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      Health‐related quality of life in patients with alopecia areata: Results of a Japanese survey with norm‐based comparisons

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          Abstract

          Alopecia areata (AA) is a non‐scarring hair loss disorder affecting approximately 2% of the global population. AA is reported to have a significant negative impact on the emotional and psychological well‐being of the patients. This study aimed to evaluate the health‐related quality of life (HRQoL) of Japanese patients with AA in comparison to the Japanese population norms (national standard values for Japanese) using Short Form Health Survey 36 Item Version 2.0 (SF‐36v2). The study also aimed to access the negative effect of AA on patients’ daily lives and the proportion of patients having anxiety and/or depression. This cross‐sectional, non‐interventional web‐based survey study included 400 participants aged 17–84 years currently suffering from medically diagnosed AA. The assessment tools integrated in the online questionnaire included SF‐36v2, the Dermatology Life Quality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). All outcome measures from the tools were evaluated across the study population. SF‐36v2 subscale scores for patients with AA revealed lower scores specifically for mental health (45.7 ± 10.1 points), social functioning (45.8 ± 10.9 points), vitality (46.2 ± 9.8 points), and role emotional (46.9 ± 11.6 points) as compared to the Japanese population norms of 50 ± 10 points each. The DLQI questionnaire‐based analysis indicated that 32.1% of respondents showed a moderate to extremely large effect on their lives; and HADS‐A (anxiety) and HADS‐D (depression) scores categorized 46.0% and 41.8% respondents as doubtful‐to‐definite cases, respectively. Multivariate linear regression revealed that hair loss range, age, comorbidities, and depression significantly worsened DLQI scores. In conclusion, the results of this survey demonstrated that a significant decrease in the HRQoL scores was observed in Japanese patients with AA in comparison with the national norms. Hence, emphasis on mental health is crucial for AA management.

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          Most cited references39

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          The hospital anxiety and depression scale.

          A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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            The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.

            A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.
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              Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use.

              A simple practical questionnaire technique for routine clinical use, the Dermatology Life Quality Index (DLQI) is described. One hundred and twenty patients with different skin diseases were asked about the impact of their disease and its treatment on their lives; a questionnaire, the DLQI, was developed based on their answers. The DLQI was then completed by 200 consecutive new patients attending a dermatology clinic. This study confirmed that atopic eczema, psoriasis and generalized pruritus have a greater impact on quality of life than acne, basal cell carcinomas and viral warts. The DLQI was also completed by 100 healthy volunteers; their mean score was very low (1.6%, s.d. 3.5) compared with the mean score for the dermatology patients (24.2%, s.d. 20.9). The reliability of the DLQI was examined in 53 patients using a 1 week test-retest method and reliability was found to be high (gamma s = 0.99).
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                Author and article information

                Contributors
                kazumasa.kamei@pfizer.com
                Journal
                J Dermatol
                J Dermatol
                10.1111/(ISSN)1346-8138
                JDE
                The Journal of Dermatology
                John Wiley and Sons Inc. (Hoboken )
                0385-2407
                1346-8138
                28 March 2022
                June 2022
                : 49
                : 6 ( doiID: 10.1111/jde.v49.6 )
                : 584-593
                Affiliations
                [ 1 ] Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
                [ 2 ] Inflammation and Immunology Medical Affairs Pfizer Japan Inc. Tokyo Japan
                [ 3 ] Health and Value Pfizer Japan Inc. Tokyo Japan
                [ 4 ] Real‐World Evidence Solutions & HEOR IQVIA Solutions Japan K.K. Tokyo Japan
                [ 5 ] Department of Rehabilitation Niigata University of Health and Welfare Niigata Japan
                Author notes
                [*] [* ] Correspondence

                Kazumasa Kamei, Inflammation and Immunology Medical Affairs, Pfizer Japan Inc., 3‐22‐7 Yoyogi, Shibuya‐ku, Tokyo, 151‐8589, Japan.

                Email: kazumasa.kamei@ 123456pfizer.com

                Author information
                https://orcid.org/0000-0002-9274-7050
                https://orcid.org/0000-0001-7220-5142
                https://orcid.org/0000-0002-3699-7231
                https://orcid.org/0000-0002-7715-5292
                https://orcid.org/0000-0002-6952-7770
                Article
                JDE16364 JDE-2022-0142.R1
                10.1111/1346-8138.16364
                9314875
                35342979
                2fd9c152-cc17-430f-a6cb-df3f2fa570ab
                © 2022 Pfizer Japan Inc. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 February 2022
                : 28 January 2022
                : 08 March 2022
                Page count
                Figures: 2, Tables: 4, Pages: 10, Words: 5610
                Funding
                Funded by: Pfizer Japan Inc. , doi 10.13039/100010793;
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                June 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:26.07.2022

                alopecia areata,cross‐sectional studies,mental health,patient reported outcome measures,quality of life

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