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Lemeshow AR, Egeberg A, Edwards T, Schachterle SE, Romero W, Myers DE, Vyas S, Silverberg JI. The Association Between Atopic Dermatitis and Select Disease Events in Adults in the United States: A Retrospective Cohort Study in the Optum Electronic Health Records Database. Dermatol Ther (Heidelb) 2025; 15:1371-1390. [PMID: 40261548 PMCID: PMC12092883 DOI: 10.1007/s13555-025-01375-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Accepted: 02/25/2025] [Indexed: 04/24/2025] Open
Abstract
INTRODUCTION Previous studies have reported positive associations between atopic dermatitis (AD) and select disease events; however, definitive conclusions are lacking. The aim of this study was to characterize demographic and clinical characteristics of patients with and without AD and estimate crude incidence rates (IRs) and adjusted hazard rate ratios (HRRs) of select disease events in these cohorts. METHODS This retrospective observational analysis used Optum® Market Clarity Electronic Health Records, a US administrative healthcare database. Adults with and without AD between 2016 and 2021 with ≥ 12 months of database activity prior to index date (based on diagnosis or first treatment) were included. Each patient with AD was matched on age and index date with five patients without AD. The AD cohort was stratified by treatment prescribed within 30 days of AD diagnosis: no AD treatment; topical corticosteroids (TCS)/topical calcineurin inhibitors (TCI) only ("TCS/TCI only"); phototherapy with/without TCS/TCI ("phototherapy"); and systemic therapy, including oral corticosteroids with/without phototherapy and with/without TCS/TCI ("systemics"). Crude IRs and adjusted HRRs of infections, malignancies, cardiovascular events, mental health outcomes, asthma, fracture, and death across patient subgroups were estimated. RESULTS The total cohort comprised 161,646 adults. Among the 25,915 patients with AD, 8384 (32.35%), 13,459 (51.94%), 366 (1.41%), and 3706 (14.30%) were included in the "no AD treatment," "TCS/TCI only," "phototherapy," and "systemics" subgroups, respectively. Crude IRs/1000 patient-years were higher among patients with AD versus those without AD for serious infections (38.35 vs. 19.21), major adverse cardiovascular events (16.51 vs. 11.82), venous thromboembolism (11.12 vs. 6.89), malignancies (excluding nonmelanoma skin cancer; 17.51 vs. 15.25), and depression (63.50 vs. 44.18); similar trends were observed after controlling for potential confounding variables. When stratified by treatment, IRs and HRRs of these events were generally higher in patients in the "systemics" subgroup versus other treatment subgroups. CONCLUSIONS Overall, certain disease event rates were higher in the population with AD versus the population without AD, with a trend towards higher rates among patients prescribed systemic therapies compared with those prescribed TCS/TCI only. This study further informs the relationship between AD and the risk of select disease events.
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Affiliation(s)
- Adina R Lemeshow
- Pfizer Inc., 66 Hudson Yards East, 13/13N-2, New York, NY, 10001, USA.
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Daniela E Myers
- Pfizer Inc., 66 Hudson Yards East, 13/13N-2, New York, NY, 10001, USA
| | - Shefali Vyas
- Pfizer Inc., 66 Hudson Yards East, 13/13N-2, New York, NY, 10001, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Yang Y, Li JX, Wang ZL, Zhu SE, Xie JZ. A comprehensive bibliometric analysis of the association between atopic dermatitis and depression (1994-2024). Arch Dermatol Res 2025; 317:771. [PMID: 40392326 PMCID: PMC12092472 DOI: 10.1007/s00403-025-04269-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2025] [Revised: 04/02/2025] [Accepted: 04/30/2025] [Indexed: 05/22/2025]
Abstract
In recent decades, the prevalence of atopic dermatitis (AD) has dramatically risen due to modern environmental exposures and drastic lifestyle changes. Furthermore, many studies emphasize that the prevalence of mental health issues, such as depression and anxiety, is much higher among patients with AD compared to the general population. Consequently, there is an urgent imperative to delve into emerging research trends and focal points concerning the association between AD and depression. By analyzing the literature on the correlation between AD and Depression in the Web of Science Core Collection (WoSCC) over the past three decades, our study aims to investigate the key research areas and trends related to the connection between AD and depression through bibliometric analysis, offering useful insights for future researchers in this area. Publications from January 1, 1994, to December 31, 2024, were retrieved from WoSCC on January 5, 2025, and visualized with Excel and Vosviewer software. Summing up to 729 papers were included, authored by 3,670 individuals. The United States, Germany, and the United Kingdom were prominent in researching the link between AD and depression, with the US publishing the highest number of papers-216 in total. Jonathan I. Silverberg stood out as the most prolific author in this field. Keywords visualization analysis revealed that "atopic dermatitis" and "depression" were core topics. It is noteworthy that there has been a significant evolution in research emphasis over time, with studies of AD associated with depression moving from early "pruritus" "psoriasis", and "stress" studies, gradually transitioning into the field of adolescent mental health, suggesting that society's interest in dermatologic conditions and their psychological impact is gradually extending from purely physical symptoms to the broader implications of mental health and quality of life. A thorough bibliometric analysis was initially performed to outline the current state and knowledge framework of the connection between AD and depression, aiming to offer guidance and new insights for future research in this area.
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Affiliation(s)
- Yan Yang
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, 528200, China
- GuangZhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Jun-Xiong Li
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, 528200, China
- GuangZhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Zi-Ling Wang
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, 528200, China
- GuangZhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Si-En Zhu
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, 528200, China
- GuangZhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Jian-Zhou Xie
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, 528200, China.
- GuangZhou University of Chinese Medicine, Guangzhou, 510006, China.
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LeBovidge JS, Schneider LC. Depression and anxiety in patients with atopic dermatitis: Recognizing and addressing mental health burden. Ann Allergy Asthma Immunol 2025; 134:506-515. [PMID: 40117438 DOI: 10.1016/j.anai.2025.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Revised: 02/12/2025] [Accepted: 02/14/2025] [Indexed: 03/23/2025]
Abstract
The psychosocial burden of atopic dermatitis (AD) is extensive, stemming from intense itch, sleep disturbance, unpredictable flares, lifestyle restrictions and missed activities, social stigma, and treatment burden. Overall, adults with AD are at a 2- to 3-fold greater risk for depression and anxiety compared with individuals without AD and children at a 1.5-fold greater risk, with greatest risk for those with more severe disease. A number of mechanisms seem to affect the relationship between AD and mental health, including poorly controlled disease, sleep disturbance, stress-induced itch, inflammation, and coping patterns. In some cases, the mental health burden of AD may also negatively affect AD management and course, creating a reinforcing cycle of psychosocial burden. Although depression and anxiety are known comorbidities of AD, the mental health burden of AD often goes unaddressed, which may further a sense of isolation for patients and families. Given the strong association between symptom severity and increased mental health burden, optimizing AD treatment and reducing itch are critical. Health care professionals can support patients with AD and their caregivers by encouraging open conversations about mental health, addressing common areas of condition-related stress, screening for depression and anxiety, and facilitating referrals to mental health professionals for further assessment and evidence-based care. Existing research supports use of cognitive-behavioral interventions to help manage the physical and mental health burden of AD. Further research is needed to evaluate psychological interventions for pediatric patients with AD and for patients with clinical diagnoses of depression and anxiety to better guide shared decision-making around support for these patients.
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Affiliation(s)
- Jennifer S LeBovidge
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
| | - Lynda C Schneider
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Cao L, Su J, Tian F, Zhou Y, Liu S, Lou F. Risk of depression in patients with atopic dermatitis: An updated systematic review and meta-analysis of children, adolescent and adult groups. J Paediatr Child Health 2024; 60:640-647. [PMID: 39287078 DOI: 10.1111/jpc.16668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/05/2024] [Accepted: 09/02/2024] [Indexed: 09/19/2024]
Abstract
AIM Atopic dermatitis is a popular allergy disease among children, adolescents and adults. The risk of depression in patients with atopic dermatitis can be evaluated using an updated systemic review and meta-analysis of observational and cross-sectional studies. METHODS The log odds ratio (OR) was transformed using the OR and 95% confidence interval (CI) to assess the risk of depression in patients with atopic dermatitis across the children, adolescent and adult groups. After a restricted selection, 39 studies of 234 306 patients with atopic dermatitis and 10 935 459 reference individuals were enrolled. The focused outcome was the OR and 95% CI of depression risk in each included study, assigned according to the age for the children, adolescent and adult groups. RESULTS In adult patients with atopic dermatitis, a significantly higher risk of depression was observed. In addition, the similar significantly higher risk of depression was observed in children and adolescent patients with atopic dermatitis, respectively. However, the significantly high heterogeneity was observed across children, adolescent and adult groups. CONCLUSIONS In the current meta-analysis, the patients with atopic dermatitis had a higher risk of depression across the children, adolescent and adult groups, respectively. However, substantial heterogeneity should be considered during the interpretation of our meta-analysis results.
