23 August 2024: Clinical Research
Type D Personality, Stress Levels, and Coping Strategies in Women with Androgenetic Alopecia and Polycystic Ovary Syndrome
Paweł Dybciak
1ABCDEF, Dorota Raczkiewicz 1ACDEG*, Ewa Humeniuk 2ADEF, Julia Helena Gujska 3CEF, Krzysztof Suski1BEF, Artur Wdowiak 4BDE, Iwona Bojar 5ADE
DOI: 10.12659/MSM.944746
Med Sci Monit 2024; 30:e944746
Abstract
BACKGROUND: The study was aimed to determine level of stress and using of coping strategies and frequency of type D personality in women with androgenetic alopecia with polycystic ovary syndrome (PCOS), to correlate personality type with level of stress and coping strategies, and to correlate severity of alopecia with personality type, level of stress, and coping strategies.
MATERIAL AND METHODS: The study was conducted in 2023 and included 146 Polish women aged 18 to 45 years with androgenetic alopecia and PCOS. A questionnaire containing social-demographic data, gynecological and obstetric history, health history, history of diagnosis, and treatment of PCOS in the past and present. Three standardized questionnaires were used: the Type-D Scale (DS)-14, Perceived Stress Scale (PSS)-10, and Coping Orientation to Problems Experienced (COPE) inventory.
RESULTS: Type D personality was found in 45% of patients. Most patients perceived high levels of stress (44%) and most frequently used active and supportive strategies, with avoidance strategies being less frequent. Women with type D personality experienced significantly higher levels of stress, used active strategies less often, and used avoidant strategies more often. Stages of androgenetic alopecia did not correlate with type D personality or levels of perceived stress.
CONCLUSIONS: In women with androgenetic alopecia, type D personality is determinative of a high level of perceived stress and more frequent use of dysfunctional coping strategies. The severity of the condition did not correlate with personality type and level of stress, while it was related to certain coping strategies.
Keywords: Stress, Psychological, Alopecia, Polycystic Ovary Syndrome, Type D personality
Introduction
OBJECTIVE:
The objective of the study was to answer the following questions:
Material and Methods
STUDY GROUP:
The data were collected in 2023 at the outpatient clinic “The Clinic Warsaw” in Warsaw, Poland, and at the Institute of Rural Medicine in Lublin, Poland.
The study included 146 women aged 18 to 45 years with PCOS with symptoms of androgenization in the form of androgenetic alopecia. The selection of this age group at reproductive age 18 to 45 years ensured the homogeneity of the study group. Women over the age of 45 often experience symptoms of menopause, which can cause changes in their emotional state. Women under 18 are teenagers whose emotional state is different from that of women of reproductive age.
PCOS in the studied women was confirmed by the Rotterdam criteria. In 2003, the American Society for Reproductive Medicine and the European Society for Human Reproduction and Embryology, reaffirmed PCOS as a “syndrome”, but expanded its definition to 3 diagnostic features (or diagnostic criteria), known as the Rotterdam criteria. They include (1) oligo-anovulation, (2) hyperandrogenism (clinical and/or biochemical), and (3) polycystic ovaries evidenced by ultrasound techniques. Other diseases causing hyperandrogenism have to be excluded during the differential diagnostic stage. Since the presence of 2 out of the 3 criteria is required for PCOS diagnosis, each patient was examined by a medical doctor for androgenic disorders: hirsutism (Ferriman-Gallwey scale) and androgenetic alopecia (Savin scale).
The inclusion criteria were age 18 to 45 years, PCOS, and androgenic alopecia. The exclusion criteria were previously diagnosed depression or other mental disease, addictions, and diagnosed chronic diseases.
The research tools included a questionnaire containing social-demographic data, data on gynecological and obstetric history, health history, and history of diagnosis and treatment of PCOS in the past and now. Three standardized questionnaires were used: the Type-D Scale (DS)-14, Perceived Stress Scale (PSS)-10, and Coping Orientation to Problems Experienced (COPE) inventory.
The study received an approval by the Ethics Committee of the Institute of Rural Medicine in Lublin, Poland (protocol number INW4/2019, date March 13, 2019) and is agreement with the Declaration of Helsinki.
SAVIN SCALE OF ANDROGENIC ALOPECIA:
The Savin Scale was used to measure androgenic alopecia in the examined women. It is worth mentioning that a different scale is used to measure alopecia in men.
