Atopic dermatitis (AD) is linked with significantly higher levels of anxiety and depression in patients, according to a study of United States adults published online in the British Journal of Dermatology.
“AD is a chronic inflammatory skin disease characterized by itch, skin pain, sleep disturbances, and multiple comorbidities,” the researchers wrote, “all of which can lead to significant psychosocial distress and mental health burden.”
To gauge the relationship between AD and anxiety and depression, researchers conducted a population-based study involving 2893 adults in the United States, 602 of whom had AD.
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“[W]e found that adults with AD had significantly higher mean Hospital Anxiety and Depression Scale anxiety (HADS‐A) and depression (HADS‐D) scores,” the researchers wrote, “and that among adults with AD, there were higher proportions of respondents with borderline and/or abnormal HADS‐A and HADS‐D scores, and higher proportions of self‐reported healthcare‐diagnosed anxiety or depression in the past year; all of which indicate a significant mental health burden of AD.”
Specifically, anxiety scores on the Hospital Anxiety and Depression Scale averaged 7.7 and depression scores averaged 6.0 in people with AD compared with 5.6 and 4.3, respectively, in control participants. Among participants with AD, 28.6% had anxiety scores and 13.5% had depression scores in the abnormal range, compared with 15.5% and 9.0%, respectively, in controls.
In fact, all participants with severe Patient‐Oriented Scoring AD (PO‐SCORAD), Patient‐Oriented Eczema Measure, and PO‐SCORAD itch had borderline or abnormal anxiety and depression scores, the study found. Some 40.0% of adults with AD reported healthcare-diagnosed anxiety or depression, compared with 17.5% of controls.
However, many participants with AD and borderline or abnormal anxiety or depression scores reported no official diagnosis of anxiety or depression, researchers reported, suggesting the mental health disorders often go unnoticed by clinicians.
“It is important for clinicians to recognize that virtually all patients with moderate‐to‐severe AD have symptoms of anxiety and depression,” researchers concluded. “We recommend that clinicians incorporate assessment of mental health symptoms in clinical practice to determine disease burden and screen for patients with symptoms of anxiety and depression.”
—Jolynn Tumolo
Reference
Silverberg JI, Gelfand JM, Margolis DJ, et al. Symptoms and diagnosis of anxiety and depression in atopic dermatitis in US adults [published online March 5, 2019]. Br J Dermatol. doi:10.1111/bjd.17683
