TY - JOUR
T1 - Atopic dermatitis and risk of major neuropsychiatric disorders in children
T2 - A population-based cohort study
AU - Wan, Joy
AU - Shin, Daniel B.
AU - Syed, Maha N.
AU - Abuabara, Katrina
AU - Lemeshow, Adina R
AU - Gelfand, Joel M.
N1 - Funding Information:
J.W. has received research and fellowship funding from Pfizer, Inc. (paid to the University of Pennsylvania and Johns Hopkins University) and research funding from the National Eczema Association (paid to Johns Hopkins University). M.S. has received fellowship funding from Pfizer, Inc. (paid to the University of Pennsylvania). K.A. has received research funding from Pfizer, Inc., and L'Oréal (paid to UCSF), and receives consulting fees for serving on the academic steering committee for TARGET RWE. A.R.L. is an employee of Pfizer, Inc. J.M.G. has served as a consultant for Abcentra, Abbvie, BMS, Boehringer Ingelheim, GSK, Lilly (DMC), Janssen Biologics, Novartis Corp, UCB (DSMB), Neuroderm (DSMB), Trevi, and Mindera Dx., receiving honoraria; and receives research grants (to the Trustees of the University of Pennsylvania) from Boehringer Ingelheim, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by pharmaceutical sponsors; is a co‐patent holder of resiquimod for treatment of cutaneous T‐cell lymphoma; serves as a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology; is Chief Medical Editor for Healio Psoriatic Disease (receiving honoraria); and is a member of the Board of Directors for the International Psoriasis Council, receiving no honoraria. D.B.S. has no disclosures to report.
Publisher Copyright:
© 2022 European Academy of Dermatology and Venereology.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Paediatric atopic dermatitis (AD) has been linked to neuropsychiatric comorbidities such as depression, anxiety and attention-deficit/hyperactivity disorder (ADHD). However, longitudinal data are limited, and the effect of AD severity on neuropsychiatric outcomes requires further characterization. Objectives: To determine the risk of several major neuropsychiatric conditions in children with AD. Methods: We analysed UK health records data in a population-based cohort study. Each patient <18 years old with AD was matched to up to five unaffected patients on age, practice and index date. Treatments served as proxies for AD severity, which was analysed in a time-updated manner. Outcomes were incident anxiety, depression, bipolar disorder, schizophrenia, ADHD, autism, obsessive–compulsive disorder (OCD), suicidal ideation or attempt, and completed suicide. Results: A total of 409,431 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) were compared to 1,809,029 children without AD. In Cox regression models adjusted for age, sex, socioeconomic status and other atopic comorbidities, no statistically significant relationships were observed between AD and incident anxiety (HR 1.01, 95% CI 0.99–1.03), ADHD (1.02, 0.97–1.06), autism (1.02, 0.98–1.06), bipolar disorder (1.08, 0.85–1.36), suicidal ideation/attempt (0.98, 0.95–1.01) or completed suicide (0.85, 0.64–1.14). Children with AD were less likely to develop depression (0.93, 0.91–0.95) or schizophrenia (0.72, 0.54–0.95) but more likely to develop OCD (1.26, 1.16–1.37). However, there was substantial variation by AD severity and age in both the direction and magnitude of effect for many of the neuropsychiatric conditions examined. Conclusions: The was no substantial impact of AD on the overall risk of many neuropsychiatric conditions in children, but disease severity and age may be important modifying factors. Additional research is needed to further dissect the complex relationship between paediatric AD and neuropsychiatric comorbidities.
AB - Background: Paediatric atopic dermatitis (AD) has been linked to neuropsychiatric comorbidities such as depression, anxiety and attention-deficit/hyperactivity disorder (ADHD). However, longitudinal data are limited, and the effect of AD severity on neuropsychiatric outcomes requires further characterization. Objectives: To determine the risk of several major neuropsychiatric conditions in children with AD. Methods: We analysed UK health records data in a population-based cohort study. Each patient <18 years old with AD was matched to up to five unaffected patients on age, practice and index date. Treatments served as proxies for AD severity, which was analysed in a time-updated manner. Outcomes were incident anxiety, depression, bipolar disorder, schizophrenia, ADHD, autism, obsessive–compulsive disorder (OCD), suicidal ideation or attempt, and completed suicide. Results: A total of 409,431 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) were compared to 1,809,029 children without AD. In Cox regression models adjusted for age, sex, socioeconomic status and other atopic comorbidities, no statistically significant relationships were observed between AD and incident anxiety (HR 1.01, 95% CI 0.99–1.03), ADHD (1.02, 0.97–1.06), autism (1.02, 0.98–1.06), bipolar disorder (1.08, 0.85–1.36), suicidal ideation/attempt (0.98, 0.95–1.01) or completed suicide (0.85, 0.64–1.14). Children with AD were less likely to develop depression (0.93, 0.91–0.95) or schizophrenia (0.72, 0.54–0.95) but more likely to develop OCD (1.26, 1.16–1.37). However, there was substantial variation by AD severity and age in both the direction and magnitude of effect for many of the neuropsychiatric conditions examined. Conclusions: The was no substantial impact of AD on the overall risk of many neuropsychiatric conditions in children, but disease severity and age may be important modifying factors. Additional research is needed to further dissect the complex relationship between paediatric AD and neuropsychiatric comorbidities.
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U2 - 10.1111/jdv.18564
DO - 10.1111/jdv.18564
M3 - Article
C2 - 36018560
AN - SCOPUS:85137517820
SN - 0926-9959
VL - 37
SP - 114
EP - 122
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
IS - 1
ER -