Adesanya Elizabeth I, Henderson Alasdair, Hayes Joseph F, Lewin Alexandra, Mathur Rohini, Mulick Amy, Morton Caroline, Smith Catherine, Langan Sinéad M, Mansfield Kathryn E
Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Division of Psychiatry, University College London, London, UK.
Clin Transl Allergy. 2024 Mar;14(3):e12348. doi: 10.1002/clt2.12348.
Evidence demonstrates that individuals with atopic eczema (eczema) have increased depression and anxiety; however, the role of ethnicity in these associations is poorly understood. We aimed to investigate whether associations between eczema and depression or anxiety differed between adults from white and minority ethnic groups in the UK.
We used UK Clinical Practice Research Datalink GOLD to conduct matched cohort studies of adults (≥18 years) with ethnicity recorded in primary care electronic health records (April 2006-January 2020). We matched (age, sex, practice) adults with eczema to up to five adults without. We used stratified Cox regression with an interaction between eczema and ethnicity, to estimate hazard ratios (HRs) for associations between eczema and incident depression and anxiety in individuals from white ethnic groups and a pooled minority ethnic group (adults from Black, South Asian, Mixed and Other groups).
We identified separate cohorts for depression (215,073 with eczema matched to 646,539 without) and anxiety (242,598 with eczema matched to 774,113 without). After adjusting for matching variables and potential confounders (age, sex, practice, deprivation, calendar period), we found strong evidence (p < 0.01) of ethnic differences in associations between eczema and depression (minority ethnic groups: HR = 1.33, 95% CI = 1.22,1.45; white ethnic groups: HR = 1.15, 95% CI = 1.12,1.17) and anxiety (minority ethnic groups: HR = 1.41, 95% CI = 1.28,1.55; white ethnic groups: HR = 1.17, 95% CI = 1.14,1.19).
Adults with eczema from minority ethnic groups appear to be at increased depression and anxiety risk compared with their white counterparts. Culturally adapted mental health promotion and prevention strategies should be considered in individuals with eczema from minority ethnic groups.
有证据表明，特应性皮炎（湿疹）患者的抑郁和焦虑水平有所升高；然而，种族在这些关联中的作用却鲜为人知。我们旨在调查在英国，白人和少数族裔成年人中，湿疹与抑郁或焦虑之间的关联是否存在差异。
我们使用英国临床实践研究数据链黄金版，对初级医疗电子健康记录（2006年4月至2020年1月）中记录了种族信息的成年人（≥18岁）进行匹配队列研究。我们将患有湿疹的成年人（年龄、性别、医疗机构）与最多五名未患湿疹的成年人进行匹配。我们使用分层Cox回归分析湿疹与种族之间的相互作用，以估计白人群体和一个合并的少数族裔群体（黑人、南亚人、混血和其他群体的成年人）中湿疹与新发抑郁和焦虑之间关联的风险比（HRs）。
我们确定了抑郁（215,073例患有湿疹者与646,539例未患湿疹者匹配）和焦虑（242,598例患有湿疹者与774,113例未患湿疹者匹配）的独立队列。在调整匹配变量和潜在混杂因素（年龄、性别、医疗机构、贫困程度、日历期）后，我们发现有强有力的证据（p < 0.01）表明，湿疹与抑郁（少数族裔群体：HR = 1.33，95%CI = 1.22,1.45；白人群体：HR = 1.15，95%CI = 1.12,1.17）以及焦虑（少数族裔群体：HR = 1.41，95%CI = 1.28,1.55；白人群体：HR = 1.17，95%CI = 1.14,1.19）之间的关联存在种族差异。
与白人相比，少数族裔患有湿疹的成年人出现抑郁和焦虑的风险似乎更高。对于少数族裔患有湿疹的个体，应考虑采用文化适应的心理健康促进和预防策略。
