Longitudinal course and predictors of depressive symptoms in atopic dermatitis

Document Type

Journal Article

Publication Date

5-9-2022

Journal

Journal of the American Academy of Dermatology

DOI

10.1016/j.jaad.2022.04.061

Keywords

atopic dermatitis; depression; eczema; emotional; longitudinal; prospective; pruritus; psychology

Abstract

BACKGROUND: Atopic dermatitis (AD) is associated with eczematous lesions, pruritus, pain, and sleep disturbance, which may negatively impact mental health over time. OBJECTIVE: Determine the predictors and longitudinal course of depressive symptoms in adults with AD. METHODS: A prospective, dermatology practice-based study was performed (n=695). AD signs, symptoms and severity and Patient Health Questionnaire (PHQ)-9 were assessed. RESULTS: At baseline, 454 (65.32%) had minimal, 139 (20.00%) mild, 57 (8.20%) moderate, 27 (3.88%) moderately severe, and 8 (2.59%) had severe depression. Most had fluctuating levels of depressive symptoms. Feeling bad, thoughts of self-harm, difficulty concentrating, and slow movement were most persistent. Predictors of persistent depression included older age, non-white race, male sex, public or no insurance, more severe itch, skin pain, facial erythema, nipple eczema, sleep disturbance, and presence of pityriasis alba. LIMITATIONS: Single center study. CONCLUSION: Depressive symptoms are closely related to and fluctuate with AD severity over time. Improved control of AD signs and symptoms, particularly itch, may secondarily improve mental health.

Department

Dermatology

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