Publication: Erkek Tipi Saç Dökülmesinde Depresyon ve Serum Bdnf İlişkisi
Abstract
Giriş ve Amaç: Erkek tipi saç dökülmesi, erkeklerde en sık görülen saç dökülme paternidir. Saç dökülmesinin şiddetine bağlı olarak hayat kalitesinde azalma, özgüvensizlik, asosyallik, azalan benlik saygısı ve bunlarla ilişki depresyon komorbiditeleri görülebilir. Depresyon ile ilişkisi literatürde gösterilen önemli bir nörotröfik faktör olan beyin türevli nörotrofik faktör (BDNF) ise saç foliküllerin anagen fazında görev alır. Serum BDNF, depresyon varlığının takibinde ve tedavide uygun ilaç seçiminde önemli bir belirteçtir. Çalışmamızda erkek tipi saç dökülmesinde depresyon varlığını ve şiddetini serum BDNF düzeyi ve psikiyatrik testler ile araştırdık. Hastalar ve Yöntem: Araştırmamıza Ocak 2023 ile Haziran 2023 arasında Ondokuz Mayıs Tıp Fakültesi Deri ve Zührevi Hastalıkları kliniğine başvuran erkek tipi saç dökülmesi olan 18-40 yaş arasında 150 erkek hastayı dâhil ettik. Hastaların hiçbirinde son 3 ay içinde herhangi bir psikotrop ilaç kullanım öyküsü, psikiyatrik hastalık öyküsü, eşlik eden sistemik ve dermatolojik hastalık yoktu. Tüm hastaların saç dökülme şiddeti Hamilton-Norwood skalasına göre yapıldı. Çalışmada elde edilen verileri karşılaştırmak için yaşa göre (18-29 yaş ve 30-40 yaş) ve dökülmenin şiddetine göre (evre 1-3 ve evre 4-7) gruplar oluşturuldu. Tüm katılımcıların demografik verileri (yaş, medeni durum, eğitim düzeyi) ve tedavi öyküsü veri formuna kaydedildi. Depresyon-Anksiyete-Stres-21 (DASS-21), Dermatolojide Yaşam Kalite İndexi (DLQI) ve Beck Depresyon Envanteri (BDE) anketleriyle hastalar değerlendirildi. Bu anketler ile depresyon, stres ve anksiyete varlığı araştırıldı. Serum BDNF düzeyi SunRed Bio (Shanghai, China) kitleri kullanılarak ELISA yöntemi ile ölçüldü. Elde edilen tüm bulgular kayıt edildi. Sonuçlar IBM SPSS V23 istatistik paket programı kullanılarak analiz edildi. Bulgular: Yaş ve evre gruplarında hastaların dağılımı benzerdi. En düşük serum BDNF düzeyi 30-40 yaş arasındaki hastalarda 4,12±0,54 ng/mL olarak bulundu. Lisans ve lisansüstü mezunu olan hastalarda ilköğretim ve lise mezunlarına göre daha yüksek BDE skorları ve daha düşük serum BDNF düzeyleri mevcuttu. Tedavi öyküsü pozitif olan grupta tedavi öyküsü negatif olan gruba göre Beck Depresyon Envanteri skor ortalaması daha yüksek, serum BDNF düzeyi daha düşük bulundu. Aile öyküsü pozitif 18-29 yaş grubundaki hastalarda DASS-21 Anksiyete puan ortalaması diğer tüm gruplara göre daha yüksekti ve anlamlı fark mevcuttu. Bekâr hastalarda ortalama Beck Depresyon Envanteri skoru 14,15±1,42, evlilerde ise 7,52±1,12 bulundu ve anlamlı fark mevcuttu (p<0,05). Ayrıca serum BDNF ortalama düzeyi bekâr hastalarda evlilere göre daha düşüktü. Serum BDNF düzeyi ile gruplarda benzer sonuçları gösteren anket ise Beck Depresyon Envanteri oldu. Dermatoloji yaşam kalite indexi (DLQI) skorlarında ise gruplar arasında farklılık görülmedi. Tartışma ve Sonuç: Erkek tipi saç dökülmesi hastalarında depresyon ve depresyona bağlı semptomlar yaş, evre, demografik özelliklere göre değişebilmektedir. Serum BDNF düzeyinin genç, bekâr, eğitim seviyesi yüksek ve tedavi öyküsü pozitif olan gruplarda daha düşük bulunması depresif bozukluk varlığını göstermiştir. Klinisyenler medikal tedavilere ek olarak eşlik edebilecek depresif bozukluklar için daha bütüncül yaklaşım göstermelidir. Anahtar Sözcükler, Serum BDNF, Erkek Tipi Saç Dökülmesi, Depresyon
Introduction and Aim: Male pattern hair loss is the most common hair loss pattern in men. Depending on the severity of hair loss, decreased quality of life, lack of self-confidence, asociality, decreased self-esteem and depression comorbidities related to these may be observed. Brain-derived neurotrophic factor (BDNF), an important neurotrophic factor that has been shown to be related to depression in the literature, is responsible for the anagen phase of hair follicles. Serum BDNF is an important marker in the follow-up of the presence of depression and in the selection of appropriate medical drugs for treatment. In our study, we aimed to show the presence and severity of depression in male pattern hair loss with serum BDNF levels and psychiatric evaluation. Patients and Methods: The study included 150 male patients between the ages of 18 and 40 with male pattern hair loss who presented to the Skin and Venereal Diseases Clinic of Ondokuz Mayıs Faculty of Medicine between January 2023 and June 2023. All included patients were over the age of 18 and under the age of 40, had no history of psychotropic drug use in the last 3 months, no history of psychiatric disease, and no accompanying systemic or dermatological diseases. All patients were staged according to the Hamilton-Norwood scale. Patients were grouped as 18-29 years old and 30-40 years old, stage 1-3, and stage 4-7. Demographic data, treatment history, and family history of all participants were recorded in the data form. Depression-Anxiety-Stress-21 (DASS-21), Dermatology Life Quality Index (DLQI), and Beck Depression Inventory (BDI) forms were applied by the patients. Depression, stress and anxiety were investigated with these forms. BDNF levels in serum were studied with ELISA method using SunRed Bio (Shanghai, China) kits. All findings were recorded. Statistical analysis was performed using IBM SPSS V23 statistical package program. Results: The distribution of patients by age and stage groups was similar. In the 30-40 age group and stage 4 and above group, the