Infant-onset eczema in relation to mental health problems at age 10 years: Results from a prospective birth cohort study (German Infant Nutrition Intervention plus)

Schmitt, Jochen; Apfelbacher, Christian; Chen, Chih-Mei; Romanos, Marcel; Sausenthaler, Stefanie; Koletzko, Sibylle; Bauer, Carl‐Peter; Hoffmann, Ute; Krämer, Ursula; Berdel, Dietrich; Berg, Andrea von; Wichmann, HE; Heinrich, Joachim

doi:10.1016/j.jaci.2009.10.055

Cited by 94 publications

(90 citation statements)

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“…The mechanisms underlying the relationship between allergic diseases and mental health disorders, however, remain uncertain. The temporal relationship between atopic dermatitis and ADHD has been studied, revealing that infants with atopic dermatitis are at an increased risk for mental health problems at 10 y of age (9). One metaanalysis study demonstrated a bidirectional relationship between allergic diseases and mental health symptoms (17).…”

Section: Discussionmentioning

confidence: 99%

“…A positive correlation between allergic diseases and ADHD has been reported in several clinical studies (7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Most of the studies focused on the relationship between ADHD and a specific allergic disease, namely, atopic dermatitis (8)(9)(10) or asthma (7,11,13). Few studies discussed the relationship between allergic rhinitis and mental health problems (14).…”

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confidence: 99%

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Associations between allergic diseases and attention deficit hyperactivity/oppositional defiant disorders in children

et al. 2016

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Background:We aim to investigate the detailed associations between allergic diseases with attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) among children. Methods: Clinical information from 2,896 children enrolled in the Taiwan Children Health Study was obtained for analyses. Allergic diseases, including atopic dermatitis, asthma, and allergic rhinitis, have been evaluated based on the questions adjusted from International Study of Asthma and Allergies in Childhood. The Swanson, Nolan, and Pelham questionnaire was used to assess symptoms of ADHD and ODD. Symptoms of depression, stress, and poor sleep quality were evaluated as the interactive risk factors. results: Children having symptoms of allergic diseases within the past 1 y were associated with having all dimensions of symptoms of ADHD and ODD. Children with ever having a physician-diagnosed atopic dermatitis were associated with inattentive and hyperactive-impulsive symptoms of ADHD. Ever diagnosed asthma was associated with ADHD and ODD. Ever diagnosed allergic rhinitis was associated with inattentive and combined symptoms of ADHD and ODD. conclusion: Children with allergic diseases, such as atopic dermatitis, asthma, and allergic rhinitis, were associated with exhibiting ADHD and ODD.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Associations between allergic diseases and attention deficit hyperactivity/oppositional defiant disorders in children

et al. 2016

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“…21,22 Eczema in infancy incorporating sleep disruption is associated with an increased risk of mental health issues at age 10 years. 23 …”

Section: How Does Eczema Affect People?mentioning

confidence: 99%

“…There was a significant difference in eczema severity, measured by the EASI scoring system, for the mupirocin and hydrocortisone group compared with the hydrocortisone-only group at the end of treatment (day 8) (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)] and the hydrocortisone and mupirocin group [26 (range 21-32); p = 0.006], was significant. There was a significant difference in treatment success, defined as a ≥ 50% reduction in lesion severity scores (measured using EASI/SCORAD), between the emollient-only group (36%) and the hydrocortisone-only group (65%) and the hydrocortisone and mupirocin group (74%) (p = 0.014 and p = 0.006, respectively) after 60 days.…”

