Cross-sectional study of psychiatric comorbidities in patients with atopic dermatitis and nonatopic eczema, urticaria, and psoriasis

Background: Recent data suggest depression has been linked to chronic skin diseases, including atopic dermatitis (AD), urticaria, and psoriasis. This study compared mental illnesses in patients with AD with those of patients with nonatopic eczema, urticaria, and psoriasis in Korea. Methods: A cross-sectional study design was used, analyzing data from the 2015 Korean National Health Insurance Research Database, a survey of 42,641 AD and 139,486 non-AD (nonatopic eczema, urticaria, and psoriasis) patients (103,938 males, 78,189 females) classified by age: infant, aged 0–3 years; early childhood, aged 4–8 years; late childhood, aged 9–12 years; adolescent, aged 13–18 years; adult, aged 19–64 years; elderly, aged above 65 years. Multiple logistic regression analysis was performed, and the odds ratio (OR) of various mental illnesses – attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), conduct disorder, depression, anxiety, suicidal ideation, schizophrenia, and sleep disorder – were calculated for patients with and without AD. Results: The incidence of depression was not significantly different between AD and non-AD patients. Severe AD showed a high OR of depression (moderate AD OR=1.75; severe AD OR=3.15, P<0.0001). Patients with AD had significantly higher incidence of ADHD (OR=1.48; 95% CI=1.27–1.72), ASD (OR=1.54; 95% CI=1.19–1.99), and conduct disorder (OR=2.88; 95% CI=1.52–5.45). Conclusion: Patients with AD were not found to have higher incidence of depression than non-AD patients. However, severe AD patients were determined to have a significantly higher incidence of depression. Therefore, the severity of dermatitis is thought to contribute to depression. Mental illnesses found to be significantly higher in AD patients were ADHD, ASD, and conduct disorder.