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Affiliation(s)
- Lihua Cao
- Department of Dermatology and Venereology, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, Yancheng, Jiangsu, China
| | - Jiangwei Su
- Department of Dermatovenereology, Ezhou Central Hospital, Ezhou, Hubei, China
| | - Fang Tian
- Department Physical Examination Center, The General Hospital of Western Theater Command of Chinese People's Liberation Army, Chengdu, Sichuan, China
| | - Yang Zhou
- Department of Dermatology, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, Yancheng, Jiangsu, China
| | - Songchun Liu
- Department of Clinical Nutrition, Ezhou Central Hospital, Ezhou, Hubei, China
| | - Fanglu Lou
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
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Chu CY, Bhat Marne R, Cheung CMT, Diep LN, Noppakun N, Novianto E, Palmero MLH, Tay YK, Zalmy AN. Advanced Systemic Treatments in Patients with Moderate-to-Severe Atopic Dermatitis: Key Learnings from Physicians Practicing in Nine Asian Countries and Territories. Dermatol Ther (Heidelb) 2024; 14:2669-2691. [PMID: 39340696 PMCID: PMC11480307 DOI: 10.1007/s13555-024-01278-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
INTRODUCTION Rapid progress made in the management of atopic dermatitis (AD) in recent years and the differences in patient journey between Asian and non-Asian populations call for a review of current atopic dermatitis landscape in Asia. METHODS A roundtable meeting with nine regional dermatological experts was held in June 2023 to discuss the optimal management approaches for moderate-to-severe AD, focusing on the use of advanced therapies. RESULTS Disease burden on patients' quality of life, treatment adherence, and financial constraints were identified as major concerns when managing patients with moderate-to-severe AD in parts of Asia. It was agreed that the Hanifin and Rajka's criteria or the UK Working Party's Diagnostic Criteria for Atopic Dermatitis can be used to guide the clinical diagnosis of AD. Meanwhile, patient-reported outcome scales including the Dermatology Life Quality Index and Atopic Dermatitis Control Tool can be used alongside depression monitoring scales to monitor treatment outcomes in patients with AD, allowing a better understanding for individualized treatment. When managing moderate-to-severe AD, phototherapy should be attempted after failure with topical treatments, followed by conventional disease-modifying antirheumatic drugs and, subsequently, biologics or Janus kinase inhibitors. Systemic corticosteroids can be used as short-term therapy for acute flares. Although these advanced treatments are known to be effective, physicians have to take into consideration safety concerns and limitations when prescribing these treatments. CONCLUSIONS Treatments in AD have evolved and its management varies country by country. Unique challenges across Asian countries necessitate a different management approach in Asian patients with AD.
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Affiliation(s)
- Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
| | - Ramesh Bhat Marne
- Department of Dermatology, Venereology, and Leprosy, and Head of Research, Father Muller Medical College, Kankanady, Mangalore, Karnataka, India
| | - Christina Man-Tung Cheung
- Division of Dermatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Le Ngoc Diep
- Department of Dermatology, Ho Chi Minh City University of Medicine and Pharmacy and Ho Chi Minh City University Medical Center - Branch 2, Ho Chi Minh City, Vietnam
| | - Nopadon Noppakun
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Endi Novianto
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | | | - Yong-Kwang Tay
- Department of Dermatology, Changi General Hospital, Singapore, Singapore
| | - Azizan Noor Zalmy
- Department of Dermatology, Hospital Kuala Lumpur, Kuala Lumpur and Thomson Hospital Kota Damansara, Selangor, Malaysia
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Heinz KC, Beaudart C, Willems D, Hiligsmann M. Treatment Preference Research in Atopic Dermatitis: A Systematic Review of Quantitative Studies. THE PATIENT 2024; 17:519-535. [PMID: 38722456 PMCID: PMC11343911 DOI: 10.1007/s40271-024-00698-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/08/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Treatment preference research can support shared and informed decision making for currently available atopic dermatitis (AD) treatments, and simultaneously guide research and development for future therapies. In this systematic literature review, we aimed to provide an overview of preferences for AD treatments. METHODS This systematic literature review was conducted in the Medline and Embase (via Ovid) databases, supplemented by manual searching. Quantitative research published from 2010 to September 2023 that investigated preferences for AD treatments were included. Quality assessment was conducted by using the purpose, respondents, explanation, findings, significance checklist, and a checklist developed by the Professional Society for Health Economics and Outcomes Research. RESULTS In total, 207 references were screened after removing duplicates and 15 studies were included. Most studies were conducted in the US, followed by European countries. On average, people directly or indirectly affected by AD rate efficacy and treatment-related risk as the most important criteria when choosing an AD therapy. Participants are willing to increase risks in order to have a higher chance of achieving a certain benefit, e.g. reduction in itch or clearer skin. Participants have preferences for different modes of administration. On average, 68% (all full-text studies) and 87% (only discrete choice experiments [DCEs]) of quality criteria per reference were rated as fulfilled. DCEs received generally higher quality assessment scores than non-DCEs. CONCLUSIONS This review revealed that AD treatment preference research is limited. Diverse study designs hampered comparison and synthesis of the results. We recommend conducting more DCEs in this field to increase the likelihood of AD patients receiving the therapy that best fits their individual needs and preferences. CLINICAL TRIALS REGISTRATION This protocol was published in PROSPERO (ID: CRD42023468757).
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Affiliation(s)
- Katja C Heinz
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
| | - Charlotte Beaudart
- Department of Biomedical Sciences, Clinical Pharmacology and Toxicology Research Unit, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, Namur, Belgium
| | - Damon Willems
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Chu CY, Chan Y, Wananukul S, Cheng H, Chandran NS, Bhat R, Son SW, Liao HF, Gardiner S, Ng QQ, Yeo SH, Chen SB, Kataoka Y. Management of Moderate-to-Severe Atopic Dermatitis in Adults: A Cross-Sectional Survey of Dermatologists Within the Asia-Pacific Region. Dermatol Ther (Heidelb) 2024; 14:2559-2576. [PMID: 39162764 PMCID: PMC11393370 DOI: 10.1007/s13555-024-01246-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/25/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION Limited evidence is available on real-world management of atopic dermatitis (AD) among Asian adults. This cross-sectional study aimed to assess current approaches in AD diagnosis and management in Asia. METHODS Practising dermatologists regularly treating patients with moderate-to-severe AD were recruited from eight Asia-Pacific territories, namely Mainland China, Hong Kong, India, Japan, Singapore, South Korea, Taiwan, and Thailand. A survey was administered to eligible dermatologists after screening and taking informed consent. Data from fully completed submissions were analysed using descriptive statistics. The study was reviewed by the institutional review board in each territory. RESULTS Data from 271 dermatologists were included for analysis. About one-third (31.7%) reported that they referred to the Hanifin and Rajka criteria during diagnosis. The majority of dermatologists used clinical impression when assessing AD severity and treatment response. Reduction of eczema and pruritus was the primary treatment objective when managing both acute (98.1%) and chronic (69.1%) AD. More than half of dermatologists preferred adding systemic anti-inflammatory medication for patients who did not respond to maximized topical treatment, while 43.6% would switch to another systemic medication for those failing to respond to maximized systemic treatment. Topical corticosteroids were frequently selected by dermatologists. For systemic therapies, oral corticosteroids were most frequently used, followed by cyclosporin and dupilumab. Narrow-band ultraviolet B was the most common phototherapy reported (84.9%). There was considerable variation in estimated average and maximum durations of therapies used to treat AD. CONCLUSION This study has provided insights on the real-world management of moderate-to-severe AD in the Asia-Pacific region. The diverse approaches in diagnosis and treatment highlight the multifactorial nature of AD, reliance on clinical judgement, and importance of personalized care. To improve outcomes in patients with AD, it will be crucial to develop biomarkers for diagnosis, reduce subjectivity in assessment, as well as promote access to newer and effective therapies.
