Behavioral disorders in children and adolescents with atopic dermatitis

Moraes, Marília Magalhães; Vaz, Fernanda Pires Cecchetti; Roque, Raíssa Monteiro Soares dos Anjos; Mallozi, Márcia de Carvalho; Solé, Dirceu; Wandalsen, Gustavo Falbo

doi:10.1016/j.jped.2023.08.006

Cited by 2 publications

(8 citation statements)

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“…Depression and anxiety are common mental disorders found in patients with chronic inflammatory diseases [ 10 ]. Depression and anxiety are highly prevalent psychiatric disorders in children and adults with AD [ 10 , 11 , 12 , 15 , 16 , 17 ]. Moraes et al [ 17 ] observed that almost half of the AD patients in their study had CBCL internalizing problem values within the clinical range.…”

Section: Discussionmentioning

confidence: 99%

“…Assessing the emotional and behavioral aspects in scientific studies is challenging because of the subjectivity of symptoms. In this context, using validated instruments allows for quantification and comparisons based on established cut-off points, making the evaluation more precise and standardized [ 17 ]. CBCL 6/18 is one of the most widely used instruments for screening psychological disorders.…”

Section: Methodsmentioning

confidence: 99%

“…CBCL 6/18 is one of the most widely used instruments for screening psychological disorders. It is part of the Achenbach System of Empirically Based Assessment (ASEBA), validated by many scientific societies and cultural groups [ 17 ]. Parents answer a questionnaire consisting of 138 questions, distributed as follows: the first 20 questions relate to social competence, divided into participation in activities, social relationships, and school, while the remaining 118 questions relate to behavioral problems.…”

Section: Methodsmentioning

confidence: 99%

“…Parents answer a questionnaire consisting of 138 questions, distributed as follows: the first 20 questions relate to social competence, divided into participation in activities, social relationships, and school, while the remaining 118 questions relate to behavioral problems. The CBCL 6/18 assesses the presence and profile of behavioral disorders, which can be an internalizing profile with a tendency towards depression, anxiety, and somatic disorders or an externalizing profile with aggressive and rule-breaking behavior [ 17 , 21 ]. Questions are classified into eight syndromes: “Anxiety/Depression”, “Isolation”, and “Somatic Complaints”, grouped as internalizing problems; “Rule-Breaking Behaviour” and “Aggressive Behaviour”, grouped as externalizing problems.…”

Section: Methodsmentioning

confidence: 99%

“…Mental difficulties can impair the response to treatment and the physical illness itself, which in turn can have a negative impact on mental health and quality of life [ 10 ]. There is a growing number of studies on quality of life, sleep, and psychiatric comorbidities in AD, but limited knowledge and research are assessing how AD is associated with mental disorders in children and how these are related to the severity of the disease [ 10 , 15 , 16 , 17 ]. The neural mediation between stress and AD exacerbations varies for each end.…”

Section: Introductionmentioning

confidence: 99%

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Associations between Atopic Dermatitis and Behavior Difficulties in Children

Kisieliene,

Aukstuolyte,

Mainelis

et al. 2024

Medicina

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Background and Objectives: There has been increasing evidence that atopic dermatitis (AD) is associated with behavioral difficulties (BDs). There is currently a lack of evidence of how the severity of the disease determines BDs and what additional factors may contribute to their manifestation. The aim is to determine what kind of BDs occur in children with AD compared to healthy children and to find out what additional factors may contribute to the development of BDs in AD patients. Materials and Methods: This is a cross-sectional, prospective study with the application of a risk assessment instrument for behavior difficulties (Child Behavior Checklist, CBCL 6/18) in pediatric patients with AD and healthy controls (6–17 years) between 1 January 2020 and 31 December 2022. For statistical comparison, mainly Wilcoxon–Mann–Whitney and Student’s t-test were used, considering a significance level of 5%. Results: This study included a total of 101 children: 48% with AD, 52% non-AD. The mean age was 10 ± 2.7 years for AD, and10.5 ± 3.1 years for the control patients. AD patients had higher internal behavior scale scores and T-scores (6.6 ± 6.4 vs. 9.6 ± 6.9 and 47.9 ± 9.5 vs. 52.3 ± 10.2, p = 0.01), anxiety/depression scale score and T-score (2.8 ± 2.7 vs. 4.3 ± 3.5 and 47.7 ± 8.4 vs. 52.5 ± 11, p = 0.02), and somatic problems scale score and T-score (2.1 ± 2.3 vs. 3.5 ± 3 and 47.6 ± 8.5 vs. 52.7 ± 10.9, p = 0.005). Patients with severe AD had sleep disturbance and itching scores higher than those with mild–moderate AD (5.4 ± 2.6 vs. 2.4 ± 2.2, p = 0.000 and 6.6 ± 2.4 vs. 4 ± 2.8, p = 0.001). The mean morning serum cortisol concentration was lower in AD patients compared to controls (252.91 ± 304.34 vs. 351.55 ± 126.09 nmol/L, p = 0.047). Conclusions: Children with AD present a higher risk of BDs than healthy controls. Patients with severe AD experience more sleep disturbances and a greater intensity of itching compared to mild–moderate AD. The occurrence of BDs was not related to serum cortisol levels. The cortisol level, severity, age, gender, duration of illness, intensity of pruritus, and sleep disturbance did not affect the development of BDs.

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