Depression, anxiety and quality of life in subjects with atopic eczema in a population‐based cross‐sectional study in Germany

Abstract

Background Atopic eczema (AE) may be associated with several mental health problems. In Germany, existing data from selected patient cohorts may lead to misestimation of the problem. Objectives We aimed to cross‐sectionally determine associations of AE with depression, anxiety, quality of life (QoL) and social interactions in subjects from the population‐based LIFE‐Adult‐Study. Methods Subjects underwent standardized interviews (medical history) and answered standardized questionnaires [Centre of Epidemiologic studies‐Depression scale (CES‐D), Generalized Anxiety Disorder (GAD‐7), Lubben Social Network Scale (LSNS), Short Form Health Survey (SF‐8)]. We compared data from subjects with AE with those from subjects with selected other chronic/disabling diseases (cardiovascular, diabetes, cancer) and adjusted for selected sociodemographic parameters. Multivariate binary logistic regression was used for categorical variables, linear regression for continuous variables. Results Out of 9104 adults included (57% female, median age 54 years), 372 (4.1%) had a history of AE. Compared with controls, subjects with AE showed higher scores for depressive symptoms (9.3% vs. 6.3%; P < 0.001) and anxiety (8.4% vs. 5.6%, P < 0.001). Odds ratio (OR) was 1.5 [CI 1.0; 2.3] (P = 0.031) for depression, which was comparable to OR in patients with a history of cancer (OR 1.6 [1–2.3], P = 0.001. OR for anxiety in AE was 1.5 [1.0; 2.2], P < 0.049, which was slightly higher than in diabetes mellitus (OR 1.2) and stroke (OR 1.4). Other than in diabetes and/or stroke, we did not find a significant association between AE and social isolation. QoL scores were lower in AE than in controls (mean 46.9 vs. 48.0, P < 0.001 for physical and 50.6 vs. 52.5, P < 0.001 for mental components). Conclusions Subjects with AE showed higher values for depression and anxiety as well as lower QoL scores compared to controls. With regard to depression, odds in AE and cancer were hardly different. Medical care of AE patients should therefore include mental health evaluation and treatment if indicated.

A case of atopic eczema treated safely with dupilumab during pregnancy and lactation

“…1,2 In pregnancy, AE frequently shows a deleterious course and may relevantly impact on quality of life. [3][4][5] According to the European Task force on Atopic Dermatitis (ETFAD), when treating pregnant and lactating women with AE, systemic treatment should be restricted to glucocorticosteroids, cyclosporine and azathioprine. There have been only few data about dupilumab in pregnancy and lactation.…”

Microscopic and functional changes observed with dynamic optical coherence tomography for severe refractory atopic dermatitis treated with dupilumab

“…4,5 Several studies have proven the efficacy of dupilumab in reducing symptoms (such as eczema and pruritus), disease activity (SCORE, EASI), and the psychological impact of the disease on the patient's life (quality of life questionnaire). 6,7 Optical coherence tomography (OCT) is a laser-based, noninvasive imaging tool that provides vertical and en-face or horizontal images of the skin with a penetration depth of up to 1.5 mm and a resolution of 3 to 15 μm. This tool enables the visualization of skin morphology through small variations in intensity of reflected light from the different structures, [8][9][10][11][12] and more recently, the dynamic OCT (D-OCT) has been introduced for vascularization analysis.…”

The use of dupilumab in severe atopic dermatitis during pregnancy: a case report

“…AD poses a significant economic burden with an estimated annual cost in Canada of $1.4 billion dollars [ 4 ]. Additionally, AD results in significant morbidity and adversely affects quality of life [ 5 – 7 ]. Current treatment options for moderate to severe AD in pregnancy include oral corticosteroids, azathioprine, cyclosporine and phototherapy [ 3 , 8 ].…”