Treated atopic eczema was associated with a 14% increase in the risk for newly diagnosed depression and a 17% increase in a subsequent anxiety diagnosis, regardless of eczema severity, according to a study.
“These results highlight the importance of a comprehensive biopsychosocial approach to limit common mental disorders in those with atopic eczema and could guide recommendations for the management of atopic eczema,” Yochai Schonmann, MD, MSc, of the department of family medicine, Sackler Faculty of Medicine at Tel-Aviv University, Israel, and colleagues wrote.
Using primary care EHR data from the U.K. Clinical Practice Research Datalink and the Hospital Episode Statistics database, the researchers identified 526,808 adults with atopic eczema who were matched to 2,569,030 adults without eczema.
Researchers identified a 1.14-fold (99% CI, 1.12-1.16) increase in the HR for depression in those with atopic eczema compared with those without eczema after adjusting for age, sex and other factors. Atopic eczema was associated with a 1.17-fold (99% CI, 1.14-1.19) increase in the risk for anxiety.
After adjusting for BMI, smoking status, harmful alcohol use and high-dose corticosteroid use, the HR for depression was 1.10 (99% CI, 1.10-1.12) and the HR for anxiety was 1.12 (99% CI, 1.10-1.15).
The association between atopic eczema and both depression and anxiety was prevalent regardless of atopic eczema severity, according to researchers.
Depression and anxiety should be addressed explicitly in updated guidelines on atopic eczema. Current U.K. guidelines only address the management of atopic eczema in children, and those from the European Academy of Dermatology and Venereology briefly comment on the psychological factors behind atopic eczema, according to researchers.
As for study limitations, the algorithm used excluded untreated patients; the eczema severity definition may have wrongly classified patients as having moderate/severe eczema when their symptoms had reduced or resolved; and smoking status and BMI were not recorded for all participants.
“Our results suggest that the association between atopic eczema and depression/anxiety is not substantially mediated through glucocorticoid treatment, obesity, smoking or harmful alcohol intake,” Schonmann and colleagues wrote.
The researchers suggested that atopic eczema was more strongly associated with depression and anxiety in patients aged 40 to 59 years old. – by Abigail Sutton
Disclosures: Schonmann reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.