Correlation Between Atopic Dermatitis, Neuropsychiatric Comorbidities in Pediatric Populations

While existing research has linked pediatric atopic dermatitis (AD) with a number of neuropsychiatric comorbidities like depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD), the effect of AD severity on neuropsychiatric outcomes requires more research.

To measure the risk, study authors analyzed health records data for a population-based cohort study in the United Kingdom. Patients with AD aged younger than 18 years were matched with up to 5 unaffected patients on age, practice, and index date. Researchers used treatments as a proxy for AD severity.

Measured outcomes included incident anxiety, depression, bipolar disorder, schizophrenia, ADHD, autism, obsessive-compulsive disorder (OCD), suicidal ideation or attempt, and completed suicide.

The final cohort included 409,431 children with AD (Severity levels: 93.2% mild, 5.5% moderate, 1.3% severe) who were compared to 1,809,029 children without AD.

According to the results using Cox regression models to adjust for age, sex, socioeconomic status and other atopic comorbidities, no statistically significant relationships were observed for AD and following:

• incident anxiety (HR 1.01, 95% CI 0.99-1.03);
• ADHD (1.02, 0.97-1.06), autism (1.02, 0.98-1.06);
• bipolar disorder (1.08, 0.85-1.36);
• suicidal ideation/attempt (0.98, 0.95-1.01); or
• completed suicide (0.85, 0.64-1.14).

Further results show that children with AD were less likely to develop depression (0.93, 0.91-0.95) or schizophrenia (0.72, 0.54-0.95); however, in this cohort, were more likely to develop OCD (1.26, 1.16-1.37). Researchers wrote “there was substantial variation by AD severity and age in both the direction and magnitude of effect for many of the neuropsychiatric conditions examined.”

Overall, researchers concluded AD’s impact on risk for the observed neuropsychiatric conditions is minimal but age and severity could be significant modifying factors; therefore, more research is needed to understand the relationship.  

Reference:
Wan J, Shin DB, Syed MN, Abuabara K, Lemeshow AR, Gelfand JM. Atopic dermatitis and risk of major neuropsychiatric disorders in children: a population-based cohort study. J Eur Acad Dermatol Venereol. Published online Aug 26, 2022. doi:10.1111/jdv.18564