Published online: August 31, 2019
Atopic eczema is a common skin condition associated with intensely itchy red skin. It reduces quality of life for both sufferers and their families and previous reports have suggested links with anxiety and depression. Mental illness is the leading cause of disability worldwide, with depression and anxiety together accounting for over half of that burden. As both atopic eczema and mental illness are common, any link could have a considerable impact. While previous research has shown a link between atopic eczema and common mental disorders, it is unclear whether atopic eczema precedes depression and anxiety (or vice versa), or if one condition causes the other.
In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Schonmann and colleagues used routinely collected data from electronic medical records from primary care consultations and hospital admissions in the United Kingdom. The study followed over 500,000 adults with atopic eczema and over 2.5 million without eczema over time to see if they were diagnosed with depression or anxiety.
The study revealed that people with eczema were more likely than those without to develop new depression (14% greater risk) and anxiety (12% greater risk), and the risk increased with increasing atopic eczema severity (e.g. risk of depression was 26% greater in people with severe eczema). However, even those with mild eczema were at greater risk of anxiety and depression than people without eczema. These findings suggest that eczema contributes to the development of depression and anxiety. The study highlights that anxiety and depression are more common in people with atopic eczema, suggesting that current eczema-management guidance should include awareness of links with common mental disorders. Knowing that people with eczema are at greater risk of mental illness, would prompt earlier recognition and management of mental illness in those with skin disease, limiting their negative impact and potentially improving adherence to eczema treatments (as mental illness may impact self-care).
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.