S7 HAIRDEX - A TOOL FOR EVALUATION OF LIFE QUALITY IN HAIR PATIENTS
Fischer TW1,2, Schmidt S3, Elsner P1
1Department of Dermatology and Allergology, Friedrich-Schiller-University, Jena, Germany
2Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
3Department of Medical Psychology, University Hospital of Hamburg Eppendorf, Hamburg, Germany

Patients with hair loss often experience significant deterioration in quality of life (QoL) and develop different strategies to cope with their problem. Before this background, a new QoL-questionnaire was established and evaluated in 75 women with androgenetic alopecia or diffuse alopecia attending an university hair clinic. QoL in patients was assessed using 5 items: symptoms, functions, emotions, self-confidence and stigmatization. Evaluation of the questionnaire quality was performed according to the following criteria: validity, reliability, accuracy and general acceptance. The general acceptance of the QoL-questionnaire itself by the patients was evaluated in an independent separate questionnaire. Clinical manifestation was categorized as "non-visible", "slightly visible" and "obviously visible". The relationship between quality of life values and degree of clinically observed manifestation of hair loss was further investigated. Coping strategies were evaluated by psychological assessment. Measurement of QoL showed that all patients had a significant reduction of life quality. Patients with "non-visible" hair loss had strong reduction of life quality in categories "emotions", self-confidence" and "stigmatization", whereas patients with "obviously visible" hair loss showed reduced values in categories "symptoms" and "functions". In the group of non-visible hair loss, a sub-group was identified showing serious signs of psychological disturbance such as tendencies to dysmorphophobic or affective disorders leading to the paradox relationship between objective and subjective symptoms. The validity, reliability and accuracy of the questionnaire were satisfactory and the acceptance (90%) very good. The results show that the Hairdex is an important QoL instrument covering the evaluation of subjective health as an additional category of disease in women with hair loss apart from clinical symptoms. Moreover, there is strong evidence that female alopecia is a condition with strong psychological impact on affected women.