Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Department of Dermatology, George Washington University School of Medicine, Washington, DC, USA.
Pediatr Dermatol. 2021 May;38(3):606-612. doi: 10.1111/pde.14588. Epub 2021 Apr 22.
BACKGROUND/OBJECTIVES: Little is known about the predictors and trends of psychological comorbidities in childhood atopic dermatitis (AD), or whether they occur in an age-dependent pattern. We hypothesized racial/ethnic and socioeconomic disparities lead to increased psychological problems among children with AD and psychological comorbidities occur in an age-dependent manner.
We analyzed cross-sectional data on 228 898 children aged 2-17 years from the 1997-2018 National Health Interview Survey.
Children with AD had higher proportions of depression/sadness (17.2% vs 12.6%; odds ratio [95% confidence interval]: 1.44 [1.37-1.51]), attention deficit (hyperactivity) disorder (ADD/ADHD) (10.0% vs 7.1%; 1.46 [1.38-1.55]), emotional/behavioral difficulties (29.9% vs 23.5%; 1.77 [1.69-1.84]), feelings of frequent worry (38.8% vs 23.5%; 1.66 [1.58-1.74]), and autism (1.9% vs 0.9%; 2.00 [1.75-2.29]). Among children with AD, psychologic comorbidity was associated with atopic comorbidities and multimorbidity and white race, households with lower income and education, and no insurance coverage. In children with or without AD, the prevalence of autism peaked during pre-adolescence; ADD/ADHD and emotional/behavioral difficulties peaked in adolescence; and depression/sadness and feelings of frequent worry increased steadily throughout childhood without plateau.
Atopic dermatitis was associated with multiple psychologic disorders, particularly among those with atopic comorbidities, white race, and low household income. Psychologic comorbidities increased in an age-dependent pattern, though similar to children without AD.
背景/目的：儿童特应性皮炎（AD）的心理合并症的预测因素和趋势知之甚少，或者它们是否存在与年龄相关的模式。我们假设种族/民族和社会经济差异导致 AD 患儿的心理问题增加，并且心理合并症以与年龄相关的方式发生。
我们分析了 1997 年至 2018 年全国健康访谈调查中 228898 名 2-17 岁儿童的横断面数据。
AD 患儿的抑郁/悲伤（17.2% vs 12.6%；优势比[95%置信区间]：1.44 [1.37-1.51]）、注意力缺陷（多动）障碍（ADD/ADHD）（10.0% vs 7.1%；1.46 [1.38-1.55]）、情绪/行为困难（29.9% vs 23.5%；1.77 [1.69-1.84]）、频繁担忧的感觉（38.8% vs 23.5%；1.66 [1.58-1.74]）和自闭症（1.9% vs 0.9%；2.00 [1.75-2.29]）的比例更高。在患有 AD 的儿童中，心理合并症与特应性合并症和多种合并症以及白人种族、收入和教育程度较低的家庭以及没有保险覆盖有关。在患有或不患有 AD 的儿童中，自闭症的患病率在青春期前达到峰值；ADD/ADHD 和情绪/行为困难在青春期达到峰值；抑郁/悲伤和频繁担忧的感觉在整个儿童期呈稳步上升趋势，没有达到平台期。
特应性皮炎与多种心理障碍相关，尤其是与特应性合并症、白种人种族和低收入家庭有关。心理合并症呈与年龄相关的模式增加，尽管与没有 AD 的儿童相似。