Figure 1 presents a range of images showing the degree of severity, from no hair loss to severe hair loss in women, according to the Savin scale. Stage I, which in an early stage of hair loss, indicates initial signs of hair thinning and consists of 4 substages: I-1, I-2, I-3, and I-4. Stage II indicates moderate hair loss and consists of 2 substages, II-1 and II-2. Stage III indicates extensive hair loss. The following eighth stage is advanced hair loss. The ninth final stage indicates frontal anterior recession [33].
DS-14 QUESTIONNAIRE:
To assess the presence of type D personality, the DS-14 questionnaire, which had been validated in Polish, was used [34,35]]. It consists of 2 subscales: negative affectivity and social inhibition, with 7 items each. The respondent selects 1 answer from a 5-point Likert scale to each item, with the answers scored as follows: 0=false, 1=rather false, 2=neutral, 3=rather true, and 4=true. There is no reversal of coding. Total scores in the negative affectivity and social inhibition subscales are the sum of the answers to all the 7 items in the 2 subscales, respectively, and range from 0 to 28, where high negative affectivity or social inhibition is indicated by at least 10 points. If the score in both subscales is at least 10 points, type D personality is diagnosed. A higher score means a higher intensity of type D personality.
The Cronbach alpha coefficient for the Polish version of DS-14 is 0.86 for negative affectivity and 0.84 for social inhibition.
PSS-10 SCALE:
To assess the level of perceived stress, the Polish adaptation of the PSS-10 scale was used. It contains 10 questions regarding how often certain feelings and situations related to personal events occurred in the last month [35,36]. The respondent selects 1 answer from a 5-point Likert scale to each question, with the answers scored as follows: 0=never, 1=almost never, 2=sometimes, 3=fairly often, and 4=very often. The points for 4 questions, 4, 5, 7, and 8, must be reversed. The overall score of the scale is the sum of all points and is from 0 to 40, with a higher score indicating a higher level of perceived stress. The test result is interpreted as follows: 0–13 points indicates a low level of perceived stress, 14–26 points indicates a moderate level of perceived stress, and 27–40 points indicates a high level of perceived stress.
The Cronbach alpha coefficient for the Polish version of the PSS-10 is 0.86.
COPE INVENTORY:
To present different ways that the examined women coped with stress and how often they used them, the COPE inventory by Carver et al, which was validated in Polish, was applied [35,37]. It consists of 60 items divided into 15 strategies (4 items in each strategy). The respondent selects 1 answer from a 4-point scale to each item, with answers scored as follows: 1=“I usually don’t do this at all”, 2=“I usually do this a little bit”, 3=“I usually do this a medium amount”, and 4=“I usually do this a lot”. There is no reversal of coding.
Total scores for each of the 15 strategies are the arithmetic mean of the answers to the 4 items belonging to its respective strategy. The scores for the strategies range from 1 to 4 and indicate how often a given strategy is used. A higher score means a higher frequency of using the strategy. The 15 strategies were divided into 3 factors: active-coping, avoidant-coping, and socially-supported.
The Cronbach alpha coefficient for the Polish version of the COPE inventory ranges from 0.48 to 0.94 for the 15 different strategies.
STATISTICAL METHODS:
The statistical analyses were conducted using STATISTICA 13 software (StatSoft Polska Sp. z o.o. Cracow, Poland).
The mean (M) and standard deviation (SD) were estimated for the continuous variables, as well as the absolute numbers (n) and percentages (%) of the occurrence of the items for categorical variables.
The
Results
CHARACTERISTICS OF WOMEN WITH ANDROGENIC ALOPECIA:
Table 1 presents the results for age, BMI, and Savin scale for androgenic alopecia. The examined women were aged from 22 to 45 years, 32.2±6.4 years on average, and the predominant age group was 20–29 years (41.1%). The mean BMI was 22 kg/m2, and most of the women had normal weight (89%). Most of the examined women had I-1 stage of hair loss (48%), followed by stage I-2 (24%), I-3 (135), I-4 (5.5%), II-1 (3%), II-2 (5%), and III (2%). For further analyses, because of the small sample sizes of the groups of women with stages II-1, II-2, and III, they were combined into 1 group of 14 women in total.
