Anxiety and Depression in Patients with Atopic Dermatitis in a Southeast Asian Tertiary Dermatological Centre

Lim, Vanessa ZY; Ho, Roger; Tee, Shang‐Ian; Pan, Jiun Yit; Lim, Yen Loo; Tang, Mark B Y; Chan, Keen Loong; Giam, Yoke Chin

doi:10.47102/annals-acadmedsg.v45n10p451

Cited by 28 publications

(14 citation statements)

References 20 publications

(20 reference statements)

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“…Adults with AD perform significantly worse at work and have fewer job opportunities compared with healthy adults . Atopic dermatitis has been associated with depression and anxiety . However, the evidence for an association between AD and suicidality is inconclusive.…”

Section: Introductionmentioning

confidence: 99%

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Association Between Atopic Dermatitis and Suicidality

Sandhu

Bui

et al. 2019

JAMA Dermatol

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IMPORTANCE Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with numerous psychiatric comorbidities. However, the association between AD and suicidality has not been well established. OBJECTIVE To synthesize the available literature to evaluate the association between AD and suicidality. DATA SOURCE The protocol was prospectively registered in the PROSPERO database (CRD42018105291). STUDY SELECTION Per PRISMA guidelines, PubMed, Embase, PsycINFO, and Cochrane databases were systematically searched for relevant articles published from 1946 to May 25, 2018. The search criteria for PubMed were as follows: (dermatitis, atopic [MeSH] OR eczema [MeSH]) AND (suicidal ideation [MeSH] OR suicide, attempted [MeSH] OR suicide [MeSH] OR suicidality OR suicidal behavior). The search criteria for Embase, PsycINFO, and Cochrane were as follows: (atopic dermatitis OR eczema) AND (suicidal ideation OR suicide attempt OR suicide OR suicidality OR suicidal behavior). DATA EXTRACTION AND SYNTHESIS This systematic review and meta-analysis performed in an academic medical setting included observational studies that evaluated suicidal ideation, suicide attempts, and completed suicide among patients with AD. MAIN OUTCOME AND MEASURE The quality of included studies was assessed using the Newcastle-Ottawa Scale for observational studies. RESULTS The analysis identified 15 studies with a total of 4 770 767 participants, of whom 310 681 were patients with AD (52.7% female) and 4 460 086 served as controls (50.9% female). In the meta-analyses, patients with AD were 44% more likely to exhibit suicidal ideation (pooled odds ratio, 1.44; 95% CI, 1.25-1.65) and 36% more likely to attempt suicide (pooled odds ratio, 1.36; 95% CI, 1.09-1.70) compared with patients without AD. Studies investigating completed suicides in patients with AD had inconsistent results. CONCLUSIONS AND RELEVANCE Results of this study suggest that patients with AD are at significantly increased risk of suicidal ideation and suicide attempts. It is important for dermatology providers to be aware of this risk, screen for suicidality in patients with AD, and make mental health referrals when necessary.

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Section: Introductionmentioning

confidence: 99%

“…7 Atopic dermatitis has been associated with depression and anxiety. [8][9][10] However, the evidence for an association between AD and suicidality is inconclusive.…”

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confidence: 99%

Association Between Atopic Dermatitis and Suicidality

Sandhu

Bui

et al. 2019

JAMA Dermatol

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“…The detection rates of depression and anxiety symptom in caretakers were higher than the findings of other studies on parental depression and anxiety [9,16]. Both the detection rates of anxiety and depression symptoms in caretakers of children with AD were higher than those reported from children and adult AD themselves [7,[17][18][19][20], which may be related to the specific disease characteristics of AD and more intimate parent-child relationship in China [21]. It was reported that compared with looking after a child with chronic asthma, caring for a child with chronic atopic eczema was associated with greater parental sleep disturbances [22].…”

Section: Discussionmentioning

confidence: 75%

Anxiety, depression and associated factors among caretakers of children with atopic dermatitis

