Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study

Schonmann, Yochai; Mansfield, Kathryn E.; Hayes, Joseph; Abuabara, Katrina; Roberts, Amanda; Smeeth, Liam; Langan, Sinéad

doi:10.1016/j.jaip.2019.08.030

Cited by 99 publications

(119 citation statements)

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“…These efforts will be particularly important to interpret effects of climate change. It is important to note that the burden of AD does not include commonly seen comorbidities such as food and respiratory allergies, or psychiatric diseases (anxiety and depression) 29 . Combining these associated diseases with AD burden estimates would help reflect the patient burden more closely.…”

Section: Discussionmentioning

confidence: 99%

The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990–2017*

et al. 2020

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Summary Background The Global Burden of Disease (GBD) Study provides an annually updated resource to study disease‐related morbidity and mortality worldwide. Objectives Here we present the burden estimates for atopic dermatitis (AD), including data from inception of the GBD project in 1990 until 2017. Methods Data on the burden of AD were obtained from the GBD Study. Results Atopic dermatitis (AD) ranks 15th among all nonfatal diseases and has the highest disease burden among skin diseases as measured by disability‐adjusted life‐years (DALYs). Overall, the global DALY rate for AD in 1990 was 121 [95% uncertainty interval (UI) 65·4–201] and remained similar in 2017 at 123 (95% UI 66·8–205). The three countries with the highest DALY rates of AD were Sweden (327, 95% UI 178–547), the UK (284, 95% UI 155–478) and Iceland (277, 95% UI 149–465), whereas Uzbekistan (85·1, 95% UI 45·2–144), Armenia (85·1, 95% UI 45·8–143) and Tajikistan (85·1, 95% UI 46·1–143) ranked lowest. Conclusions The global prevalence rate of AD has remained stable from 1990 to 2017. However, the distribution of AD by age groups shows a bimodal curve with the highest peak in early childhood, decreasing in prevalence among young adults, and a second peak in middle‐aged and older populations. We also found a moderate positive correlation between a country’s gross domestic product and disease burden. GBD data confirm the substantial worldwide burden of AD, which has remained stable since 1990 but shows significant geographical variation. Lifestyle factors, partially linked to affluence, are likely important disease drivers. However, the GBD methodology needs to be developed further to incorporate environmental risk factors, such as ultraviolet exposure, to understand better the geographical and age‐related variations in disease burden.

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Section: Discussionmentioning

confidence: 99%

The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990–2017*

et al. 2020

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“…Although not life threatening, eczema can lead to sleeplessness and have a substantial impact on quality of life. Patients with eczema are more likely to suffer from anxiety and depression [ 6 , 7 ], resulting in serious public health problems and economic costs [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Runzao Zhiyang Capsule as an Add-On Therapy for Chronic Eczema: A Systematic Review and Meta-Analysis

Zhou

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. Runzao Zhiyang capsule (RZC), an oral Chinese herbal medicine, has been widely used for chronic eczema in China for many years. This study aims to evaluate the efficacy and safety of RZC as an add-on therapy to conventional treatment for chronic eczema. Methods. Randomized controlled trials (RCTs) assessing the efficacy and safety of RZC as an add-on therapy for chronic eczema were retrieved from eight literature databases from their inception to 31 August, 2020, including CNKI, WanFang, VIP, Sinomed, PubMed, Cochrane Library, Web of Science, and Embase. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. The data were analyzed by RevMan5.3 software. Results. A total of 18 RCTs involving 1896 patients with chronic eczema were included. Compared with no oral treatment, RZC was superior on the total efficacy rate (TER) (RR = 1.45, 95% CI: 1.23 to 1.72, P < 0.0001 ), Eczema Area and Severity Index (EASI) (MD = −0.73, 95% CI: −0.90 to −0.56, P < 0.00001 ), and Visual Analogue Scale (VAS) for pruritus (MD = −2.76, 95%CI: −4.53 to −0.99, P = 0.002 ). Similar results were also seen in a randomized, placebo-controlled trial. Compared with the antihistamine (AH) group, TER in the RZC combined with AH group was significantly higher (RR = 1.32, 95% CI: 1.21 to 1.43, P < 0.00001 ), and the EASI score (MD = −0.29, 95% CI: −0.38 to −0.20, P < 0.001 ), the VAS score (MD = −0.19, 95% CI: −0.23 to −0.15, P < 0.00001 ), and the level of serum total IgE (MD = −9.83 ng/ml, 95% CI: −11.66 to −8.00 ng/ml, P < 0.00001 ) decreased more significantly in the RZC combined with AH group. In terms of safety, mild gastrointestinal diseases occurred more frequently in the RZC group, and no serious adverse effect was reported. Conclusions. RZC as an add-on therapy to conventional treatment shows good effects on chronic eczema, and there is no severe side effect from short-term use of RZC. However, due to suboptimal quality of the included studies, more large-sample and high-quality RCTs are needed to improve the evidence quality.

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“…Evidence suggests that people with atopic eczema or psoriasis are at increased risk of mental illness. [6][7][8][9][10][11][12][13][14] The temporal sequence of the associations between skin disease and mental illness is also well recognised, with evidence suggesting that atopic eczema or Strengths and limitations of this study ► This protocol promotes transparent review methods, enables comparison of our final review to our initial plans, minimises risk of bias, and reduces the chance of unplanned duplication. ► Our systematic review will be the first to critically evaluate studies of the risk factors for mental illness in adults with atopic eczema or psoriasis.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for mental illness in adults with atopic eczema or psoriasis: protocol for a systematic review

et al. 2020

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IntroductionEvidence indicates that people with the common inflammatory skin diseases atopic eczema or psoriasis are at increased risk of mental illness. However, the reasons for the relationship between skin disease and common mental disorders (ie, depression and anxiety) or severe mental illnesses (ie, schizophrenia, bipolar disorder and other psychoses) are unclear. Therefore, we aim to synthesise the available evidence regarding the risk factors for mental illness in adults with atopic eczema or psoriasis.Methods and analysisWe will conduct a systematic review of randomised controlled trials, cohort, case–control and cross-sectional studies. We will search the following databases from inception to March 2020: Medline, Embase, Global Health, Scopus, the Cochrane Library, Web of Science, Base, PsycInfo, the Global Resource of Eczema Trials, and the grey literature databases Open Grey, PsycExtra and the New York Academy of Medicine Grey Literature Report. We will also search the bibliographies of eligible studies and relevant systematic reviews to identify additional relevant studies. Citation searching of large summary papers will be used to further identify relevant publications. Two reviewers will initially review study titles and abstracts for eligibility, followed by full text screening. We will extract data using a standardised data extraction form. We will assess the risk of bias of included studies using the Quality in Prognosis Studies tool. We will synthesise data narratively, and if studies are sufficiently homogenous, we will consider a meta-analysis. We will assess the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework.Ethics and disseminationEthical approval is not required for a systematic review. Results of the review will be published in a peer-reviewed journal and disseminated through conferences.PROSPERO registration numberCRD42020163941.

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Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study

Cited by 99 publications

References 100 publications

The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990–2017*

The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990–2017*

Efficacy and Safety of Runzao Zhiyang Capsule as an Add-On Therapy for Chronic Eczema: A Systematic Review and Meta-Analysis

Risk factors for mental illness in adults with atopic eczema or psoriasis: protocol for a systematic review

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