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Affiliation(s)
- Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung Chan
- Apex Dermatology Institute, Hong Kong, China
| | - Siriwan Wananukul
- Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Hao Cheng
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Nisha Suyien Chandran
- Division of Dermatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Ramesh Bhat
- Father Muller Medical College, Mangalore, India
| | - Sang Wook Son
- Department of Dermatology, Korea University College of Medicine, Seoul, South Korea
| | | | - Sean Gardiner
- Pfizer Singapore, 80 Pasir Panjang Road, #16-81/82 Mapletree Business City II, Singapore, 117372, Singapore.
| | - Qi Qing Ng
- IQVIA Solutions Asia, Real World Solutions, Singapore, Singapore
| | - See-Hwee Yeo
- IQVIA Solutions Asia, Real World Solutions, Singapore, Singapore
| | | | - Yoko Kataoka
- Department of Dermatology, Osaka Habikino Medical Center, Habikino, Japan
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Chu CY, Chan Y, Wananukul S, Cheng H, Chandran NS, Bhat R, Son SW, Liao HF, Gardiner S, Yeo SH, Chen SB, Ng QQ, Kataoka Y. Bridging the Gap: Comparing Patient-Clinician Views on Treatment Goals and Communication in the Management of Atopic Dermatitis Within the Asia-Pacific Region. Dermatol Ther (Heidelb) 2024; 14:2195-2208. [PMID: 39008225 PMCID: PMC11333385 DOI: 10.1007/s13555-024-01232-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/03/2024] [Indexed: 07/16/2024] Open
Abstract
INTRODUCTION It remains unclear how patients with atopic dermatitis (AD) and clinicians perceive the level of patient-clinician communication and if there could be potential lapses. This cross-sectional study aims to compare perspectives between patients with AD and dermatologists regarding communication and treatment expectations in Asia. METHODS Moderate-to-severe patients with AD and practicing dermatologists were recruited from eight Asia-Pacific territories, including Mainland China, Hong Kong, India, Japan, Singapore, South Korea, Taiwan, and Thailand. Patients and dermatologists completed separate surveys designed to elicit their expectations regarding AD management, and their perceived level of patient-clinician communication. Patients were also asked about their treatment satisfaction and whether they prefer additional treatment beyond what was prescribed. Demographic information and responses were analyzed using descriptive statistics. The study was reviewed by the institutional review board in each territory, and all participants provided informed consent. RESULTS A total of 1103 patients and 271 dermatologists completed the surveys. Both patients and dermatologists were largely aligned in their top treatment goals in AD management. However, greater proportions of patients prioritized the prevention of exacerbation (78.0% versus 47.2%), minimization of treatment adverse effects (46.4% versus 9.1%), and improvement in mental health (16.0% versus 4.9%), compared with dermatologists. Although patient-clinician communication was observed to be generally good, 10.9% of patients reported dissatisfaction with communication in AD management. The majority of patients were either "very satisfied" or "satisfied" with their latest acute AD treatment, but 65.5% of patients still desired additional treatment. CONCLUSIONS This multinational study has provided insights on the perspectives of Asian patients and dermatologists in treatment goals, AD management, and communication. In general, both patients and dermatologists were aligned in treatment goals and there was satisfactory patient-clinician communication in most aspects. However, potential areas of improvement have been identified to further enhance patient-centered care.
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Affiliation(s)
- Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung Chan
- Apex Dermatology Institute, Hong Kong, China
| | - Siriwan Wananukul
- Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Hao Cheng
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Nisha Suyien Chandran
- Division of Dermatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Ramesh Bhat
- Father Muller Medical College, Mangalore, India
| | - Sang Wook Son
- Department of Dermatology, Korea University College of Medicine, Seoul, South Korea
| | | | - Sean Gardiner
- Pfizer Ltd, 80 Pasir Panjang Road, #16-81/82 Mapletree Business City II, Singapore, 117372, Singapore.
| | - See-Hwee Yeo
- IQVIA Solutions Asia, Real World Solutions, Singapore, Singapore
| | | | - Qi Qing Ng
- IQVIA Solutions Asia, Real World Solutions, Singapore, Singapore
| | - Yoko Kataoka
- Department of Dermatology, Osaka Habikino Medical Center, Habikino, Japan
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Almutawa YM, AlGhareeb M, Bhattarai E, Aljalahma J. Investigation of the Impact of Atopic Dermatitis (AD) on Stress, Depression, Anxiety, and Suicidal Ideation: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e63376. [PMID: 39077283 PMCID: PMC11283933 DOI: 10.7759/cureus.63376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/31/2024] Open
Abstract
Skin inflammation, known as atopic dermatitis (AD), is often accompanied by various psychological disorders. The objective of this meta-analysis was to assess the impact of AD on stress, depression, anxiety, and suicidal ideation. A comprehensive search was conducted using nine databases. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS). ORs were generated to analyze the results. Thirty-one articles met the requirements for inclusion, with 25 deemed of good quality and six of fair quality. A positive association was observed between AD and stress (OR = 1.546; 95% CI: 1.445-1.653; p = 0.000), depression (OR = 1.140; 95% CI: 1.127-1.153; p = 0.000), anxiety (OR = 1.080; 95% CI: 1.063-1.097; p = 0.000), and suicidal ideation (OR = 1.158; 95% CI: 1.144-1.172; p = 0.000). Interestingly, a significant publication bias was found in the outcomes related to depression and anxiety. This analysis suggests that AD significantly impacts the psychological well-being of patients. Stress, depression, anxiety, and suicidal ideation are among the mental health issues commonly associated with AD. Therefore, clinicians should consider mental health evaluations for patients with AD.
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Affiliation(s)
- Yaser Mansoor Almutawa
- Dermatology and Venereology, Salmaniya Medical Complex, Manama, BHR
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Muneera AlGhareeb
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Emma Bhattarai
- Dermatology and Internal Medicine, George Eliot Hospital National Health Service (NHS) Trust, Nuneaton, GBR
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Alessandrello C, Sanfilippo S, Minciullo PL, Gangemi S. An Overview on Atopic Dermatitis, Oxidative Stress, and Psychological Stress: Possible Role of Nutraceuticals as an Additional Therapeutic Strategy. Int J Mol Sci 2024; 25:5020. [PMID: 38732239 PMCID: PMC11084351 DOI: 10.3390/ijms25095020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/29/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin condition with a considerable impact on patients' quality of life. Its etiology is multifactorial and, among the predisposing factors, a role is played by oxidative stress. Pollution, recurrent infections, and psychological stress contribute to oxidative stress, amplifying the production of proinflammatory cytokines and worsening barrier damage. There are various oxidative stress mechanisms involved in the pathogenesis of AD. Moreover, AD often appears to be associated with psychological disorders such as alexithymia, depression, and anxiety due to severe itching and related insomnia, as well as social distress and isolation. The increasing incidence of AD requires the evaluation of additional therapeutic approaches in order to reduce the psychological burden of this condition. Our review aims to evaluate the role of some nutraceuticals in AD treatment and its related psychological comorbidities. The combination of some natural compounds (flavonoids, alkaloids, terpenes, isothiocyanates) with traditional AD treatments might be useful in improving the effectiveness of therapy, by reducing chronic inflammation and preventing flare-ups, and in promoting corticosteroid sparing. In addition, some of these nutraceuticals also appear to have a role in the treatment of psychological disorders, although the underlying oxidative stress mechanisms are different from those already known for AD.
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Affiliation(s)
| | | | - Paola L. Minciullo
- School and Operative Unit of Allergy and Clinical Immunology, University Hospital of Messina, 98125 Messina, Italy; (C.A.); (S.S.); (S.G.)
