- The bidirectional relationship between MDD and AA was news to me as a clinician and I will be putting this in my practice right away. The idea is to screen AA patients for depression (dermatologist and PCP to be aware). Psychiatrists should ask MDD patients about hair loss in round patches on the scalp or other parts of the body. My patients have at times complained of hair loss and I have thought it may be due to divalproex or other medications. In retrospect I should have asked about AA.
- There are several other conditions which have a bidirectional relationship with MDD. These include vitiligo, heart disease, irritable bowel syndrome, and hip fracture.
- In summary I suggest that we screen for depression, and aim to treat to remission. We should ask about hair loss and further about bald patches. When we think of hair loss due to medications, we should also think of AA and ask a couple screening questions.
--Is the hair falling intact?
--Is the hair falling in round patches in the scalp or elsewhere in the body?
Labs: Measurement of hormone levels suggested include DHEAS (Dehydroepiandrosterone), testosterone, prolactin, FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone)
Serum iron, ferritin and Total Iron Binding Capacity (TIBC)
TSH, VDRL (Venereal Disease Research Laboratory), CBC
Refer to a dermatologist.