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Association of atopic dermatitis with depression, anxiety, and suicidal ideation in children and adults: A systematic review and meta-analysis - 16/08/18

Doi : 10.1016/j.jaad.2018.03.017 
Amalie Thorsti Møller Rønnstad, MS a, b, Anne-Sofie Halling-Overgaard, MS a, b, Carsten R. Hamann, MD a, b, Lone Skov, MD, PhD, DMSc a, b, Alexander Egeberg, MD, PhD a, b, Jacob P. Thyssen, MD, PhD, DMSc a, b, c,
a Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark 
b Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark 
c National Allergy Research Centre, Herlev and Gentofte Hospital, Hellerup, Denmark 

Correspondence to: Jacob P. Thyssen, MD, PhD, DMSc, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark.Department of Dermatology and AllergyHerlev and Gentofte HospitalUniversity of CopenhagenHellerup2900Denmark

Abstract

Background

Atopic dermatitis (AD) has been associated with anxiety and depression, but the magnitude of the alleged association is unknown.

Objective

To perform a systematic review and meta-analysis of the association between AD in children and adults and, respectively, depression, anxiety, and suicidal behavior.

Methods

The medical databases PubMed, Embase, and PsychINFO were searched.

Results

There was a significant association between adult AD and, respectively, depression (pooled odds ratio [OR], 2.19; 95% confidence interval [CI], 1.87-2.57) and anxiety (pooled OR, 2.19; 95% CI, 1.75-2.73). AD was also associated with depression in children (pooled OR, 1.27; 95% CI, 1.12-1.45); few data were available for anxiety. A positive association was found between AD in adults and adolescents and suicidal ideation (pooled OR, 4.32; 95% CI, 1.93-9.66). Only a few studies examined the risk of completed suicide, but the majority showed a positive association between completed suicide and AD.

Limitations

Included studies used different definitions of depression and anxiety, and few studies examined the severity of AD.

Conclusion

Depression, anxiety, and suicidal ideation should be considered by doctors when treating patients with AD. Because AD disease improvement appears to reduce these risks, this should be a priority.

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Key words : anxiety, atopic dermatitis, depression, meta-analysis, suicidal ideation, suicide, systematic review

Abbreviations used : AD, CI, NOS, OR


Plan


 Ms Rønnstad and Ms Halling-Overgaard contributed equally to this project.
 Funding sources: Dr Thyssen is supported by an unrestricted grant from the Lundbeck Foundation. Ms Anne-Sofie Halling-Overgaard is supported by a scholarship from Herlev and Gentofte Hospital.
 Disclosure: Dr Thyssen has attended an advisory board for Roche and Sanofi-Genzyme and been a speaker on atopic dermatitis for LEO Pharma and Sanofi-Genzyme. Dr Skov has received research funding from Sanofi, LEO Pharma, Pfizer, Novatis, and Janssen, as well as honoraria as a consultant and/or speaker from Pfizer, AbbVie, Eli Lilly, Novartis, LEO Pharma, Janssen-Cilag, and Sanofi; Dr Skov has also served as an investigator for Pfizer, AbbVie, Eli Lilly, Novartis, Amgen, Regeneron, Boehringer Ingelheim, and LEO Pharma. Dr Egeberg has received research funding from Pfizer and Eli Lilly and honoraria as a consultant and/or speaker from LEO Pharma, Samsung Bioepis, Pfizer, Eli Lilly, Novartis, Galderma, and Janssen Pharmaceuticals. Ms Halling-Overgaard, Ms Rønnstad, and Dr Hamann have no conflicts of interest to disclose.
 Dr Thyssen, Dr Egeberg, Ms Halling-Overgaard, and Ms Rønnstad had full access to all of the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis, as well as for the study concept and design. All the authors take responsibility for acquisition, analysis, and interpretation of the data; critical revision of the manuscript for important intellectual content; administrative, technical, or material support; and study supervision. Dr Thyssen, Dr Hamann, Ms Halling-Overgaard, and Ms Rønnstad take responsibility for drafting of the manuscript. Dr Egeberg takes responsibility for statistical analysis.
 Reprints not available from the authors.


© 2018  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 79 - N° 3

P. 448 - septembre 2018 Retour au numéro
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