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Ferrucci SM, Tavecchio S, Ceresa A, Angileri L, Berti E, Marzano AV, Buoli M. Which Factors Are Associated with Persistence of Depressive and Anxiety Symptoms in Patients Affected by Atopic Dermatitis despite 2-Year Treatment with Dupilumab? J Clin Med 2024; 13:1980. [PMID: 38610745 PMCID: PMC11012912 DOI: 10.3390/jcm13071980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Atopic Dermatitis (AD) is a prevalent inflammatory skin disease whose course is often complicated by the presence of concomitant anxiety and depressive disorders. Dupilumab has been demonstrated to be largely effective in AD. The aims of the present study were to (1) to verify the effectiveness of 2-year dupilumab treatment on the depressive and anxiety symptoms of patients affected by AD and (2) to identify predictors of the persistence of psychiatric symptoms despite maintenance treatment with dupilumab. Methods: A total of 331 patients with severe AD were assessed at baseline and at different times over 2 years by a large set of rating scales, including the Eczema Area and Severity Index (EASI), the Hospital Anxiety and Depression Scale (HADS), and the Dermatology Life Quality Index (DLQI). Paired sample t-tests were performed to verify the effectiveness of dupilumab on the severity of AD and mental health items. Two binary logistic regression models were then used to identify the predictors of the persistence of clinically significant depression and anxiety, defined by a score ≥ 8 on each sub-scale of the HADS. Results: After 2 years of treatment with dupilumab, the patients benefited, showing a significant improvement in both the dermatological disease and comorbid depression/anxiety (p < 0.001 for all scales). Overall, 17.5% and 13% of patients, respectively, reported residual depressive and anxiety symptoms after the 2-year treatment with dupilumab. The baseline predictors of the persistence of clinically significant depressive symptoms after the 2-year treatment with dupilumab were found to be a higher body mass index (BMI) (p = 0.012), a lower impact of dermatological disease on quality of life (p = 0.015), and more severe depressive symptoms (p < 0.01), while for anxiety, the only predictor was found to be female gender (p = 0.03). Conclusions: Using a multidisciplinary approach, at baseline, dermatologists should more closely monitor patients who are at a greater risk of maintaining residual psychiatric symptoms despite therapy, such as those with more severe depressive symptoms and those who are overweight.
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Affiliation(s)
- Silvia Mariel Ferrucci
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
| | - Simona Tavecchio
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Luisa Angileri
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
| | - Emilio Berti
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Angelo Valerio Marzano
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
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12
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Adesanya EI, Henderson A, Hayes JF, Lewin A, Mathur R, Mulick A, Morton C, Smith C, Langan SM, Mansfield KE. Ethnic differences in depression and anxiety among adults with atopic eczema: Population-based matched cohort studies within UK primary care. Clin Transl Allergy 2024; 14:e12348. [PMID: 38526449 PMCID: PMC10962487 DOI: 10.1002/clt2.12348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND 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. METHODS 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). RESULTS 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). CONCLUSIONS 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.
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Affiliation(s)
- Elizabeth I. Adesanya
- Department of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Alasdair Henderson
- Department of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | | | - Alexandra Lewin
- Department of Medical StatisticsLondon School of Hygiene & Tropical MedicineLondonUK
| | - Rohini Mathur
- Centre for Primary CareWolfson Institute of Population HealthQueen Mary University of LondonLondonUK
| | - Amy Mulick
- Department of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Caroline Morton
- Centre for Primary CareWolfson Institute of Population HealthQueen Mary University of LondonLondonUK
| | - Catherine Smith
- St John's Institute of DermatologyGuys and St Thomas' Foundation Trust and King's College LondonLondonUK
| | - Sinéad M. Langan
- Department of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Kathryn E. Mansfield
- Department of Non‐Communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
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13
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Laird M, Sicco KL. Defining and Measuring the Scope of Atopic Dermatitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1447:105-116. [PMID: 38724788 DOI: 10.1007/978-3-031-54513-9_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
Atopic dermatitis (AD) has no definitive diagnostic test and has a large range of phenotypes, making it a difficult disease to assess and define. However, an agreed-upon definition of AD is important for clinical trials, population-based studies, and clinical practice. Several diagnostic criteria systems have been proposed to fill these needs, with none considered the gold standard. To further aid in standardized assessment of AD patients, numerous disease severity and quality-of-life measurement tools have been proposed. There is similarly no gold standard and efforts are ongoing to develop a single consensus scale. Finally, assessment of AD-associated comorbidities, including allergic/immunologic conditions, psychiatric disorders, and metabolic/cardiac conditions, is important when evaluating this patient population.
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Affiliation(s)
- Mary Laird
- New York University Langone Medical Center, The Ronald O. Perelman Department of Dermatology, New York, NY, USA
| | - Kristen Lo Sicco
- New York University Langone Medical Center, The Ronald O. Perelman Department of Dermatology, New York, NY, USA.
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14
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Heinz KC, Beaudart C, Willems D, Wiethoff I, Hiligsmann M. Cost-Effectiveness of Emerging Treatments for Atopic Dermatitis: A Systematic Review. PHARMACOECONOMICS 2023; 41:1415-1435. [PMID: 37392363 PMCID: PMC10570180 DOI: 10.1007/s40273-023-01293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Numerous therapies have recently emerged for treatment of patients with atopic dermatitis (AD), a common skin disease, and understanding their cost-effectiveness is of high importance for policy makers. This systematic literature review (SLR) aimed to provide an overview of full economic evaluations that assessed cost-effectiveness of emerging AD treatments. METHODS The SLR was conducted in Medline, Embase, UK National Health Service Economic Evaluation Database and EconLit. Reports published by the National Institute for Health and Care Excellence, the Institute for Clinical and Economic Review and the Canadian Agency for Drugs and Technologies in Health were manually searched. Economic evaluations published from 2017 to September 2022 that compared emerging AD treatments with any comparator were included. Quality assessment was conducted by using the Consensus on Health Economic Criteria list. RESULTS A total of 1333 references were screened after removing duplicates. Among those references, 15 that conducted a total of 24 comparisons were included. Most studies were from the USA, UK or Canada. Seven different emerging treatments were compared, mostly with usual care. In 15 comparisons (63%), the emerging treatment was cost-effective, and 11 out of 14 dupilumab comparisons (79%) reported that dupilumab was cost-effective. Upadacitinib was the only emerging therapy that was never classified as cost-effective. On average, 13 out of 19 quality criteria (68%) per reference were rated as fulfilled while manuscripts and health technology reports received generally higher quality assessment scores than published abstracts. DISCUSSION This study revealed some discrepancies in the cost-effectiveness of emerging therapies for AD. A variety of designs and guidelines made comparison difficult. Therefore, we recommend that future economic evaluations use more similar modelling approaches to improve comparability of results. OTHERS The protocol was published in PROSPERO (ID: CRD42022343993).
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Affiliation(s)
- Katja C Heinz
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
| | - Charlotte Beaudart
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Damon Willems
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Isabell Wiethoff
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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15
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Chen S, Tang L, Nie T, Fang M, Cao X. Fructo-oligofructose ameliorates 2,4-dinitrofluorobenzene-induced atopic dermatitis-like skin lesions and psychiatric comorbidities in mice. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:5004-5018. [PMID: 36987580 DOI: 10.1002/jsfa.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by pruritus and eczema lesions and psychiatric comorbidities. The gut-brain-skin axis plays a pivotal role during AD development, which might suggest a novel therapeutic strategy for AD. The present study aims to uncover the protective effects and underlying mechanisms of fructo-oligofructose (FOS), a type of prebiotic, on AD-like skin manifestations and comorbid anxiety and depression in AD mice. RESULTS Female Kunming mice were treated topically with 2,4-dinitrofluorobenzene (DNFB) to induce AD-like symptoms and FOS was administered daily for 14 days. The results showed that FOS could alleviate AD-like skin lesions markedly as evidenced by dramatic decreases in severity score, scratching bouts, the levels of immunoglobulin E (IgE) and T helper 1(Th1)/Th2-related cytokines, and the infiltration of inflammatory cells and mast cells to the dermal tissues. The comorbid anxiety and depressive-like behaviors, estimated by the forced swimming test (FST), the tail-suspension test (TST), the open-field test (OFT), and the zero maze test (ZMT) in AD mice, were significantly attenuated by FOS. Fructo-oligofructose significantly upregulated brain neurotransmitters levels of 5-hydroxytryptamine (5-HT) and dopamine (DA). Furthermore, FOS treatment increased the relative abundance of gut microbiota, such as Prevotella and Lactobacillus and the concentrations of short-chain fatty acids (SCFAs), especially acetate and iso-butyrate in the feces of AD mice. The correlation analysis indicated that the reshaped gut microbiome composition and enhanced SCFAs formation are associated with skin inflammation and behavioral alteration. CONCLUSION Collectively, these data identify FOS as a promising microbiota-targeted treatment for AD-like skin inflammation and comorbid anxiety and depressive-like behaviors. © 2023 Society of Chemical Industry.
