PDF format.

Key words : alopecia areata, cohort study, epidemiology, major depressive disorder, siblings, Taiwan's National Health Insurance Research Database

Abbreviations used : CI, MDD, NHIRD



 Funding sources: This study was funded by the Ministry of Science and Technology, R.O.C. under Grant (MOST 107-2314-B-075-032-MY3-2).
 Conflicts of interest: None disclosed.
 IRB approval status: This study was approved by the Taipei Veterans General Hospital Institutional Review Board (2018-07-016AC).
 Reprints not available from the authors.



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