Psychiatric Comorbidities of Childhood-onset Atopic Dermatitis in Relation to Eczema Severity: A Register-based Study among 28,000 Subjects in Finland
DOI:
https://doi.org/10.2340/actadv.v104.40790Keywords:
atopic dermatitis, comorbidity, disease severity, childhood-onset ADAbstract
Data on the severity of childhood-onset atopic dermatitis (AD) in relation to psychiatric comorbidities is scarce, even though AD predisposes to psychiatric comorbidities and the commonness of childhood-onset AD and its significance in disease progression are recognized. The purpose of this nationwide, register-based study of child patients diagnosed with AD in Finland between 1987 and 2017 was to determine how psychiatric comorbidities of AD patients differ depending on the disease severity of childhood-onset AD. AD severity was assessed by purchased AD treatment and risk of comorbidities was analyzed by the age of 18 and 30 years.
The main finding of our study is that risk of several psychiatric disorders, i.e., depression, anxiety disorders and bipolar disorder, increased by the AD severity in childhood-onset AD already at young age. No difference was found for behavioral disorders, including hyperkinetic disorder, depending on AD severity. Childhood-onset AD is associated with different psychiatric comorbidities depending on AD severity, which supports the importance of mental health evaluation in AD patients.
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References
Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet 2020; 396: 345-360.
https://doi.org/10.1016/S0140-6736(20)31286-1 DOI: https://doi.org/10.1016/S0140-6736(20)31286-1
Brunner PM, Silverberg JI, Guttman-Yassky E, Paller AS, Kabashima K, Amagai M, et al. Increasing comorbidities suggest that atopic dermatitis is a systemic disorder. J Invest Dermatol 2017; 137: 18-25.
https://doi.org/10.1016/j.jid.2016.08.022 DOI: https://doi.org/10.1016/j.jid.2016.08.022
Radtke S, Grossberg AL, Wan J. Mental health comorbidity in youth with atopic dermatitis: a narrative review of possible mechanisms. Pediatric Dermatol 2023; 40: 977-982.
https://doi.org/10.1111/pde.15410 DOI: https://doi.org/10.1111/pde.15410
Kauppi S, Jokelainen J, Timonen M, Tasanen K, Huilaja L. Adult patients with atopic eczema have a high burden of psychiatric disease: a Finnish nationwide registry study. Acta Derm Venereol 2019; 99: 647-651.
https://doi.org/10.2340/00015555-3165 DOI: https://doi.org/10.2340/00015555-3165
Appiah MM, Haft MA, Kleinman E, Laborada J, Lee S, Loop L, et al. Atopic dermatitis: review of comorbidities and therapeutics. Ann Allergy Asthma Immunol 2022; 129: 142-149.
https://doi.org/10.1016/j.anai.2022.05.015 DOI: https://doi.org/10.1016/j.anai.2022.05.015
Kiiski V, Ukkola-Vuoti L, Vikkula J, Ranta M, Lassenius MI, Kopra J. Effect of disease severity on comorbid conditions in atopic dermatitis: nationwide registry-based investigation in Finnish adults. Acta Derm Venereol 2023; 103: adv00882.
https://doi.org/10.2340/actadv.v103.4447 DOI: https://doi.org/10.2340/actadv.v103.4447
Rønnstad ATM, Halling-Overgaard A-S, Hamann CR, Skov L, Egeberg A, Thyssen JP. Association of atopic dermatitis with depression, anxiety, and suicidal ideation in children and adults: a systematic review and meta-analysis. J Am Acad Dermatol 2018; 79: 448-456.e30.
https://doi.org/10.1016/j.jaad.2018.03.017 DOI: https://doi.org/10.1016/j.jaad.2018.03.017
Sandhu JK, Wu KK, Bui T-L, Armstrong AW. Association between atopic dermatitis and suicidality: a systematic review and meta-analysis. JAMA Dermatol 2019; 155: 178.
https://doi.org/10.1001/jamadermatol.2018.4566 DOI: https://doi.org/10.1001/jamadermatol.2018.4566
Barbarot S, Auziere S, Gadkari A, Girolomoni G, Puig L, Simpson EL, et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy 2018; 73: 1284-1293.
https://doi.org/10.1111/all.13401 DOI: https://doi.org/10.1111/all.13401
Vittrup I, Andersen YMF, Droitcourt C, Skov L, Egeberg A, Fenton MC, et al. Association between hospital-diagnosed atopic dermatitis and psychiatric disorders and medication use in childhood. Br J Dermatol 2021; 185: 91-100.
https://doi.org/10.1111/bjd.19817 DOI: https://doi.org/10.1111/bjd.19817
Irvine AD, Mina-Osorio P. Disease trajectories in childhood atopic dermatitis: an update and practitioner's guide. Br J Dermatol 2019; 181: 895-906.
