Symptoms of depression are associated with severity of atopic dermatitis and vary as the disease severity fluctuates, suggests a study published in the Journal of the American Academy of Dermatology.

In this single center study, researchers examined 695 adult patients with atopic dermatitis to find out factors that increased the risk of depression. At the time of their enrollment, 60% of patients had moderate to severe itch; nearly 50% had mild atopic dermatitis, 31.7% had moderate disease, while 10.7% had severe atopic dermatitis. Nearly 8% had clear to almost clear Eczema Area and Severity Index (EASI) scores. Depression was assessed through Patient Health Questionnaire-9 scores.

Out of the 695 patients included in the study, 454 (65.3%) had minimal depression. Fifty-seven (8.2%) participants had moderate depression, 27 (3.8%) had moderate to severe depression, while 2.5% were severely depressed. The most persistent symptoms of depression were difficulty in concentration, thoughts of harming oneself, feeling bad and slow movements. Older patients (≥65 years), males and those who belonged to the non-white race (Hispanic, African-American or other) were more likely to be depressed. Other factors that increased the risk of depression were severe itch, skin pain, facial erythema, disturbed sleep, pityriasis alba and public or no insurance. The intensity of symptoms persisted in 45.6% after two follow-ups, while the severity varied in around 50% and improved in nearly 5% of patients.

Atopic dermatitis is a chronic disease characterized by markedly itchy eczematous lesions on the skin. It significantly affects quality of life of the patients and may adversely affect mental health. All patients with atopic dermatitis should be regularly screened for signs of depression followed by appropriate referral for timely management. Symptomatic improvement may favorably affect the mental health of the patients.

Reference

1. Chatrath S, et al. Longitudinal course and predictors of depressive symptoms in atopic dermatitis. J Am Acad Dermatol. 2022 May 9;S0190-9622(22)00792-7. doi: 10.1016/j.jaad.2022.04.061.