Suicidal Ideation in Adult Patients with Atopic Dermatitis: A German Cross-sectional Study

Dieris-Hirche, Jan; Gieler, Uwe; Petrak, Frank; Milch, Wolfgang; Wildt, Bert Theodor te; Dieris, Barbara; Herpertz, Stephan

doi:10.2340/00015555-2741

Cited by 47 publications

(76 citation statements)

References 29 publications

(45 reference statements)

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“…1,2 Although the mortality and lethality is lowexcept for patients who committed suicide because of the intractable condition 45 atopic eczema can ruin lives by impairing the quality of life and preventing normal development and fulfilling of life achievements. 1,2 Although the mortality and lethality is lowexcept for patients who committed suicide because of the intractable condition 45 atopic eczema can ruin lives by impairing the quality of life and preventing normal development and fulfilling of life achievements.…”

Section: Discussionmentioning

confidence: 99%

Atopic eczema: burden of disease and individual suffering – results from a large EU study in adults

Ring

Zink

Arents

et al. 2019

Acad Dermatol Venereol

105

112

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Background Atopic eczema (AE, atopic dermatitis) is one of the most common non‐communicable inflammatory skin diseases affecting 1–5% of the adult population in Europe with marked impairment in quality of life. In spite of great progress in understanding the pathophysiology of disturbed skin barrier and immune deviation, AE still represents a problem in daily clinical practice. Furthermore, the true impact of AE on individual suffering is often not recognized. Objectives With a large European study, we wanted to provide insights into the actual suffering and individual burden of disease in adult patients with AE. Methods A total of 1189 adult patients (18–87 years, 56% female) with moderate to severe AE were recruited in nine European countries by dermatologists or allergists together with the help of patient organizations. A computer‐assisted telephone interview was performed by experienced interviewers between October 2017 and March 2018. The following instruments were used to assess severity or measure quality of life: Patient‐Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS‐D) and a newly developed Atopic Eczema Score of Emotional Consequences (AESEC). Patients were also asked to self‐assess the severity of their disease. Results Despite current treatment, 45% of participants still had actual moderate to very severe AE in POEM. Due to their skin disease, 57% missed at least 1 day of work in the preceding year. DLQI showed moderate to extremely large impairment in 55%. According to HADS‐D, 10% scored on or above the threshold of eight points with signs of depressive symptoms. Assessed with AESEC, 57% were emotionally burdened with feelings such as ‘trying to hide the eczema’, ‘feeling guilty about eczema’, having ‘problems with intimacy’ and more. Of persons actually suffering from severe AE, 88% stated that their AE at least partly compromised their ability to face life. Conclusions This real‐life study shows that adults with a moderate to severe form of AE are suffering more than what would be deemed acceptable. There is a need for increased awareness of this problem among healthcare professionals, policymakers and the general public to support research in the development of new and more effective treatments and provide access to better and affordable health care for affected patients.

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Section: Discussionmentioning

confidence: 99%

Atopic eczema: burden of disease and individual suffering – results from a large EU study in adults

Ring

Zink

Arents

et al. 2019

Acad Dermatol Venereol

105

112

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“…Currently available data on adults with AE from Germany rely on selected cohorts of patients, including health insurance data . 22.5% of 181 subjects with AE, sampled from a psychodermatological department, from dermatological practices and from an internet forum in Germany, reported on mental disorders . When compared to controls, significantly more of these patients reached values indicating depression (8.8% vs. 1.6%; P = 0.049) and anxiety (26.0% vs. 12.5%; P = 0.026) and suicidal ideation was high (21.3%) .…”

Section: Introductionmentioning

confidence: 99%

“…22.5% of 181 subjects with AE, sampled from a psychodermatological department, from dermatological practices and from an internet forum in Germany, reported on mental disorders . When compared to controls, significantly more of these patients reached values indicating depression (8.8% vs. 1.6%; P = 0.049) and anxiety (26.0% vs. 12.5%; P = 0.026) and suicidal ideation was high (21.3%) . Data from the TREAT registry (TREatment of ATopic eczema), investigating 241 patients in Germany, revealed significantly reduced quality of life (QoL) .…”

Section: Introductionmentioning

confidence: 99%

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

Treudler¹,

Zeynalova

Riedel-Heller

et al. 2020

Acad Dermatol Venereol

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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.

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“…In individuals with AD, pruritus can lead to longterm psychological problems, including anxiety, depression and suicidal ideation [50][51][52][53][54]. The prevalence of mental health issues is higher in patients with AD than in the general population, and pruritus has a detrimental effect on comfort levels and sleep [52,[55][56][57].…”

mentioning

confidence: 98%

Crisaborole and its Potential Role in Treating Atopic Dermatitis: Overview of Early Clinical Studies

Zane¹,

Chanda²,

Jarnagin³

et al. 2016

Immunotherapy

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Atopic dermatitis (AD), a chronic, relapsing, inflammatory skin disease that is characterized by intense pruritus and eczematous lesions with up to 90% of patients presenting with mild to moderate disease. Current topical treatments for AD have not changed in over 15 years and are associated with safety concerns. In AD, overactivity of phosphodiesterase 4 (PDE4), leads to inflammation and disease exacerbation. Crisaborole Topical Ointment, 2%, is a novel, nonsteroidal, topical anti-inflammatory PDE4 inhibitor currently being investigated for the treatment of mild to moderate AD. Preliminary studies in children and adults demonstrated favorable efficacy and safety profiles. Crisaborole may represent an anti-inflammatory option that safely minimizes the symptoms and severity of AD and that can be used for both acute and long-term management.

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Suicidal Ideation in Adult Patients with Atopic Dermatitis: A German Cross-sectional Study

Cited by 47 publications

References 29 publications

Atopic eczema: burden of disease and individual suffering – results from a large EU study in adults

Atopic eczema: burden of disease and individual suffering – results from a large EU study in adults

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

Crisaborole and its Potential Role in Treating Atopic Dermatitis: Overview of Early Clinical Studies

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