Mental Health Symptoms and Functional Impairment in Children With Atopic Dermatitis

Dermatitis. 2021 Sep-Oct;32(5):353-361. doi: 10.1097/DER.0000000000000680.

Abstract

Background: The impact of childhood atopic dermatitis (AD) on social and behavioral issues is not well understood.

Objective: This study sought to determine the prevalence and predictors of social and behavioral symptoms and functional impairment among US children with AD.

Methods: The 1996 to 2015 Medical Expenditure Panel Surveys were analyzed, including a representative, cross-sectional study of 2553 US children with AD. Behavioral and functional issues were examined using Columbia Impairment Scale (CIS) scores.

Results: Childhood AD was associated with behavioral and functional problems, particularly nervousness (odds ratio [OR], 1.18; 95% confidence interval [95% CI], 1.06-1.31), home behavior (OR, 1.18; 95% CI, 1.06-1.32), staying out of trouble (OR, 1.18; 95% confidence interval, 1.06-1.31), and relationships with other kids (OR, 1.17; 95% CI, 1.05-1.31) and with siblings (OR, 1.14; 95% CI, 1.02-1.28). Higher CIS scores were present in children with AD versus without AD (adjusted β, 0.62; 95% CI, 0.22-1.02) and with psoriasis (adjusted β, 0.86; 95% CI, 0.22-1.49). Among children with AD, higher CIS scores were notably associated with male sex, older age, lower household income, public insurance, and comorbid depression and anxiety.

Conclusions: AD was associated with behavioral and functional impairment, similar to psoriasis and other common chronic conditions. There are significant sociodemographic differences in CIS scores.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cross-Sectional Studies
  • Dermatitis, Atopic / complications
  • Dermatitis, Atopic / epidemiology*
  • Dermatitis, Atopic / psychology*
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Odds Ratio
  • Prevalence
  • Psychological Distress
  • Sociodemographic Factors