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Affiliation(s)
- Shaoze Chen
- School of Medicine, Jianghan University, Wuhan, China
| | - Liu Tang
- Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tingting Nie
- School of Medicine, Jianghan University, Wuhan, China
| | - Mingyu Fang
- School of Medicine, Jianghan University, Wuhan, China
| | - Xiaoqin Cao
- School of Medicine, Jianghan University, Wuhan, China
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16
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Ruppe NM, Clawson AH, Ankney RL, Welch G, Mullins LL, Chaney JM. Depressive Symptom Trajectories Across Adolescence and Adulthood Among Individuals With Asthma. J Pediatr Psychol 2023; 48:572-582. [PMID: 37130344 PMCID: PMC10321385 DOI: 10.1093/jpepsy/jsad022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE Individuals with asthma experience increased depressive symptoms, which is associated with deleterious health outcomes. No studies have examined depressive symptom trajectories among individuals with asthma despite increased risk. This study expanded prior literature by identifying the following: (1) depressive symptoms trajectories for individuals with and without asthma and (2) predictors of baseline levels and changes in symptoms across time for individuals with asthma. METHODS Adolescents with (N = 965) and without (N = 7,392) asthma self-reported on depressive symptoms (CESD-9) across development. Covariates included: demographics and persistence of asthma. Latent growth curve modeling (LGCM) was used to identify depressive symptom trajectories and their predictors. RESULTS A multigroup LCGM identified no significant differences between depressive symptom trajectories of individuals with and without asthma. Depressive symptoms followed a quadratic shape across time for individuals with asthma (Mintercept = 5.73, p < .00; Mlinear = -0.38,p < .001; Mquad = 0.03, p < .001), with a linear deceleration in depressive symptoms during adolescence and an acceleration of symptoms into adulthood. Next predictors of depressive trajectories among individuals with asthma were examined. Female sex (B = 0.58, p < .001), lower parent education (B = -0.57, p < .001), older age (B = 0.19, p < .001), and identifying as Black (B = 0.31, p = .04) were associated with greater baseline depressive symptoms. Older individuals exhibited faster linear symptom decelerations (B = -0.56, p < .001) and faster symptom accelerations (B = 0.73, p < .001). American Indian (AIAN) individuals exhibited faster linear symptom decelerations (B = -1.98, p = .005) and faster quadratic accelerations (B = 3.33, p = .007). DISCUSSION Our results suggest that the depressive symptom trajectories of individuals with asthma are curvilinear and similar to individuals without asthma. When examining predictors of depressive symptom trajectories for those with asthma, socioeconomic disadvantage and racial marginalization were associated with greater baseline depressive symptoms. Although AIAN youth demonstrated more favorable trajectories in adolescence, they also exhibited worse trajectories across young adulthood and adulthood. Findings suggest the need to better understand the impact of multilevel risk and protective factors on depressive symptoms trajectories for individuals with asthma, especially marginalized populations.
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Affiliation(s)
- Nicole M Ruppe
- Department of Psychology, Oklahoma State University, USA
- Center for Pediatric Psychology, Oklahoma State University, USA
| | - Ashley H Clawson
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham St., #820, Little Rock, AR 72205, USA
| | | | - Ginger Welch
- Department of Human Development and Family Science, Oklahoma State University, USA
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, USA
- Center for Pediatric Psychology, Oklahoma State University, USA
| | - John M Chaney
- Department of Psychology, Oklahoma State University, USA
- Center for Pediatric Psychology, Oklahoma State University, USA
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17
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Ishak N, Mukhtar F, Munawar K, Coudhry FR, Roy M, Jalal FA, Choi CS. Psychological assessment of atopic dermatitis in Asia: a systematic review. PSYCHOL HEALTH MED 2023; 28:1-26. [PMID: 35000520 DOI: 10.1080/13548506.2021.1971727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Atopic dermatitis (AD) is a frequently occurring skin disorder in Asia that substantially impacts the social, financial, and psychological lives of individuals. However, there is uncertainty regarding the psychological instruments for this domain. Hence, this review systematically assessed the existing measurement instruments used, developed, and/or validated for the measurement of psychological outcomes in Asian adult patients with AD as well as the scope of those assessment tools (e.g. validity and reliability). Electronic searches were performed using six databases (inception to February 2020) to identify studies. Thematic analysis of 44 included studies revealed that the commonly employed tools to assess the quality of life were the Dermatology Life Quality Index followed by the Skindex-16 questionnaire, the European Quality of Life-5 Dimensions, and the Quality of Life Hand Eczema Questionnaire. Similarly, the Patient Health Questionnaire, Self-rating depression scale (SDS), and Hospital Anxiety and Depression Scale were frequently employed to assess depressive symptoms. Additionally, symptoms of anxiety were frequently assessed through Interaction Anxiousness Scale and the Spielberger State-Trait Anxiety Inventory. Although a variety of psychological assessment measures have been used in research, data on their reliability and validity is limited. Also, information on the cultural applicability of these instruments is scantier. More research is needed to ascertain the suitability of tools for use in clinical practice.
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Affiliation(s)
- Nurhafidah Ishak
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Firdaus Mukhtar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Khadeeja Munawar
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, Ucsi University Malaysia, Cheras, Kuala Lumpur, Malaysia.,Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Fahad Riaz Coudhry
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur Malaysia
| | - Mollika Roy
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Farah Atiqah Jalal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Chong Seng Choi
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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18
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Wan J, Shin DB, Syed MN, Abuabara K, Lemeshow AR, Gelfand JM. Atopic dermatitis and risk of major neuropsychiatric disorders in children: A population-based cohort study. J Eur Acad Dermatol Venereol 2023; 37:114-122. [PMID: 36018560 PMCID: PMC9929490 DOI: 10.1111/jdv.18564] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/18/2022] [Indexed: 12/15/2022]
Abstract
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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Affiliation(s)
- Joy Wan
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel B Shin
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Maha N Syed
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Katrina Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | | | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Muacevic A, Adler JR, Choday S, Kampa P, Ravi N, Sherpa ML, Agrawal H, Alfonso M. A Molecular Basis Approach of Eczema and Its Link to Depression and Related Neuropsychiatric Outcomes: A Review. Cureus 2022; 14:e32639. [PMID: 36660532 PMCID: PMC9845527 DOI: 10.7759/cureus.32639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
"What about my eczema do I love the most? The hurt? A scratch? The humiliation of the public? Oh, there are so many options available!" Studies have shown an association between atopic eczema (AE), a common inflammatory skin condition, and an increased risk of mental health problems. Despite this, experts are still examining the causes of the links between common mental diseases (such as depression and anxiety) and skin conditions. We collected studies that were published in the past 10 years. We searched the following databases: PubMed, PubMed Central, Science Direct, and Google Scholar. Further relevant research was assessed by examining the bibliographies of eligible studies and related ones. Two reviewers looked at the titles and abstracts of the studies to see if they were eligible, and then they read the full texts. We went through eczema and depression relationships, their etiopathogenesis, molecular basis, immune response, the role of genetic factors, and possible interactions between neurons and the immune system. Another possible contributing factor could be a change in cutaneous microbiota in eczema patients. Part of the initial connection could be explained by psychological stress, which further leads to depression in eczema patients. Healthcare professionals treating eczema patients must be aware of the comorbidity of mental problems and the potential that people with poor mental health may need social or emotional support. Patients with eczema, especially youngsters, can benefit from routine health checks since they can help identify neuropsychiatric issues like depression early and lessen the burden of both physical sickness and poor mental health. Given that AE is a condition that appears to be related to depression and anxiety, more research with larger samples is needed to determine a potential role for targeted mental health screening in people with AE, as well as the possibility of mental health modification through improved AE control (e.g., using new biologic agents).