lowest serum BDNF level was found to be 4.12±0.54 ng/mL. The group with undergraduate and graduate degrees had higher BDI scores and lower serum BDNF levels compared to the primary and high school graduate groups. The mean Beck Depression Inventory score was found to be higher and the serum BDNF level was found to be lower in the group with a positive treatment history compared to the group with a negative treatment history. The mean DASS-21 Anxiety score in the 18-29 age group with a positive family history was higher than in all other groups and there was a significant difference. The mean Beck Depression Inventory score was found to be 14.15±1.42 in single patients and 7.52±1.12 in married patients and there was a significant difference (p<0.05). In addition, the mean serum BDNF level was lower in single patients compared to married patients. The form that showed similar results in the groups with serum BDNF level was the Beck Depression Inventory. There was no difference between the groups in the Dermatology Life Quality Index(DLQI) scores. Discussion and Conclusion: Depression and symptoms related to depression in male pattern hair loss patients may vary according to age, stage, and demographic characteristics. The fact that serum BDNF levels were found to be lower in young, single, highly educated, and positive treatment history groups indicated that we needed to investigate the depression clinic. The importance of hair in the social environment in terms of gender roles has increased today, and as clinicians, we believe that a more holistic approach should be taken in addition to medical treatment options. Keywords, Serum BDNF, Male Pattern Hair Loss, Depression
Introduction and Aim: Male pattern hair loss is the most common hair loss pattern in men. Depending on the severity of hair loss, decreased quality of life, lack of self-confidence, asociality, decreased self-esteem and depression comorbidities related to these may be observed. Brain-derived neurotrophic factor (BDNF), an important neurotrophic factor that has been shown to be related to depression in the literature, is responsible for the anagen phase of hair follicles. Serum BDNF is an important marker in the follow-up of the presence of depression and in the selection of appropriate medical drugs for treatment. In our study, we aimed to show the presence and severity of depression in male pattern hair loss with serum BDNF levels and psychiatric evaluation. Patients and Methods: The study included 150 male patients between the ages of 18 and 40 with male pattern hair loss who presented to the Skin and Venereal Diseases Clinic of Ondokuz Mayıs Faculty of Medicine between January 2023 and June 2023. All included patients were over the age of 18 and under the age of 40, had no history of psychotropic drug use in the last 3 months, no history of psychiatric disease, and no accompanying systemic or dermatological diseases. All patients were staged according to the Hamilton-Norwood scale. Patients were grouped as 18-29 years old and 30-40 years old, stage 1-3, and stage 4-7. Demographic data, treatment history, and family history of all participants were recorded in the data form. Depression-Anxiety-Stress-21 (DASS-21), Dermatology Life Quality Index (DLQI), and Beck Depression Inventory (BDI) forms were applied by the patients. Depression, stress and anxiety were investigated with these forms. BDNF levels in serum were studied with ELISA method using SunRed Bio (Shanghai, China) kits. All findings were recorded. Statistical analysis was performed using IBM SPSS V23 statistical package program. Results: The distribution of patients by age and stage groups was similar. In the 30-40 age group and stage 4 and above group, the lowest serum BDNF level was found to be 4.12±0.54 ng/mL. The group with undergraduate and graduate degrees had higher BDI scores and lower serum BDNF levels compared to the primary and high school graduate groups. The mean Beck Depression Inventory score was found to be higher and the serum BDNF level was found to be lower in the group with a positive treatment history compared to the group with a negative treatment history. The mean DASS-21 Anxiety score in the 18-29 age group with a positive family history was higher than in all other groups and there was a significant difference. The mean Beck Depression Inventory score was found to be 14.15±1.42 in single patients and 7.52±1.12 in married patients and there was a significant difference (p<0.05). In addition, the mean serum BDNF level was lower in single patients compared to married patients. The form that showed similar results in the groups with serum BDNF level was the Beck Depression Inventory. There was no difference between the groups in the Dermatology Life Quality Index(DLQI) scores. Discussion and Conclusion: Depression and symptoms related to depression in male pattern hair loss patients may vary according to age, stage, and demographic characteristics. The fact that serum BDNF levels were found to be lower in young, single, highly educated, and positive treatment history groups indicated that we needed to investigate the depression clinic. The importance of hair in the social environment in terms of gender roles has increased today, and as clinicians, we believe that a more holistic approach should be taken in addition to medical treatment options. Keywords, Serum BDNF, Male Pattern Hair Loss, Depression
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