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Br J Dermatol. 2019 Mar 5. doi: 10.1111/bjd.17683. [Epub ahead of print]

Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults.

Author information

1
Feinberg School of Medicine, Northwestern University, Chicago, IL, U.S.A.
2
School of Medicine, University of Pennsylvania Perelman, Philadelphia, PA, U.S.A.
3
National Jewish Health, Denver, CO, U.S.A.
4
School of Medicine, University of Colorado, Denver, CO, U.S.A.
5
NYU Winthrop Hospital, Mineola, NY, U.S.A.
6
Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, U.S.A.
7
Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, U.S.A.
8
Oregon Health & Science University, Portland, OR, U.S.A.

Abstract

BACKGROUND:

The relationship between atopic dermatitis (AD), anxiety and depression in the U.S. adult population is not well established.

OBJECTIVES:

To determine the relationship of AD and its severity with symptoms and diagnosis of anxiety and depression in U.S. adults.

METHODS:

A cross-sectional, population-based study of 2893 adults was performed. AD was determined using modified U.K. Diagnostic Criteria.

RESULTS:

Adults with AD vs. those without AD had higher mean Hospital Anxiety and Depression Scale anxiety (HADS-A) (7·7 vs. 5·6) and depression (HADS-D) (6·0 vs. 4·3) scores and higher prevalences of abnormal (≥ 11) HADS-A (28·6% vs. 15·5%) and HADS-D (13·5% vs. 9·0%) scores. In multivariable linear and logistic regression models controlling for sociodemographics, AD was associated with significantly higher mean HADS-A and HADS-D scores (7·7 and 6·0) and higher odds of abnormal HADS-A [odds ratio (OR) 2·19, 95% confidence interval (CI) 1·65-2·91] and HADS-D scores (OR 1·50, 95% CI 1·04-2·17) (P ≤ 0·03 for all). Mean and abnormal HADS-A and HADS-D scores were increased in moderate and severe/very severe self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD), PO-SCORAD itch and sleep (P < 0·0001 for all). All respondents with severe PO-SCORAD, POEM and PO-SCORAD itch had borderline or abnormal HADS-A and HADS-D scores. Adults with AD vs. those without AD had higher prevalence of self-reported healthcare-diagnosed anxiety or depression in the past year (40·0% vs. 17·5%). Many adults with AD who had borderline and/or abnormal HADS-A or HADS-D scores reported no diagnosis of anxiety or depression.

CONCLUSIONS:

AD is associated with significantly increased anxiety and depression, which may go undiagnosed.

PMID:
30838645
DOI:
10.1111/bjd.17683

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