Wu Zhe, Wu Chenglong, Chen Xuanyi, Qian Qiufang, Yao Zhirong
Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Dermatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Acta Derm Venereol. 2025 May 15;105:adv43133. doi: 10.2340/actadv.v105.43133.
Atopic dermatitis is a chronic inflammatory skin disorder that significantly impacts quality of life and is often associated with psychiatric comorbidities. How-ever, the causal relationship between atopic dermatitis and psychiatric disorders remains unclear. This study employed bidirectional 2-sample Mendelian randomization to investigate the potential causal relationships between atopic dermatitis and 8 psychiatric conditions: depression, anxiety, autism spectrum disorder, attention deficit hyperactivity disorder, suicidality, bipolar disorder, obsessive-compulsive disorder, and schizophrenia. Genetic instruments were derived from large-scale genome-wide association studies of European ancestry. Forward Mendelian randomization analysis indicated that atopic dermatitis causally increases the risk of anxiety (inverse variance weighting p = 0.016; odds ratio = 1.110, 95% confidence interval: 1.019-1.208). Reverse Mendelian randomization analysis revealed a significant causal effect of bipolar disorder on increasing the risk of atopic dermatitis (inverse variance weighting p = 0.005; odds ratio = 1.062, 95% confidence interval: 1.018-1.107). No significant causal relationships were found for other psychiatric conditions. Sensitivity analyses confirmed the robustness of these findings, with no evidence of horizontal pleiotropy. These results highlight the need for integrated dermatological and psychiatric care, emphasizing early mental health screening for atopic dermatitis patients and dermatological evaluation for individuals with bipolar disorder. Future research should explore underlying biological mechanisms and validate findings across diverse populations.
特应性皮炎是一种慢性炎症性皮肤病，严重影响生活质量，且常与精神疾病共病。然而，特应性皮炎与精神疾病之间的因果关系仍不明确。本研究采用双向双样本孟德尔随机化方法，调查特应性皮炎与8种精神疾病之间的潜在因果关系：抑郁症、焦虑症、自闭症谱系障碍、注意力缺陷多动障碍、自杀倾向、双相情感障碍、强迫症和精神分裂症。基因工具来自欧洲血统的大规模全基因组关联研究。正向孟德尔随机化分析表明，特应性皮炎会因果性地增加焦虑风险（逆方差加权p = 0.016；优势比 = 1.110，95%置信区间：1.019 - 1.208）。反向孟德尔随机化分析显示，双相情感障碍对增加特应性皮炎风险有显著因果效应（逆方差加权p = 0.005；优势比 = 1.062，95%置信区间：1.018 - 1.107）。其他精神疾病未发现显著因果关系。敏感性分析证实了这些发现的稳健性，没有水平多效性的证据。这些结果强调了综合皮肤科和精神科护理的必要性，强调对特应性皮炎患者进行早期心理健康筛查，以及对双相情感障碍患者进行皮肤科评估。未来的研究应探索潜在的生物学机制，并在不同人群中验证研究结果。