Figure 2 presents the results for age and BMI by the Savin scale for androgenic alopecia of the examined women. The groups of women with different stages of androgenic alopecia differed significantly in terms of age (P<0.001); however, they did not differ in terms of BMI (P=0.771). The first 2 groups of women with the lowest stages of androgenic alopecia (I-1 and I-2) were significantly younger than the women with higher stages (I-3, I-4, II-1, II-2, and III), with a mean age of approximately 30 vs approximately 40 years.
PSYCHOLOGICAL TEST RESULTS IN WOMEN WITH ANDROGENIC ALOPECIA:
Three psychological test were used: the DS-14 questionnaire to assess type of personality, PSS-10 scale to assess level of stress, and COPE inventory to assess ways of coping with stress.
Table 2 presents the results for type D personality according to the DS-14 in the examined women. High negative affectivity was found in approximately 60% of the examined women and high social inhibition in 65%. Both high negative affectivity and high social inhibition, which results in type D personality, was found in 45% of the examined women.
Table 3 presents the results for level of perceived stress according to the PSS-10 in the examined women. Most of the women showed a high level of perceived stress (44%), whereas a similar number of women showed low and moderate level of perceived stress (27.4% and 29%, respectively).
Figure 3 presents how often the examined women used different ways of coping with stress, according to the COPE inventory. The most frequent ways of coping with stress used by the examined women were planning, positive reinterpretation, active-coping, and suppression of competing activities, which belong to the active-coping strategies, and instrumental and emotional social supports and focus on and venting of emotions, which belong to the socially-supported strategies.
The medium frequent ways of coping with stress used by the examined women were acceptance and restraint-coping, which belong to the active-coping strategies, and religion and mental disengagement, which belong to the avoidant-coping strategies.
The least frequent ways of coping with stress used by the examined women were denial, substance use, humor, and behavioral disengagement, which belong to the avoidant-coping strategies.
LEVEL OF STRESS AND WAYS OF COPING WITH STRESS BY TYPE OF PERSONALITY:
Table 4 presents the level of perceived stress according to the PSS-10 by type of personality of the examined women. On comparing PSS-10 scores between the 2 groups of women, with and without type D personality, a significantly higher level of stress was found in the women with type D personality (21.7 points, on average) than in the women without type D personality (15.2 points, on average, P<0.001).
Also, the 2 groups of women, with and without type D personality, differed significantly in terms of the 3 intervals of the PSS-10 (low, moderate, and high level of stress;
Figure 4 presents frequency of different ways of coping with stress, according to the COPE, by type of personality of the examined women. In comparison with the women without type D personality, the women with type D personality used the following self-sufficient strategies less often: planning, positive reinterpretation, active-coping, suppression of competing activities, and restraint-coping. Similarly, they used the following socially-supported strategies less often: instrumental and emotional social supports. On the contrary, the women with type D personality used the following avoidant-coping strategies more often: denial, substance use, humor, and behavioral disengagement.
The frequency of the following strategies did not significantly differ between the women with and without type D personality: acceptance, religion, mental disengagement, and focus on and venting of emotions.
STAGES OF ANDROGENIC ALOPECIA AND PSYCHOLOGICAL TEST RESULTS:
Stages of androgenic alopecia did not correlate with type D personality, according to the DS-14 (Table 5; P=0.205). Stages of androgenic alopecia did not correlate with the level of perceived stress, according to the PSS-10 (Table 6; P=0.898 for scores and P=0.710 for intervals: low, moderate, and high levels of stress).
On the contrary, the stages of androgenic alopecia correlated with frequency of different ways of coping with stress, according to the COPE (Figure 5). The women with I-4 stage of androgenic alopecia used the following strategies more often: positive reinterpretation, acceptance, mental disengagement, denial, and emotional social support than did the women with other stages of androgenic alopecia. Moreover, they used the following strategies less often: restraint-coping, religion, and behavioral disengagement. However, the frequency of using the following strategies did not correlate with the stages of androgenic alopecia: planning, active coping, suppression of competing activities, humor, substance use, instrumental social support, and focus on and venting of emotions (P>0.05).
Discussion
LIMITATIONS OF THE STUDY:
The study had a number of limitations. One limitation was the cross-sectional type of survey, preventing comprehensive evaluation of all the studied aspects. Another limitation was the use of self-reporting questionnaires, which may have resulted in biased responses. The scope of the future research in this area should also include other elements of functioning and other mental disorders and dysfunctions in women with PCOS and androgenic alopecia.