Chen

Gao

et al. 2022

Ann Gen Psychiatry

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Background The prevalence of anxiety and depression symptoms among caretakers of children with atopic dermatitis (AD) and associated factors is unclear. The study was designed to explore anxiety and depression symptoms among caretakers of AD, and screen factors associated with anxiety and depression symptoms. Methods A total of 901 children with AD and their caretakers were continuously enrolled and interviewed at dermatology department of Capital Institute of Pediatrics, Beijing, China. Children’s medication was administered by their caretakers. Caretakers’ anxiety and depression symptoms were evaluated by Hamilton Depression Rating Scale-17 and Hamilton Depression Rating Scale, while medication compliance was evaluated and divided into poor (< 6 points), moderate (6–7 points), and good (> 7 points) by Morisky Medication Adherence Scale. Multilevel ordered logistic regression was used to screen factors associated with caretakers’ anxiety and depression. Results Among caretakers, 41.5% had anxiety symptoms, 39.6% had depression symptoms, 51.4% have any of the two and 29.7% had both of the two. Factors associated with caretakers’ anxiety symptoms included longer duration of the illness (OR, 0.99, 95% CI 0.98–0.99) and taking care of children with severe AD (OR, 2.55, 95% CI 1.43–4.55). Factors associated with caretakers’ depression symptoms included higher educational level (OR, 0.56, 95% CI 0.39–0.80), taking care of children with moderate (OR, 2.01, 95% CI 1.15–3.50) and severe AD (OR, 3.99, 95% CI 2.10–7.59) and poor medication compliance (OR, 3.45, 95% CI 1.13–10.56). Conclusions Prevalence of anxiety and depression symptoms among caretakers of AD were high. Attention should be paid to caretakers of AD at higher risk for those psychological problems.

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“…The prevalence of ADHD in patients with AD was reported by 10 studies 12,15,23,27,30,34,36,46,52,59 ; all were published between 2009 and 2021. Forty‐two studies reported the prevalence of depression with AD 8,12,13,15,17,23–54,56–60 and were published between 2004 and 2021. Twenty‐four studies reported the prevalence of anxiety in AD, 8,12,13,17,23,26,27,29,31,34–37,42,43,45–49,52,56,58,60 between 2012 and 2022.…”

Section: Resultsmentioning

confidence: 99%

“…Subsequently, 221 articles were subjected to full‐text review; 178 were removed because they lacked clear diagnostic criteria, the type of research was unclear, the irrelevance of the topic, lack of English language, missing data, no reporting of ethical content or informed consent, or duplication. Ultimately, 43 studies 8,12,13,15,17,23–60 were included in the meta‐analysis and all were published between 1998 and 2022. Among the retrieved articles, articles reporting AD with comorbid bipolar disorder, manic episodes, somatic symptoms, conduct disorder, alexithymia, obsessive‐compulsive diseases, attachment disorder, self‐reported memory impairment or autism spectrum disorder (ASD) ( n = 16, in total) were few; therefore, these were not included in the meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

Epidemiology of mental health comorbidity in patients with atopic dermatitis: An analysis of global trends from 1998 to 2022

Cai,

Wang,

Wang

et al. 2023

Acad Dermatol Venereol

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The prevalence rates of attention deficit hyperactivity disorder (ADHD), depression, anxiety and suicide are increasing in patients with atopic dermatitis (AD), although no research has systematically examined these trends yet. Here, we explore the prevalence of the occurrence of comorbidities, such as ADHD, depression, anxiety and suicide with AD. We searched seven electronic databases from inception to October 2022 to identify relevant studies, and the Agency for Healthcare Research and Quality (AHRQ) and Newcastle–Ottawa Scale (NOS) tools were used to assess the quality of observational studies. Statistical analysis was performed using R software. Publication bias was evaluated using Egger's and Begg's linear tests. The global prevalence rates of ADHD, depression, anxiety and suicidal ideation in patients with AD were 7%, 17%, 21% and 13%, respectively, between 1998 and October 2022. Among children (aged <18 years), North American children with AD had the highest prevalence rates of ADHD (10%), depression (13%) and anxiety (20%). Among the adult (aged ≥18 years) population, patients with AD in Africa had the highest prevalence rates of depression (36%) and anxiety (44%), while Asian adults with AD had the highest prevalence rates of ADHD (7%) and suicidal ideation (20%). These results highlight the high prevalence and comorbidity rates of mental illnesses with AD, which should be brought to the attention of patients with AD and their physicians.

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Anxiety and Depression in Patients with Atopic Dermatitis in a Southeast Asian Tertiary Dermatological Centre

Cited by 28 publications

References 20 publications

Association Between Atopic Dermatitis and Suicidality

Association Between Atopic Dermatitis and Suicidality

Anxiety, depression and associated factors among caretakers of children with atopic dermatitis

Epidemiology of mental health comorbidity in patients with atopic dermatitis: An analysis of global trends from 1998 to 2022

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