Adult Patients with Atopic Eczema have a High Burden of Psychiatric Disease: A Finnish Nationwide Registry Study

Abstract

Atopic dermatitis is associated with several comorbidities. In this study we investigated psychiatric comorbidities of adult patients with atopic dermatitis. Our study shows that at least one psychiatric diagnosis was found in 17.2% of the atopic dermatitis patients. Actually, every mental diagnosis studied was more common in patients with atopic dermatitis compared to the melanocytic naevi controls. We report, for the first time, that atopic dermatitis is associated with both schizophrenia and bipolar disorders. Since psychiatric morbidity is significant in patients with atopic dermatitis, assessing patients' mental health status should be considered as part of standard care. Atopic dermatitis is associated with several comorbidities. Epidemiological studies on psychiatric comorbidities in adult atopic dermatitis patients are sparse. We analyzed psychiatric comorbidities in a Finnish nationwide adult atopic dermatitis cohort. The study included 57,690 adult patients with atopic dermatitis as cases and 40,363 individuals diagnosed with melanocytic naevi as controls. Data was obtained from the statutory Finnish Care Register for Health Care. The prevalence of preselected comorbidities between the atopic dermatitis and control groups was compared. Every psychiatric disorder studied was more common in patients with atopic dermatitis than in controls. At least one psychiatric diagnosis was found in 17.2% of the atopic dermatitis patients and 13.1% of controls. Psychiatric morbidity is significant in patients with atopic dermatitis and therefore assessing patients' mental health status should be considered as part of standard care.

Características clínicas de una población con dermatitis atópica en un centro de tercer nivel

“…21 En una revisión sistemática y metaanálisis, en DA del adulto se encontró asociación con ansiedad, depresión, ideación suicida e intento suicida, con 44 y 36 % de estos dos últimos, respectivamente, en comparación con quienes no tienen DA 21,15,22 Los trastornos mentales en estos pacientes fueron más comunes en las mujeres. 23 La gravedad de la enfermedad se asoció a afectación ocular en forma similar a los hallazgos de Thyssen, 24 quien observó mayor riesgo de conjuntivitis, queratitis y queratocono en los pacientes con DA en comparación con la población general.…”

Atopic Eczema Dan Komorbiditas Kondisi Psikologis: Bagaimana Hubungan Dan Tatalaksananya

“…Penelitian sebelumnya yang melaporkan hubungan antara AD dan komorbiditas psikiatri seperti depresi atau kecemasan pada pasien remaja dan dewasa dengan AD dan juga ditemukan gangguan terkait gangguan afektif, stres, gangguan perilaku dan psikosis (Kauppi et al, 2019b).…”

“…Penelitian di Jerman melaporkan bahwa terdpaat hubungan antara AD dan beberapa komorbiditas psikiatri. Ditemukan bahwa 34% pasien dengan DA memiliki setidaknya satu diagnosis psikiatri (Kauppi et al, 2019a). Diantara semua diagnosis psikiatri pada pasien dengan DA, risiko depresi didapatkan paling tinggi.…”

“…Sebuah studi cross-sectional di AS juga mengungkapkan bahwa individu dengan DA secara signifikan lebih sering menunjukkan gejala depresi seperti kehilangan minat, keputusasaan, penurunan nafsu makan, kelelahan, dan penurunan kemampuan berkonsentrasi. Depresi tampaknya terkait dengan kehadiran sitokin proinflamasi, khususnya tumor nekrosis faktor (TNF)-α, interleukin 6 dan CRP (Kauppi et al, 2019a;Kage and Treudler, 2020).…”

Childhood atopic dermatitis as a precursor for developing attention deficit/hyperactivity disorder

“…2,3 Big data reveal increase in AD burden with several comorbidities, both cutaneous 5 and systemic ones 6,7 AD shows itself with dysfunctioning immune and non-immune skin-barrier components. AD patients have a low compliance with long-term therapies and that may be due to the underrecognized psychiatric burden 8 occasionally relapsing for different stressful conditions such as COVID-19 outbreak. 9 Not only impulsive behaviors and above-normal hyperactive levels but also inattention are regarded as attention deficit/hyperactivity disorder (ADHD).…”