@article{064e607dbc7e4dd99bee609a182a24b2,
title = "Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults",
abstract = "Background: The relationship between atopic dermatitis (AD), anxiety and depression in the U.S. adult population is not well established. Objectives: To determine the relationship of AD and its severity with symptoms and diagnosis of anxiety and depression in U.S. adults. Methods: A cross-sectional, population-based study of 2893 adults was performed. AD was determined using modified U.K. Diagnostic Criteria. Results: Adults with AD vs. those without AD had higher mean Hospital Anxiety and Depression Scale anxiety (HADS-A) (7·7 vs. 5·6) and depression (HADS-D) (6·0 vs. 4·3) scores and higher prevalences of abnormal (≥ 11) HADS-A (28·6% vs. 15·5%) and HADS-D (13·5% vs. 9·0%) scores. In multivariable linear and logistic regression models controlling for sociodemographics, AD was associated with significantly higher mean HADS-A and HADS-D scores (7·7 and 6·0) and higher odds of abnormal HADS-A [odds ratio (OR) 2·19, 95% confidence interval (CI) 1·65–2·91] and HADS-D scores (OR 1·50, 95% CI 1·04–2·17) (P ≤ 0·03 for all). Mean and abnormal HADS-A and HADS-D scores were increased in moderate and severe/very severe self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD), PO-SCORAD itch and sleep (P < 0·0001 for all). All respondents with severe PO-SCORAD, POEM and PO-SCORAD itch had borderline or abnormal HADS-A and HADS-D scores. Adults with AD vs. those without AD had higher prevalence of self-reported healthcare-diagnosed anxiety or depression in the past year (40·0% vs. 17·5%). Many adults with AD who had borderline and/or abnormal HADS-A or HADS-D scores reported no diagnosis of anxiety or depression. Conclusions: AD is associated with significantly increased anxiety and depression, which may go undiagnosed. What's already known about this topic?. Previous studies found higher rates of anxiety and depression in clinical cohorts of patients with atopic dermatitis. What does this study add?. This study found dramatically higher rates of anxiety and depression among adults with atopic dermatitis in the U.S. population, which was primarily driven by atopic dermatitis severity. Anxiety and depression often go undiagnosed in adults with atopic dermatitis.",
author = "Silverberg, {J. I.} and Gelfand, {J. M.} and Margolis, {D. J.} and M. Boguniewicz and L. Fonacier and Grayson, {M. H.} and Ong, {P. Y.} and {Chiesa Fuxench}, {Z. C.} and Simpson, {E. L.}",
note = "Funding Information: J.I.S. served as a consultant and/or advisory board member for AbbVie, Asana, Eli Lilly, Galderma, GlaxoSmithKline, Glenmark, Kiniksa, Leo, Menlo, Pfizer, Regeneron‐Sanofi, Realm and Roivant, receiving honoraria. He has been a speaker for Regeneron‐Sanofi and received research grants from GlaxoSmithKline and Regeneron‐Sanofi. J.I.S. is supported by the Dermatology Foundation. J.M.G. served as a consultant for BMS, Boehringer Ingelheim, GSK, Janssen Biologics, Menlo Therapeutics, Novartis Corp, Regeneron, Dr Reddy's Laboratories, UCB (DSMB), Sanofi and Pfizer Inc., receiving honoraria. J.M.G. receives research grants (to the Trustees of the University of Pennsylvania) from AbbVie, Janssen, Novartis Corp, Sanofi, Celgene, Ortho Dermatologics and Pfizer Inc. and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly and Ortho Dermatologics. J.M.G. is a copatent holder of resiquimod for treatment of cutaneous T‐cell lymphoma. J.M.G. is a Deputy Editor for the Journal of Investigative Dermatology , receiving honoraria from the Society for Investigative Dermatology. Z.C.C.F. has served as a consultant for the National Eczema Association and the Allergy and Asthma Foundation of America (AAFA), receiving honoraria, and receives or has received research grants (to the Trustees of the University of Pennsylvania) from Regeneron, Sanofi, Tioga and Vanda pharmaceuticals and Realm Therapeutics for work in atopic dermatitis. Z.C.C.F. has received payment for continuing medical education work related to atopic dermatitis, which was supported indirectly by Regeneron and/or Sanofi. D.J.M. is the chair of the data monitoring committee for many Sanofi clinical trials of dupilumab, and, with respect to atopic dermatitis, has received independent research funding to his institution from the National Institutes of Health and Valeant. M.B. has received research funding from Anacor and Regeneron and consulted for Regeneron, Sanofi Genzyme and Pfizer. L.F. has served as a consultant for Regeneron, receiving honoraria. L.F. has also been a speaker for Regeneron and has received research and educational grants from Genentech, Baxter and Pfizer. M.H.G. is a board member of the AAFA and chair for the AAFA Medical Scientific Council, and has served as a consultant for AstraZeneca. E.L.S. has served as a consultant and/or advisory board member for Regeneron‐Sanofi. P.Y.O. is a coinvestigator of the Atopic Dermatitis Research Network. He has consulted for Pfizer and Theravance, and has received research funding from Regeneron. Publisher Copyright: {\textcopyright} 2019 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.",
year = "2019",
doi = "10.1111/bjd.17683",
language = "English (US)",
volume = "181",
pages = "554--565",
journal = "British Journal of Dermatology",
issn = "0007-0963",
publisher = "Wiley-Blackwell",
number = "3",
}