Atopic Dermatitis Is Associated With Multiple Behavioral Problems in US Children and Adolescents

Abstract

Background: Atopic dermatitis (AD) is a chronic, inflammatory skin disease associated with itch, sleep disturbance, psychosocial distress, anxiety, and depression.

Objective: We aimed to understand the association between AD and aberrant childhood behaviors.

Methods: We used data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of 4898 urban children.

Results: Atopic dermatitis was associated with the 75th or greater percentile of mean behavioral scores at 5 years (multivariable logistic regression; adjusted odds ratio [aOR] [95% confidence interval {95% CI}] = 1.51 [1.18-1.93]), 9 years (1.62 [1.32-1.99]), and 15 years (1.44 [1.17-1.76]). There were significantly increased behavioral problems at age of 15 years when AD persisted at ages of 5, 9, and 15 years (Poisson regression; adjusted risk ratio [95% CI] = 1.17 [1.01-1.35]). Atopic dermatitis was associated with 12 aberrant behaviors, particularly fighting (repeated-measures logistic regression; aOR [95% CI] = 1.40 [1.15-1.70]), physically attacking people (1.38 [1.09-1.76]), being sullen (1.31 [1.15-1.49]), worrying (1.41 [1.23-1.61]), and threatening others (1.35 [1.08-1.70]). Significant 2-way interactions were present between AD and sleep as predictors of underactivity (4.31 [3.06-6.08]), being threatening (aOR [95% CI] = 3.42 [2.20-5.34]), being sullen (3.86 [2.74-5.43]), and nervousness (4.56 [3.29-6.32]).

Conclusions: Childhood AD, particularly persistent disease with sleep disturbances, was associated with a wide range of behavioral problems in childhood and adolescence.