Conclusions
Type D personality was found in 45% of the examined women with PCOS and androgenic alopecia. Type D personality was determinative of a high level of perceived stress and more frequent use of dysfunctional coping strategies. Active strategies are the most common ways of coping with stress in women with PCOS and androgenic alopecia. The severity of the condition did not correlate with type D personality and stress levels, while it was related to certain coping strategies, with no trend toward more dysfunctional strategies observed.
Figures
Figure 1. Savin scale. Figure was generated in Microsoft Paint, Microsoft, Redmond, USA. 
Figure 2. (A) Age by stage of androgenic alopecia. (B) Body mass index by stage of androgenic alopecia. P for F test analysis of variance. Figures were generated in STATISTICA 13.3 software, Statsoft, Cracow, Poland. 
Figure 3. Ways of coping with stress according to COPE inventory in the study group (N=146) Midpoint=mean; Whisker=mean±SD. The COPE inventory is a 4-point scale, in which: 1=I usually don’t do this at all; 2=I usually do this a little bit; 3=I usually do this a medium amount; 4=I usually do this a lot. Figure was generated in Microsoft Excel 18, Microsoft, Redmond, USA. 
Figure 4. Ways of coping with stress according to COPE inventory, by type of personality (N=146). Midpoint=mean, * significant differences. The COPE inventory is a 4-point scale, in which: 1=I usually don’t do this at all; 2=I usually do this a little bit; 3=I usually do this a medium amount; 4=I usually do this a lot The t test was used for analysis. Figure was generated in Microsoft Excel 18, Microsoft, Redmond, USA. 
Figure 5. Ways of coping with stress according to COPE, by stages of androgenic alopecia (N=146). Midpoint=mean, * significant differences. The COPE inventory is a 4-point scale, in which: 1=I usually don’t do this at all; 2=I usually do this a little bit; 3=I usually do this a medium amount; 4=I usually do this a lot F test analysis of variance was used. Figure was generated in Microsoft Excel 18, Microsoft, Redmond, USA. Tables
Table 1. Study group characteristics (N=146).
Table 2. Type of personality according to DS-14 in the study group (N=146).
Table 3. Level of perceived stress according to PSS-10 in the study group (N=146).
Table 4. Level of perceived stress according to PSS-10, by type of personality (N=146).
Table 5. Type of personality according to DS-14, by stage of androgenic alopecia, n (%).
Table 6. Level of perceived stress according to PSS-10, by stage of androgenic alopecia (N=146).
References
1. Bertoli MJ, Sadoughifar R, Schwartz RA, Female pattern hair loss: A comprehensive review: Dermatol Ther, 2020; 33(6); e14055
2. del Marmol V, Jouanique CAndrogenetic alopecia: Rev Med Brux, 2004; 25(4); A277-81 [in French]
3. Gupta S, Goyal I, Mahendra A, Quality of life assessment in patients with androgenetic alopecia: Int J Trichology, 2019; 11(4); 147-52
4. Lohia K, Doshi B, Manjunathswamy B, Hair loss severity and its impact on quality of life in patients suffering from androgenic alopecia: A one-year cross-sectional study: Clin Dermatol Rev, 2021; 5(1); 59
5. Nestor MS, Ablon G, Gade A, Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics: J Cosmet Dermatol, 2021; 20(12); 3759-81
6. Starace SM, Orlando G, Alessandrini A, Piraccini BM, Female androgenetic alopecia: An update on diagnosis and management: Am J Clin Dermatol, 2020; 21(1); 69-84
7. Ramos PM, Miot HA, Female pattern hair loss: A clinical and pathophysiological review: An Bras Dermatol, 2015; 90(4); 529-43
8. Motofei IG, Rowland DL, Tampa M, Finasteride and androgenic alopecia; From therapeutic options to medical implications: J Dermatolog Treat, 2020; 31(4); 415-21
9. Reid EE, Haley AC, Borovicka JH, Clinical severity does not reliably predict quality of life in women with alopecia areata, telogen effluvium, or androgenic alopecia: J Am Acad Dermatol, 2012; 66(3); e97-102