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20
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Involvement of Atopic Dermatitis in the Development of Systemic Inflammatory Diseases. Int J Mol Sci 2022; 23:ijms232113445. [PMID: 36362231 PMCID: PMC9658023 DOI: 10.3390/ijms232113445] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
The skin is recognized as a peripheral lymphoid organ that plays an essential defensive action against external environmental stimuli. However, continuous stimulation of these factors causes chronic inflammation at the local site and occasionally causes tissue damage. Chronic inflammation is recognized as a trigger for systemic organ inflammation. Atopic dermatitis (AD) is a chronic inflammatory skin disease that is influenced by various external environmental factors, such as dry conditions, chemical exposure, and microorganisms. The pathogenesis of AD involves various Th2 and proinflammatory cytokines. Recently updated studies have shown that atopic skin-derived cytokines influence systemic organ function and oncogenesis. In this review, we focus on AD’s influence on the development of systemic inflammatory diseases and malignancies.
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21
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Tang CH, Huang YH, Chuang PY, Wang BCM, Wei CY, Ng KJ, Treuer T, Chu CY. Patient Characteristics, Treatment Patterns, Healthcare Resource Utilization, and Costs of Targeted Therapy-Eligible Atopic Dermatitis Patients in Taiwan-A Real-World Study. Dermatol Ther (Heidelb) 2022; 12:2547-2562. [PMID: 36155881 PMCID: PMC9510234 DOI: 10.1007/s13555-022-00816-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/09/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The objective of this study was to conduct a retrospective analysis to understand the patient profile, treatment patterns, healthcare resource utilization, and cost of atopic dermatitis (AD) of patients eligible for targeted therapy in Taiwan. METHODS A retrospective, claims-based analysis was undertaken using Taiwan's National Health Insurance Research Database from 01 January 2014 to 31 December 2017. Patients aged ≥ 2 years and with at least one diagnosis code for AD during 2015 were identified. Patients with comorbid autoimmune diseases were excluded. Enrolled AD patients were categorized using claims-based treatment algorithms by disease severity and their eligibility for targeted therapy treatment. A cohort of targeted therapy-eligible patients was formed, and a matched cohort using patients not eligible for targeted therapy was derived using propensity score matching based on age, gender, and the Charlson Comorbidity Index (CCI). Treatment patterns, resource utilization, and costs were measured during a 1-year follow-up period. RESULTS A total of 377,423 patients with AD were identified for this study. Most patients had mild AD (84.5%; n = 318,830) with 11.9% (n = 45,035) having moderate AD, and 3.6% (n = 13,558) having severe AD. Within the 58,593 moderate-to-severe AD patients, 1.5% (n = 897) were included in the targeted therapy-eligible cohort. The matched cohort consisted of 3558 patients. During the 1-year follow-up period, targeted therapy-eligible patients utilized antihistamines (85.5%), topical treatments (80.8%), and systemic anti-inflammatories (91.6%) including systemic corticosteroids (51.4%) and azathioprine (59.1%). During the first year of follow-up, targeted therapy-eligible patients (70.5%; 7.01 [SD = 8.84] visits) had higher resource utilization rates and frequency of AD-related outpatient visits compared with the matched cohort (40.80%; 1.85 [SD = 4.71] visits). Average all-cause direct costs during 1-year follow-up were $2850 (SD = 3629) and $1841 (SD = 6434) for the eligible targeted therapy and matched cohorts, respectively. AD-related costs were 17.7% ($506) of total costs for the targeted therapy eligible cohort and 2.2% ($41) for the matched cohort. CONCLUSIONS AD patients eligible for targeted therapy in Taiwan experienced high resource and economic burden compared with their non-targeted-therapy-eligible counterparts.
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Affiliation(s)
- Chao-Hsiun Tang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | | | | | | | - Ching-Yun Wei
- Eli Lilly and Company (Taiwan), Inc., Taipei, Taiwan
| | - Khai Jing Ng
- Eli Lilly and Company (Taiwan), Inc., Taipei, Taiwan
| | | | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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The potential action of SSRIs in the treatment of skin diseases including atopic dermatitis and slow-healing wounds. Pharmacol Rep 2022; 74:947-955. [PMID: 36203121 PMCID: PMC9584846 DOI: 10.1007/s43440-022-00423-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/09/2022] [Accepted: 09/21/2022] [Indexed: 10/31/2022]
Abstract
AbstractSelective serotonin reuptake inhibitors (SSRIs) are used to treat affective and anxiety disorders. Antidepressants have also been shown to have antimicrobial and immunomodulatory effects, which may affect the microbiota-intestinal-brain axis. Studies show that SSRIs have antimicrobial activity both in vivo and in vitro and influence bacteria by inhibiting biofilm, affecting efflux pumps, among others. A huge challenge today is the prevention and treatment of skin diseases, including atopic dermatitis (AD) and slow-healing wounds. Skin diseases including AD and non-healing wounds are serious medical problem. People suffering from these conditions feel constant discomfort, which also affects their psychological state. Research on new treatments for AD and slow-healing wounds is essential because current medications are not fully effective and have many side effects. Exploring new drug groups for AD and slow-healing wounds will allow for the creation of an alternative treatment for these diseases. SSRIs represent a hope for the treatment of skin diseases due to their immunomodulatory and antimicrobial properties.
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Peters EMJ, Stierle C. [Psychodermatology: Foundations for new developments in integrated care]. Psychother Psychosom Med Psychol 2022; 72:155-168. [PMID: 35385880 DOI: 10.1055/a-1740-9408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The burden of a skin disease is easily understood by any observer due to its visibility: psychosocial issues are therefore ubiquitous in dermatology. Current evidence now shows that this relationship is two-way, as psychosocial stress can cause skin disease and its worsening. This interrelationship poses a major challenge.
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Long Q, Jin H, You X, Liu Y, Teng Z, Chen Y, Zhu Y, Zeng Y. Eczema is a shared risk factor for anxiety and depression: A meta-analysis and systematic review. PLoS One 2022; 17:e0263334. [PMID: 35180242 PMCID: PMC8856547 DOI: 10.1371/journal.pone.0263334] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/17/2022] [Indexed: 12/18/2022] Open
Abstract
Globally, anxiety and depression are the most common psychiatric disorders that add large burdens to individuals and society; however, the mechanisms underlying these disorders are unclear. Several studies have found that eczema is a shared risk factor for both these conditions. We identified and evaluated eligible observational studies from EMBASE and PubMed. In total, 20 relevant cohort and case-control studies comprising 141,910 patients with eczema and 4,736,222 control participants fulfilled our established criteria. Information extracted included study design, location, sample size, sex distribution of cases and controls or reference cohorts, measurements of outcomes, odds ratio (OR) with 95% confidence interval (CI), and adjusted factors for exposure associated with outcome risk. The meta-analysis was performed by calculating the pooled OR with 95% CI, and heterogeneity was assessed using Cochrane Q and I2 statistics. The pooled effect showed a positive association (n = 4,896,099, OR = 1.63, 95% CI [1.42-1.88], p<0.001) between eczema and depression or anxiety, with positive associations also observed in the depression (n = 4,878,746, OR = 1.64, 95% CI [1.39-1.94], p<0.001) and anxiety (n = 4,607,597, OR = 1.68, 95% CI [1.27-2.21], p<0.001) groups. Subgroup and sensitivity analyses confirmed that these findings were stable and reliable. This study suggests that eczema is associated with an increased risk of developing depression and anxiety, which may assist clinicians in the prevention or treatment of these disorders.
