Longitudinal course and predictors of depressive symptoms in atopic dermatitis

Background: Atopic dermatitis (AD) is associated with eczematous lesions, pruritus, pain, and sleep disturbance, which may negatively impact mental health over time. Objective: To determine the predictors and longitudinal course of depressive symptoms in adults with AD. Methods: A prospective, dermatology practice-based study was performed (N = 695). AD signs, symptoms, and severity and patient health questionnaire-9 (PHQ-9) were assessed. Results: At baseline, of the 695 participants, 454 (65.32%) had minimal, 139 (20.00%) had mild, 57 (8.20%) had moderate, 27 (3.88%) had moderately severe, and 8 (2.59%) had severe depression. Most had fluctuating levels of depressive symptoms. Feeling bad, thoughts of self-harm, difficulty concentrating, and slow movement were most persistent. Predictors of persistent depression included older age, non-White race, male sex, public or no insurance, more severe itch, skin pain, facial erythema, nipple eczema, sleep disturbance, and presence of pityriasis alba. Limitations: Single center study. Conclusion: Depressive symptoms are closely related to and fluctuate with AD severity over time. Improved control of AD signs and symptoms, particularly itch, may secondarily improve mental health.

Automated summary

Depressive symptoms in adults with atopic dermatitis are closely related and fluctuate with the severity of the skin condition. Improved control of atopic dermatitis, particularly reducing itchiness, may indirectly improve mental health.