Can atopic dermatitis affect a child’s mental health?

Published Online: December 14, 2012

Atopic dermatitis exacts a toll on the quality of life of affected children for several reasons. The chronically inflamed, dry, and cracked skin lesions are accompanied by unrelenting pruritus often leading to disturbed sleep and difficulty at school. Children with atopic dermatitis also frequently suffer from skin infections and allergic disorders like asthma. Recently, studies from Europe suggest that children with atopic dermatitis may be at an increased risk of developing attention-deficit hyperactivity disorder. Further studies in different populations are needed to confirm these findings.

In a study recently published in The Journal of Allergy and Clinical Immunology (JACI), Yaghmaie, et al. utilized the 2007 National Survey of Children’s Health to investigate the prevalence of various mental health outcomes in children with atopic dermatitis in the U.S. This survey includes data from 91,642 children aged 0-17 and was designed to estimate the prevalence of various child health issues, including physical, emotional, and behavioral factors. The survey included questions regarding physician-diagnosed eczema, attention-deficit hyperactivity disorder, anxiety, conduct disorder, and autism.

The investigators found an increased prevalence of the mental health outcomes in children with atopic dermatitis. The estimate of risk of these disorders was approximately 1.8 to 3-fold for the various conditions and these estimates were all statistically significant. There was a direct correlation between the severity of the skin disease and the probability of having a mental health condition.

These findings reveal a striking burden of mental health conditions in children with atopic dermatitis, especially in those with more severe skin disease. The mechanisms underlying these associations are not clear but may involve chronic sleep loss. Further longitudinal studies are needed to further explore and confirm these associations. More precise disease definitions are also needed in future studies.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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