10. Schmitt JV, Ribeiro CF, Souza FH, Hair loss perception and symptoms of depression in female outpatients attending a general dermatology clinic: An Bras Dermatol, 2012; 87(3); 412-17
11. Penha MÁ, Santos PM, Miot HA, Dimensioning the fear of dermatologic diseases: An Bras Dermatol, 2012; 87(5); 796-99
12. Tabolli S, Sampogna F, di Pietro C, Health status, coping strategies, and alexithymia in subjects with androgenetic alopecia: A questionnaire study: Am J Clin Dermatol, 2013; 14(2); 139-45
13. Kranz D, Young men’s coping with androgenetic alopecia: Aacceptance counts when hair gets thinner: Body Image, 2011; 8(4); 343-48
14. Aukerman EL, Jafferany M, The psychological consequences of androgenetic alopecia: A systematic review: J Cosmet Dermatol, 2023; 22(1); 89-95
15. Cash TF, The psychosocial consequences of androgenetic alopecia: A review of the research literature: Br J Dermatol, 1999; 141(3); 398-405
16. Harvima IT, Nilsson G, Stress, the neuroendocrine system and mast cells: Current understanding of their role in psoriasis: Expert Rev Clin Immunol, 2012; 8(3); 235-41
17. Pavlovic S, Daniltchenko M, Tobin DJ, Further exploring the brain-skin connection: Stress worsens dermatitis via substance P-dependent neurogenic inflammation in mice: J Invest Dermatol, 2008; 128(2); 434-46
18. Tas B, Kulacaoglu F, Belli H, Altuntas M, The tendency towards the development of psychosexual disorders in androgenetic alopecia according to the different stages of hair loss: A cross-sectional study: An Bras Dermatol, 2018; 93(2); 185-90
19. Sonmez D, Hocaoglu C, Psychological aspect of alopecia: Alopecia management-an update, 2023, IntechOpen Available from: https://www.intechopen.com/chapters/82698
20. Hadshiew IM, Foitzik K, Arck PC, Paus R, Burden of hair loss: Stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia: J Invest Dermatol, 2004; 123(3); 455-57
21. Christian BJ, Translational research – the importance of adaptation and resilience for coping with the stress of chronic conditions in children: J Pediatr Nurs, 2024; 74; 138-40
22. Nkyi AK, Baaba B, Coping, health anxiety, and stress among health professionals during COVID-19, Cape Coast, Ghana: PLoS One, 2024; 19(1); e0296720
23. Monselise A, Bar-On R, Chan L, Examining the relationship between alopecia areata, androgenetic alopecia, and emotional intelligence: J Cutan Med Surg, 2013; 17(1); 46-51
24. Dybciak P, Humeniuk E, Raczkiewicz D, Anxiety and depression in women with polycystic ovary syndrome: Medicina (Kaunas), 2022; 58(7); 942
25. Kowalewska B, Krajewska-Kułak E, Sobolewski M, The impact of stress-coping strategies and the severity of psoriasis on self-esteem, illness acceptance and life satisfaction: Dermatol Ther (Heidelb), 2022; 12(2); 529-43
26. Baysak S, Kılıç FA, Karagün E, Baysak ERelationship of alexithymia, rumination and coping style with psoriasis and their effects on the clinical features: Turk Psikiyatri Derg, 2020; 31(4); 252-58 [in Turkish]
27. Liluashvili S, Kituashvili T, Dermatology Life Quality Index and disease coping strategies in psoriasis patients: Postepy Dermatol Alergol, 2019; 36(4); 419-24
28. Kołodziej K, Kurowska A, Majda A, Intensification of type D personality traits and coping strategies of people staying in Polish penitentiary institutions-cross-sectional study: Int J Environ Res Public Health, 2022; 19(4); 2301
29. Buczkowska M, Górski M, Domagalska J, Type D personality and health behaviors in people living with obesity: Int J Environ Res Public Health, 2022; 19(22); 14650
30. Lecic-Tosevski D, Vukovic O, Stepanovic J, Stress and personality: Psychiatriki, 2011; 22(4); 290-97
31. Sumin AN, Prokashko IY, Shcheglova AV, Evaluation of coping strategies among students with type D personality: Int J Environ Res Public Health, 2022; 19(8); 4918
32. Sánchez-Díaz M, Montero-Vílchez T, Quiñones-Vico MI, Type D personality as a marker of poorer quality of life and mood status disturbances in patients with skin diseases: A systematic review: Acta Derm Venereol, 2023; 103; adv00846