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Affiliation(s)
- Qing Long
- Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
| | - Hongxia Jin
- Ziyang Hospital of Traditional Chinese Medicine, Ziyang, Sichuan, China
| | - Xu You
- Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
| | - Yilin Liu
- Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
| | - Zhaowei Teng
- Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
- The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yatang Chen
- Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
| | - Yun Zhu
- Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
- * E-mail: (YZ); (YZ)
| | - Yong Zeng
- Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
- Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- * E-mail: (YZ); (YZ)
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25
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Hsu CJ, Shen D, Chan TC, Cho YT, Tang CH, Chu CY. Correlation between anxiety and depression risk and atopic dermatitis severity in Taiwan: A cross-sectional study. JAAD Int 2022; 7:22-30. [PMID: 35243405 PMCID: PMC8873920 DOI: 10.1016/j.jdin.2021.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Limited studies on atopic dermatitis (AD) have investigated the possible covariance of sociodemographic factors with the Hospital Anxiety and Depression Scale (HADS). Objective This study aimed to examine the possible covariance between AD severity and HADS scores of patients in Taiwan. Methods Patients with AD from a medical center and 2 regional hospitals in Taiwan were enrolled in this cross-sectional study from April 2018 to April 2019. AD severity was measured using the “scoring atopic dermatitis” index, and anxiety and depression were screened based on HADS. Results A total of 200 patients were included. After correcting for sociodemographic variables, significantly more borderline (≥8) and abnormal (≥11) cases of anxiety/depression (P < .05) were noted in patients with moderate-to-severe AD. Limitations First, the cross-sectional study design cannot show causality. Second, baseline data, including a history of underlying cancer or previous psychiatric disorder, were not obtained in the questionnaire and may confound the HADS scores. Finally, a standardized psychiatric clinical interviews study design should be used for higher accuracy in the assessment of psycho-comorbidities. Conclusion Higher anxiety and depression risks were noted in patients with moderate-to-severe AD. Except for psychosomatic symptoms, all kinds of anxiety and depression symptoms occurred more frequently in patients with moderate-to-severe AD.
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Affiliation(s)
- Chia-Jung Hsu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Dereck Shen
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Tom C. Chan
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Tsu Cho
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chao-Hsiun Tang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Correspondence to: Chia-Yu Chu, MD, PhD, Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, 15F, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
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26
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Yang B, Ryu JS, Rim C, Shin JU, Kwon MS. Possible role of arginase 1 positive microglia on depressive/anxiety-like behaviors in atopic dermatitis mouse model. Arch Pharm Res 2022; 45:11-28. [DOI: 10.1007/s12272-022-01369-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/13/2022] [Indexed: 12/19/2022]
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AAD Guidelines: awareness of comorbidities associated with atopic dermatitis in adults. J Am Acad Dermatol 2022; 86:1335-1336.e18. [PMID: 35085682 DOI: 10.1016/j.jaad.2022.01.009] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/21/2022]
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Heinz KC, Willems D, Hiligsmann M. Economic evaluation of a JAK inhibitor compared to a monoclonal antibody for treatment of moderate-to-severe atopic dermatitis from a UK perspective. J Med Econ 2022; 25:491-502. [PMID: 35350959 DOI: 10.1080/13696998.2022.2059220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by severe itching, erythema and scaling, causing pain, stigmatization and social isolation. Despite the growing availability of treatment options, unmet care needs remain. This research aimed to assess the cost-effectiveness of a novel JAK inhibitor (JAKi) compared to a monoclonal antibody and to identify key drivers of cost-effectiveness. MATERIALS AND METHODS A de novo economic model was developed to assess the cost-effectiveness of a novel JAKi compared to an established monoclonal antibody for the treatment of moderate-to-severe AD patients from a UK perspective. A targeted literature review was conducted to inform the development of the economic model with an advanced model structure. Various scenario and sensitivity analyses were performed to account for parameter- and structural uncertainty and to identify key drivers of cost-effectiveness. RESULTS The JAKi was not cost-effective compared to the monoclonal antibody (£219,733.88 per quality-adjusted life year (QALY) gained) at selected price levels when applying the UK willingness-to-pay threshold of £30,000 per QALY gained. Key drivers of cost-effectiveness were utility values, intervention efficacy and drug acquisition costs. A decrease in JAKi's dose costs, as well as a lower dose, lead to cost-effectiveness. LIMITATIONS Assumptions regarding parameter inputs were necessary, therefore a considerable level of uncertainty regarding efficacy and cost data is to be accounted for in the interpretation of the results. In particular, the efficacy data were based on single clinical studies. CONCLUSIONS This research revealed the cost-effectiveness of a JAKi compared to a monoclonal antibody for the treatment of moderate-to-severe AD to be highly sensitive to the costs and effectiveness inputs and identified further cost-effectiveness drivers. It demonstrated that the JAKi could be cost-effective compared to an established monoclonal antibody with a lower dose or a reduced price.
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Affiliation(s)
- Katja C Heinz
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Damon Willems
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Linares-Gonzalez L, Lozano-Lozano I, Gutierrez-Rojas L, Lozano-Lozano M, Rodenas-Herranz T, Ruiz-Villaverde R. Sexual Dysfunction and Atopic Dermatitis: A Systematic Review. Life (Basel) 2021; 11:life11121314. [PMID: 34947845 PMCID: PMC8708093 DOI: 10.3390/life11121314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disease of the skin whose main symptom is pruritus and may affect all age ranges. Regarding the prevalence, it has been estimated at around 10% of the world population. Many concomitant diseases have been associated with AD, but the causal relationship between AD and psychological impairment has not been clearly established. Scientific literature studying the probable association between male or female sexual dysfunction and dermatological pathology is limited, even more so in AD. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and the Cochrane Collaboration methodology for systematic reviews. All relevant articles in English were identified through a search from inception to 10 December 2020, including the following databases: Medline (via PubMed), Scopus, Web of Science Core Collection, and SciELO. The results of the search were compiled using the COVIDENCE software for systematic reviews. The methodological quality of the included studies was done using the “Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies” and the “Quality Assessment of Case-Control Studies” developed by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH). Our search yielded potentially relevant studies. Five studies that evaluated the prevalence of sexual dysfunction in atopic dermatitis were retrieved after applying the selection criteria. The present systematic review achieved data from 8088 patients with atopic dermatitis from four articles. Sample sizes for atopic dermatitis patients ranged from 266 to 3997. We identified one cohort study with four years of follow-up, three studies with a cross-sectional design, and one case-control study. Three studies reported data disaggregated by the severity of atopic dermatitis. Two studies included healthy controls with a total sample size of 1,747,755 subjects. Two studies compared data with other dermatological conditions such as psoriasis. In conclusion, we can establish that unlike other psychological comorbidities such as anxiety and depression, sexual dysfunction is a field scarcely explored in the literature. This sexual dysfunction focuses on the male sex in large population studies and in clinical diagnoses without exploring it through specific and validated questionnaires in this regard. Further studies focused on both genders are needed. It is important to correlate this sexual dysfunction with the severity of the disease, previous treatments, and cardiovascular comorbidities.
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Affiliation(s)
- Laura Linares-Gonzalez
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Correspondence:
| | - Ignacio Lozano-Lozano
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
| | - Luis Gutierrez-Rojas
- Department of Psychiatry, University of Granada, 18011 Granada, Spain;
- Psychiatry Service, Hospital Clínico San Cecilio, 18016 Granada, Spain
- CTS-549 Research Group, Institute of Neuroscience, University of Granada, 18016 Granada, Spain
| | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18011 Granada, Spain
- Sport and Health Joint University Institute (iMUDS), University of Granada, 18011 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18011 Granada, Spain
| | - Teresa Rodenas-Herranz
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
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Helmert C, Haufe E, Heinrich L, Siegels D, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Zink A, Pawlak M, Schäkel K, Wildberger J, Weidinger S, Werfel T, Schmitt J. Atopic dermatitis and depressive symptoms. Results of the German national AD Registry TREATgermany. J Eur Acad Dermatol Venereol 2021; 36:e279-e282. [PMID: 34779054 DOI: 10.1111/jdv.17812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Helmert
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - L Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - D Siegels
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - S Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig, Germany
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service, Selters/Westerwald, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - M Pawlak
- Practice Dr. med, Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt, Germany
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | | | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Ferrucci SM, Tavecchio S, Angileri L, Surace T, Berti E, Buoli M. Factors Associated with Affective Symptoms and Quality of Life in Patients with Atopic Dermatitis. Acta Derm Venereol 2021; 101:adv00590. [PMID: 34518893 PMCID: PMC9455335 DOI: 10.2340/00015555-3922] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to detect demographic and clinical factors associated with affective symptoms and quality of life in patients with severe atopic dermatitis. First, one-way analyses of variance and correlations were performed to compare a large set of qualitative and quantitative clinical variables. Three final multivariable regression models were performed, with depression/anxiety subscales and Dermatology Life Quality Index scores as dependent variables, and the factors that were statistically significant on univariate analyses as independent ones. More severe anxiety symptoms and poorer quality of life (p < 0.01) were significantly associated with more severe depressive symptoms. Female sex and disturbed sleep (p = 0.03) were significantly associated with more severe anxiety. Finally, previous treatment with cyclosporine (p = 0.03) or methotrexate (p = 0.04), more severe depressive symptoms (p < 0.01), itch (p = 0.03), impaired sleep (p < 0.01) and perceived severity of dermatological illness (p < 0.01) were significant predictors of low quality of life. This study shows a complex interplay between the severity of atopic dermatitis, poor quality of life and presence of clinically relevant affective symptoms. These results will help dermatologists to identify patients who need psychiatric consultation within the framework of a multidisciplinary approach.