https://doi.org/10.1111/bjd.17766 DOI: https://doi.org/10.1111/bjd.17766
Sinikumpu S-P, Jokelainen J, Huilaja L. The association between atopic dermatitis and acne: a retrospective Finnish nationwide registry study. Br J Dermatol 2023; 189: 242-244.
https://doi.org/10.1093/bjd/ljad086 DOI: https://doi.org/10.1093/bjd/ljad086
Kern C, Wan J, LeWinn KZ, Ramirez FD, Lee Y, McCulloch CE, et al. Association of atopic dermatitis and mental health outcomes across childhood: a longitudinal cohort study. JAMA Dermatol 2021; 157: 1200.
https://doi.org/10.1001/jamadermatol.2021.2657 DOI: https://doi.org/10.1001/jamadermatol.2021.2657
Ahn H-J, Shin MK, Seo J-K, Jeong SJ, Cho AR, Choi S-H, et al. Cross-sectional study of psychiatric comorbidities in patients with atopic dermatitis and nonatopic eczema, urticaria, and psoriasis. Neuropsychiatr Dis Treat 2019; 15: 1469-1478.
https://doi.org/10.2147/NDT.S191509 DOI: https://doi.org/10.2147/NDT.S191509
Dieris-Hirche J, Gieler U, Petrak F, Milch W, Wildt B, Dieris B, et al. Suicidal ideation in adult patients with atopic dermatitis: a German cross-sectional study. Acta Derm Venereol 2017; 97: 1189-1195.
https://doi.org/10.2340/00015555-2741 DOI: https://doi.org/10.2340/00015555-2741
Thyssen JP, Hamann CR, Linneberg A, Dantoft TM, Skov L, Gislason GH, et al. Atopic dermatitis is associated with anxiety, depression, and suicidal ideation, but not with psychiatric hospitalization or suicide. Allergy 2018; 73: 214-220.
https://doi.org/10.1111/all.13231 DOI: https://doi.org/10.1111/all.13231
Zhang J, Loman L, Oldhoff JM, Schuttelaar MLA. Beyond anxiety and depression: loneliness and psychiatric disorders in adults with atopic dermatitis. Acta Derm Venereol 2023; 103: adv9378.
https://doi.org/10.2340/actadv.v103.9378 DOI: https://doi.org/10.2340/actadv.v103.9378
Wan J, Wang S, Shin DB, Syed MN, Abuabara K, Lemeshow AR, et al. Neuropsychiatric disorders in adults with atopic dermatitis: a population-based cohort study. J Eur Acad Dermatol Venereol 2024; 38: 543-548.
https://doi.org/10.1111/jdv.19518 DOI: https://doi.org/10.1111/jdv.19518
Wei H-T, Lan W-H, Hsu J-W, Huang K-L, Su T-P, Li C-T, et al. Risk of developing major depression and bipolar disorder among adolescents with atopic diseases: a nationwide longitudinal study in Taiwan. J Affect Disord 2016; 203: 221-226.
https://doi.org/10.1016/j.jad.2016.06.012 DOI: https://doi.org/10.1016/j.jad.2016.06.012
Schans J van der, Çiçek R, de Vries TW, Hak E, Hoekstra PJ. Association of atopic diseases and attention-deficit/hyperactivity disorder: a systematic review and meta-analyses. Neurosci Biobehav Rev 2017; 74: 139-148.
https://doi.org/10.1016/j.neubiorev.2017.01.011 DOI: https://doi.org/10.1016/j.neubiorev.2017.01.011
Cheng Y, Lu J-W, Wang J-H, Loh C-H, Chen T-L. Associations of atopic dermatitis with attention deficit/hyperactivity disorder and autism spectrum disorder: a systematic review and meta-analysis. Dermatology 2024; 240: 13-25.
https://doi.org/10.1159/000533366 DOI: https://doi.org/10.1159/000533366
Kurki M, Sinikumpu S-P, Kiviniemi E, Jokelainen J, Huilaja L. Validation of diagnoses of atopic dermatitis in hospital registries: a cross-sectional database study from Finland. Acta Derm Venereol 2023; 103: adv7266.
https://doi.org/10.2340/actadv.v103.7266 DOI: https://doi.org/10.2340/actadv.v103.7266
Freeman, D, Sheaves B, Waite F, Harvey A, Harrison PJ. Sleep disturbance and psychiatric disorders. Lancet Psychiatry 2023; 7: 628-663.
https://doi.org/10.1016/S2215-0366(20)30136-X DOI: https://doi.org/10.1016/S2215-0366(20)30136-X
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Copyright (c) 2024 Amanda Blanco Sequeiros, Suvi-Päivikki Sinikumpu, Jari Jokelainen, Laura Huilaja
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