Atopic Dermatitis and Hospitalization for Mental Health Disorders in the United States

Abstract

Little is known about mental health (MH) emergencies in AD and their financial burden. We sought to determine hospitalization rates and costs of MH disorders in AD patients. We analyzed data from the Nationwide Inpatient Sample from 2002-2012, containing a representative 20% sample of US hospitalizations. Overall, 835 (1.36%) AD and 2,434,703 (0.75%) non-AD patients had a primary admission for a MH disorder. AD patients admitted for MH disorders were more likely to be younger, Asian and Black race, higher income-quartile, and have an increasing number of chronic conditions. In multivariable logistic regression models adjusting for demographics, AD was associated with a primary admission for mental health disorders in adults, including mood disorders, schizophrenia, and developmental disorders. AD was not associated with a primary admission for a MH disorder in children. There were an estimated $183,821,629 excess costs of care annually for MH disorders in inpatients with vs. without AD. In conclusion, AD was associated with higher odds of hospitalization for all MH disorders and substantial excess costs of inpatient care.

Real-world persistence with dupilumab among adults with atopic dermatitis

“…In AD, psychological distress can reach levels that are clinically relevant and may be so severe that drug treatment and even psychiatric hospitalization may be warranted. [50][51][52][53][54][55] Moreover, the use of these medications is likely related to sleep problems and pain, which are common complaints among patients with AD. 8,10,11 Persistence on dupilumab in real-world clinical practice was high, with more than three-quarters of patients (77.3%) remaining on dupilumab at 12 months.…”

A Review of Skin Disease in Schizophrenia

“…Several studies show a positive relationship between schizophrenia and the presence of atopic dermatitis [23, 34-37], with a possible association between atopic dermatitis in children and the risk of having a psychotic experience by the age of 13 years [38]. In the USA, schizophrenia as the primary reason for admission to hospital was more likely in adult patients with atopic dermatitis compared to those without [36]. Similarly, Weber et al [39] examined the discharge records of over 5 million people across hospitals in the USA between 1979 and 2003; discharge records with schizophrenia as the primary diagnosis were more likely to include contact dermatitis and other eczema compared to controls.…”

Age-dependent Distribution of Atopic Dermatitis in Primary Care: A Nationwide Population-based Study from Finland

“…Chiesa Fuxench et al ( 23 ) showed, in a cross-sectional study from the USA, a high prevalence of AD in adults (7.3%), but there were no sex differences. However, there have been studies of concomitant psychiatric diseases, which have shown a female dominance regarding depression and anxiety and other psychiatric comorbidities ( 24 – 26 ). In children < 1 year of age, a predominance of the male sex has been reported, as well as an early-onset, severe disease course and an association with asthma ( 27 ).…”