33. Savin R: Evaluating androgenetic alopecia in male and female patients, 1994, Kalamazoo: MI, The Upjohn Company
34. Denollet J, DS14: Standard assessment of negative affectivity, social inhibition, and type D personality: Psychosom Med, 2005; 67(1); 89-97
35. Juczyński Z, Ogińska-Bulik N: Narzędzia pomiaru stresu i radzenia sobie ze stresem, 2009, Warszawa, PTP [in Polish]
36. Cohen S, Kamarck T, Mermelstein R, A global measure of perceived stress: J Health Soc Behav, 1983; 24(4); 385-96
37. Carver CS, Scheier MF, Weintraub JK, COPE inventory [database record]: APA PsycTests, 2012 Available from:http://doi.apa.org/getdoi.cfm?doi=10.1037/t10027-000
38. Van Der Donk J, Hunfeld JA, Quality of life and maladjustment associated with hair loss in women with alopecia androgenetica: Soc Sci Med, 1994; 38(1); 159-63
39. Norazirah M, Mazlin M, Adawiyah J, Shamsul A, Psychological impact, self-perception and the contributing factors in patients with androgenetic alopecia: Journal of Cosmetology & Trichology, 2017; 3(3); 123
40. Cash TF, Price VH, Savin RC, Psychological effects of androgenetic alopecia on women: Comparisons with balding men and with female control subjects: J Am Acad Dermatol, 1993; 29(4); 568-75
41. Kozicka K, Łukasik A, Jaworek A, The level of stress and the assessment of selected clinical parameters in patients with androgenetic alopecia: Pol Merkur Lekarski Dec, 2020; 48(288); 427-30
42. Titeca G, Goudetsidis L, Francq B, ‘The psychosocial burden of alopecia areata and androgenetica’: A cross-sectional multicentre study among dermatological out-patients in 13 European countries: J Eur Acad Dermatol Venereol, 2020; 34(2); 406-11 [Erratum in: J Eur Acad Dermatol Venereol. 2020;34(5):1119]
43. Toussi A, Barton VR, Le ST, Agbai ON, Kiuru M, Psychosocial and psychiatric comorbidities and health-related quality of life in alopecia areata: A systematic review: J Am Acad Dermatol, 2021; 85(1); 162-75
44. Manolache L, Benea V, Stress in patients with alopecia areata and vitiligo: J Eur Acad Dermatol Venereol, 2007; 21(7); 921-28
45. Adamowicz R, Załęcki P, Dukiel A, Nowicka D, Association between androgenetic alopecia and psychosocial disease burden: A cross-sectional survey among Polish men: Dermatol Res Pract, 2022; 2022; 1845044
46. Jafferany M, Psychodermatology: A guide to understanding common psychocutaneous disorders: Prim Care Companion J Clin Psychiatry, 2007; 9(3); 203-13
47. Fairfax A, Brehaut J, Colman ICanadian Inherited Metabolic Diseases Research Network, A systematic review of the association between coping strategies and quality of life among caregivers of children with chronic illness and/or disability: BMC Pediatr, 2019; 19(1); 215
48. Halamová J, Kanovský M, Strnádelová B, The development of the revised COPE 68 inventory with English and Slovak versions: Front Psychol, 2023; 14; 1202571
49. Matzer F, Egger JW, Kopera D, Psychosocial stress and coping in alopecia areata: A questionnaire survey and qualitative study among 45 patients: Acta Derm Venereol, 2011; 91(3); 318-27
50. Mols F, Denollet J, Type D personality in the general population: A systematic review of health status, mechanisms of disease, and work-related problems: Health Qual Life Outcomes, 2010; 8; 9
51. Sánchez-Díaz M, Salazar-Nievas MC, Molina-Leyva A, Arias-Santiago S, Type D personality is associated with poorer quality of life in patients with chronic spontaneous urticaria: A cross-sectional study: Acta Derm Venereol, 2022; 102; adv00734
52. Molina-Leyva A, Caparros-delMoral I, Ruiz-Carrascosa JC, Elevated prevalence of type D (distressed) personality in moderate to severe psoriasis is associated with mood status and quality of life impairment: A comparative pilot study: J Eur Acad Dermatol Venereol, 2015; 29(9); 1710-17
53. Zac RI, da Costa A, Patient satisfaction and quality of life among adult women with androgenetic alopecia using 5% topical minoxidil: J Clin Aesthet Dermatol, 2021; 14(5); 26-30