Section: Assessment Of Risk Of Biasmentioning

confidence: 99%

Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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BackgroundEczema is a very common chronic inflammatory skin condition.ObjectivesTo update the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) systematic review of treatments for atopic eczema, published in 2000, and to inform health-care professionals, commissioners and patients about key treatment developments and research gaps.Data sourcesElectronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Skin Group Specialised Register, Latin American and Caribbean Health Sciences Literature (LILACS), Allied and Complementary Medicine Database (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from the end of 2000 to 31 August 2013. Retrieved articles were used to identify further randomised controlled trials (RCTs).Review methodsStudies were filtered according to inclusion criteria and agreed by consensus in cases of uncertainty. Abstracts were excluded and non-English-language papers were screened by international colleagues and data were extracted. Only RCTs of treatments for eczema were included, as other forms of evidence are associated with higher risks of bias. Inclusion criteria for studies included availability of data relevant to the therapeutic management of eczema; mention of randomisation; comparison of two or more treatments; and prospective data collection. Participants of all ages were included. Eczema diagnosis was determined by a clinician or according to published diagnostic criteria. The risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool. We used a standardised approach to summarising the data and the assessment of risk of bias and we made a clear distinction between what the studies found and our own interpretation of study findings.ResultsOf 7198 references screened, 287 new trials were identified spanning 92 treatments. Trial reporting was generally poor (randomisation method: 2% high, 36% low, 62% unclear risk of bias; allocation concealment: 3% high, 15% low, 82% unclear risk of bias; blinding of the intervention: 15% high, 28% low, 57% unclear risk of bias). Only 22 (8%) trials were considered to be at low risk of bias for all three criteria. There was reasonable evidence of benefit for the topical medications tacrolimus, pimecrolimus and various corticosteroids (with tacrolimus superior to pimecrolimus and corticosteroids) for both treatment and flare prevention; oral ciclosporin; oral azathioprine; narrow band ultraviolet B (UVB) light; Atopiclair™ and education. There was reasonable evidence to suggest no clinically useful benefit for twice-daily compared with once-daily topical corticosteroids; corticosteroids containing antibiotics for non-infected eczema; probiotics; evening primrose and borage oil; ion-exchange water softeners; protease inhibitor SRD441 (Serentis Ltd); furfuryl palmitate in emollient; cipamfylline cream; andMycobacterium vaccaevaccine. Additional research evidence is needed for emollients, bath additives, antibacterials, specialist clothing and complementary and alternative therapies. There was no RCT evidence for topical corticosteroid dilution, impregnated bandages, soap avoidance, bathing frequency or allergy testing.LimitationsThe large scope of the review coupled with the heterogeneity of outcomes precluded formal meta-analyses. Our conclusions are still limited by a profusion of small, poorly reported studies.ConclusionsAlthough the evidence base of RCTs has increased considerably since the last NIHR HTA systematic review, the field is still severely hampered by poor design and reporting problems including failure to register trials and declare primary outcomes, small sample size, short follow-up duration and poor reporting of risk of bias. Key areas for further research identified by the review include the optimum use of emollients, bathing frequency, wash products, allergy testing and antiseptic treatments. Perhaps the greatest benefit identified is the use of twice weekly anti-inflammatory treatment to maintain disease remission. More studies need to be conducted in a primary care setting where most people with eczema are seen in the UK. Future studies need to use the same core set of outcomes that capture patient symptoms, clinical signs, quality of life and the chronic nature of the disease.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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“…Zur Klärung des zeitlichen Zusammenhangs im Erkrankungsauftreten von Neurodermitis und ADHS analysierten wir in der Folge in Kooperation mit dem Helmholtz Zentrum Daten zweier prospektiver Geburtskohortenstudien hinsichtlich des Zusammenhangs von Neurodermitis und ADHS im Längsschnitt [42,43]. In beiden Studien zeigte sich eine signifikante Assoziation von Neurodermitis in den ersten beiden Lebensjahren (LJ) und ADHS-Symptomen im Alter von 10 Jahren [42,43].…”

Section: Atopische Komorbidität Der Neurodermitisunclassified

Health services research the example of atopic dermatitis

Schmitt

2011

Hautarzt

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Within the past years, health services research projects have analyzed critically the management of atopic eczema (AE) in routine care, quantified the utility of controlling severe AE, and introduced an international standardization of core outcome measures for AE. With a prevalence of 16%, AE is the most frequent chronic condition at all among children and adolescents seeking medical care. Despite lower prevalence in adults, about 60% of patients with AE in routine care are adults. There is a clinically relevant comorbidity of AE and psychiatric conditions. Independent of patient's age and physician's medical discipline topical corticosteroids dominate outpatient treatment of AE. However, there is considerable heterogeneity in the management of AE between treating physicians. Despite a lack of clinical trials, systemic corticosteroids are most frequently prescribed for severe AE. In contrast, cyclosporine only plays a minor role in routine care of severe AE although its efficacy is well-documented in trials. This observation stimulated a head-to-head trial that indicated superiority of cyclosporine over prednisolone for severe adult AE. The control of severe AE has high priority from the perspective of the general population and from the patients' perspective. Competence of the treating physician, disease severity and patient's competence to adjust treatment to disease activity are the main determinants of patient satisfaction. Aiming for a better comparability of clinical trials and better translation of trial evidence into clinical practice, we conducted a Delphi exercise including clinical experts from 11 countries, editors of international dermatological journals, regulatory agencies, and patient representatives. The preliminary core set of outcome domains for eczema trials as defined by the panel included symptoms, physician-assessed clinical signs, and a measurement for long-term control of flares. Symptoms such as itching should be regularly assessed in clinical practice. The presented studies indicate that health services research not only describes and critically analyzes the effectiveness of routine clinical care, but is also translational research in that it may stimulate clinical trials and generate new, clinically relevant hypotheses for experimental studies.

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Infant-onset eczema in relation to mental health problems at age 10 years: Results from a prospective birth cohort study (German Infant Nutrition Intervention plus)

Cited by 94 publications

References 28 publications

Associations between allergic diseases and attention deficit hyperactivity/oppositional defiant disorders in children

Associations between allergic diseases and attention deficit hyperactivity/oppositional defiant disorders in children

Scoping systematic review of treatments for eczema

Health services research the example of atopic dermatitis

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