Which ethnic group has the highest risk of alopecia areata (AA)-associated anxiety disorders?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: December 27, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Ethnic Disparities in Alopecia Areata-Associated Anxiety Disorders

Black ethnicity patients with alopecia areata have the highest risk of AA-associated anxiety disorders, with an adjusted odds ratio of 2.92 (95% CI 1.71-4.91) compared to matched controls. 1

Evidence from Population-Based Studies

The most robust evidence comes from a 2024 UK population-based cohort study examining 6,961 people with alopecia areata across multiple ethnic groups. 1 This study specifically stratified mental health outcomes by ethnicity and found:

  • Black ethnicity patients demonstrated the highest anxiety risk with an adjusted odds ratio of 2.92 (95% CI 1.71-4.91) compared to matched controls without AA 1
  • This represents nearly 3-fold increased odds of anxiety disorders specifically in Black patients with AA 1
  • The same study found Black ethnicity patients also had the greatest risk of work-related impairment (adjusted hazard ratio 2.54,95% CI 1.80-3.56) 1

Broader Ethnic Patterns in AA Incidence

While the question focuses on anxiety specifically, understanding the overall ethnic distribution of AA provides important context:

  • Asian ethnicity showed the highest lifetime incidence of AA at 5.87% (95% CI 5.51-6.24), followed by Other ethnicity (4.5%), Mixed ethnicity (4.4%), and Black ethnicity (3.0%), all substantially higher than White ethnicity (1.7%) 1
  • However, incidence does not correlate with anxiety risk—Asian patients had the highest AA rates but Black patients had the highest anxiety burden 1

General Anxiety Prevalence in AA

Across all ethnic groups, patients with alopecia areata face elevated psychiatric comorbidity:

  • Generalized anxiety disorder rates reach 39% in AA patients 2
  • Overall anxiety prevalence is significantly elevated in AA patients compared to controls, with mean anxiety scores of 12.76±7.21 versus 8.54±6.37 (P=0.003) 3
  • AA patients are exposed to anxiety approximately three times more than healthy individuals 3

Clinical Implications

Clinicians should implement targeted psychiatric screening for Black patients with AA, given their disproportionately high anxiety risk. 1 The marked heterogeneity in mental health impact across ethnic groups necessitates culturally-adapted assessment and intervention strategies. 1

Key Screening Considerations:

  • Black patients with AA warrant immediate anxiety screening at diagnosis and throughout treatment 1
  • Female patients aged 30-49 represent another high-risk subgroup for depression comorbidity across ethnicities 4
  • Standardized anxiety rating scales should be incorporated into routine dermatologic care for AA patients 3

Important Caveats

The evidence base for ethnic-specific anxiety outcomes in AA remains limited to primarily UK and Israeli populations. 1, 4 Generalizability to other geographic contexts requires caution, though the biological and psychosocial mechanisms underlying AA-associated anxiety likely transcend specific healthcare systems.

Depression shows different ethnic patterns than anxiety—while anxiety peaks in Black patients, depression associations are more uniform across ethnic groups but particularly elevated in the 30-49 age range and among females. 4

References

Related Questions

What does a low serum creatinine level indicate in a patient?
What are the signs and symptoms of severe pneumonia in infants?
What is the diagnosis of a patient with alcohol dependence, pruritus, hyperbilirubinemia, and elevated phosphate levels, is this primary or metabolic dysfunction associated with liver disease?
What treatment options are available for severe acne that develops after stopping birth control (hormonal contraception)?
What is the management plan for a patient with recurrent syncope and orthostatic intolerance, diagnosed via a positive head-up tilt table test, with normal cardiac investigations?
What is the recommended dosage of Levolin (levosalbutamol) for a child requiring nebulization?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question