54. Sereflican B, Tuman TC, Tuman BA, Parlak AH, Type D personality, anxiety sensitivity, social anxiety, and disability in patients with acne: A cross-sectional controlled study: Postepy Dermatol Alergol, 2019; 36(1); 51-57
55. Sajid MI, Najaf DE, Niaz A, SARS-CoV-2 & androgenic alopecia: Exploring links!: Int J Dermatol, 2021; 60(5); e195-e97
Figures
Figure 1. Savin scale. Figure was generated in Microsoft Paint, Microsoft, Redmond, USA.Figure 2. (A) Age by stage of androgenic alopecia. (B) Body mass index by stage of androgenic alopecia. P for F test analysis of variance. Figures were generated in STATISTICA 13.3 software, Statsoft, Cracow, Poland.Figure 3. Ways of coping with stress according to COPE inventory in the study group (N=146) Midpoint=mean; Whisker=mean±SD. The COPE inventory is a 4-point scale, in which: 1=I usually don’t do this at all; 2=I usually do this a little bit; 3=I usually do this a medium amount; 4=I usually do this a lot. Figure was generated in Microsoft Excel 18, Microsoft, Redmond, USA.Figure 4. Ways of coping with stress according to COPE inventory, by type of personality (N=146). Midpoint=mean, * significant differences. The COPE inventory is a 4-point scale, in which: 1=I usually don’t do this at all; 2=I usually do this a little bit; 3=I usually do this a medium amount; 4=I usually do this a lot The t test was used for analysis. Figure was generated in Microsoft Excel 18, Microsoft, Redmond, USA.Figure 5. Ways of coping with stress according to COPE, by stages of androgenic alopecia (N=146). Midpoint=mean, * significant differences. The COPE inventory is a 4-point scale, in which: 1=I usually don’t do this at all; 2=I usually do this a little bit; 3=I usually do this a medium amount; 4=I usually do this a lot F test analysis of variance was used. Figure was generated in Microsoft Excel 18, Microsoft, Redmond, USA. Tables
Table 1. Study group characteristics (N=146).Table 2. Type of personality according to DS-14 in the study group (N=146).Table 3. Level of perceived stress according to PSS-10 in the study group (N=146).Table 4. Level of perceived stress according to PSS-10, by type of personality (N=146).Table 5. Type of personality according to DS-14, by stage of androgenic alopecia, n (%).Table 6. Level of perceived stress according to PSS-10, by stage of androgenic alopecia (N=146).Table 1. Study group characteristics (N=146).Table 2. Type of personality according to DS-14 in the study group (N=146).Table 3. Level of perceived stress according to PSS-10 in the study group (N=146).Table 4. Level of perceived stress according to PSS-10, by type of personality (N=146).Table 5. Type of personality according to DS-14, by stage of androgenic alopecia, n (%).Table 6. Level of perceived stress according to PSS-10, by stage of androgenic alopecia (N=146). In Press
Review article
Long COVID or Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) and the Urgent Need to Identify Diagnostic...Med Sci Monit In Press; DOI: 10.12659/MSM.946512
Clinical Research
Intravenous Lidocaine Response as a Predictor for Oral Oxcarbazepine Efficacy in Neuropathic Pain Syndrome:...Med Sci Monit In Press; DOI: 10.12659/MSM.945612
Review article
Cariprazine in Psychiatry: A Comprehensive Review of Efficacy, Safety, and Therapeutic PotentialMed Sci Monit In Press; DOI: 10.12659/MSM.945411
Clinical Research
Comparison of Remimazolam and Dexmedetomidine for Sedation in Awake Endotracheal Intubation in Scoliosis Su...Med Sci Monit In Press; DOI: 10.12659/MSM.944632
Most Viewed Current Articles
17 Jan 2024 : Review article 6,053,124
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research 1,840,708
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research 693,001
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
07 Jan 2022 : Meta-Analysis 257,439
Efficacy and Safety of Light Therapy as a Home Treatment for Motor and Non-Motor Symptoms of Parkinson Dise...DOI :10.12659/MSM.935074
Med Sci Monit 2022; 28:e935074