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Affiliation(s)
| | | | | | | | | | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, IT-20122, Milan, Italy.
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Cork MJ, McMichael A, Teng J, Valdez H, Rojo R, Chan G, Zhang F, Myers DE, DiBonaventura M. Impact of oral abrocitinib on signs, symptoms and quality of life among adolescents with moderate-to-severe atopic dermatitis: an analysis of patient-reported outcomes. J Eur Acad Dermatol Venereol 2021; 36:422-433. [PMID: 34743361 PMCID: PMC9299698 DOI: 10.1111/jdv.17792] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/22/2021] [Indexed: 11/26/2022]
Abstract
Background A significant improvement in clinical signs was demonstrated with abrocitinib relative to placebo in adolescents with moderate‐to‐severe atopic dermatitis (AD) in three phase 3, randomized, double‐blinded, placebo‐controlled studies (JADE TEEN [ClinicalTrials.gov, NCT03796676], JADE MONO‐1 [NCT03349060] and JADE MONO‐2 [NCT03575871]). Objectives To evaluate the impact of abrocitinib on patient‐reported signs/symptoms, including sleep loss and quality of life among adolescents with moderate‐to‐severe AD. Methods JADE TEEN, JADE MONO‐1 and JADE MONO‐2 were conducted in the Asia‐Pacific region, Europe and North America and included patients aged 12–17 years with moderate‐to‐severe AD and inadequate response to ≥ 4 consecutive weeks of topical medication or treatment with systemic therapy for AD. Patients were randomly assigned (1 : 1 : 1, JADE TEEN; 2 : 2 : 1, JADE MONO‐1/‐2) to receive once‐daily oral abrocitinib (200 or 100 mg) or placebo for 12 weeks in combination with topical therapy (JADE TEEN) or as monotherapy (JADE MONO‐1/‐2). Data from adolescent patients in JADE MONO‐1/‐2 were pooled for these analyses. Results At week 12, more adolescents treated with abrocitinib (200 or 100 mg) vs. placebo achieved a ≥ 4‐point improvement from baseline in the Patient‐Oriented Eczema Measure in JADE TEEN (83.9% and 77.0% vs. 60.2%) and JADE MONO‐1/‐2 (83.0% and 69.4% vs. 43.5%) and a ≥ 6‐point improvement from baseline in the Children’s Dermatology Life Quality Index in JADE TEEN (73.8% and 67.5% vs. 56.5%) and JADE MONO‐1/‐2 (70.0% and 57.1% vs. 19.0%). Significant improvements in SCORing Atopic Dermatitis Visual Analog Scale for sleep loss scores were demonstrated with abrocitinib vs. placebo at weeks 2‐12 in JADE TEEN and JADE MONO‐1/‐2. Conclusions Patient‐reported signs/symptoms, including reduction of sleep loss and quality of life, were substantially improved with abrocitinib monotherapy or combination therapy relative to placebo in adolescents with moderate‐to‐severe AD.
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Affiliation(s)
- M J Cork
- Sheffield Dermatology Research, University of Sheffield, Sheffield, UK
| | - A McMichael
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - J Teng
- Department of Dermatology, Stanford University, Stanford, CA, USA
| | | | - R Rojo
- Pfizer Inc, Groton, CT, USA
| | - G Chan
- Pfizer Inc, Groton, CT, USA
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Cao H, Li S, Baranova A, Zhang F. Shared Genetic Liability Between Major Depressive Disorder and Atopic Diseases. Front Immunol 2021; 12:665160. [PMID: 34566951 PMCID: PMC8455950 DOI: 10.3389/fimmu.2021.665160] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/16/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives Deciphering the genetic relationships between major depressive disorder (MDD) and atopic diseases (asthma, hay fever, and eczema) may facilitate understanding of their biological mechanisms as well as the development of novel treatment regimens. Here we tested the genetic correlation between MDD and atopic diseases by linkage disequilibrium score regression. Methods A polygenic overlap analysis was performed to estimate shared genetic variations between the two diseases. Causal relationships between MDD and atopic diseases were investigated using two-sample bidirectional Mendelian randomization analysis. Genomic loci shared between MDD and atopic diseases were identified using cross-trait meta-analysis. Putative functional genes were evaluated by fine-mapping of transcriptome-wide associations. Results The polygenic analysis revealed approximately 15.8 thousand variants causally influencing MDD and 0.9 thousand variants influencing atopic diseases. Among these variants, approximately 0.8 thousand were shared between the two diseases. Mendelian randomization analysis indicates that genetic liability to MDD has a causal effect on atopic diseases (b = 0.22, p = 1.76 × 10-6), while genetic liability to atopic diseases confers a weak causal effect on MDD (b = 0.05, p = 7.57 × 10-3). Cross-trait meta-analyses of MDD and atopic diseases identified 18 shared genomic loci. Both fine-mapping of transcriptome-wide associations and analysis of existing literature suggest the estrogen receptor β-encoding gene ESR2 as one of the potential risk factors for both MDD and atopic diseases. Conclusion Our findings reveal shared genetic liability and causal links between MDD and atopic diseases, which shed light on the phenotypic relationship between MDD and atopic diseases.
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Affiliation(s)
- Hongbao Cao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,School of Systems Biology, George Mason University, Fairfax, VA, United States
| | - Sheng Li
- Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Suzhou Institute of Systems Medicine, Suzhou, China
| | - Ancha Baranova
- School of Systems Biology, George Mason University, Fairfax, VA, United States.,Research Centre for Medical Genetics, Moscow, Russia
| | - Fuquan Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Cao H, Li S, Baranova A, Zhang F. Shared Genetic Liability Between Major Depressive Disorder and Atopic Diseases. Front Immunol 2021. [PMID: 34566951 DOI: 10.3389/fimmu.2021.665160/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Deciphering the genetic relationships between major depressive disorder (MDD) and atopic diseases (asthma, hay fever, and eczema) may facilitate understanding of their biological mechanisms as well as the development of novel treatment regimens. Here we tested the genetic correlation between MDD and atopic diseases by linkage disequilibrium score regression. METHODS A polygenic overlap analysis was performed to estimate shared genetic variations between the two diseases. Causal relationships between MDD and atopic diseases were investigated using two-sample bidirectional Mendelian randomization analysis. Genomic loci shared between MDD and atopic diseases were identified using cross-trait meta-analysis. Putative functional genes were evaluated by fine-mapping of transcriptome-wide associations. RESULTS The polygenic analysis revealed approximately 15.8 thousand variants causally influencing MDD and 0.9 thousand variants influencing atopic diseases. Among these variants, approximately 0.8 thousand were shared between the two diseases. Mendelian randomization analysis indicates that genetic liability to MDD has a causal effect on atopic diseases (b = 0.22, p = 1.76 × 10-6), while genetic liability to atopic diseases confers a weak causal effect on MDD (b = 0.05, p = 7.57 × 10-3). Cross-trait meta-analyses of MDD and atopic diseases identified 18 shared genomic loci. Both fine-mapping of transcriptome-wide associations and analysis of existing literature suggest the estrogen receptor β-encoding gene ESR2 as one of the potential risk factors for both MDD and atopic diseases. CONCLUSION Our findings reveal shared genetic liability and causal links between MDD and atopic diseases, which shed light on the phenotypic relationship between MDD and atopic diseases.
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Affiliation(s)
- Hongbao Cao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,School of Systems Biology, George Mason University, Fairfax, VA, United States
| | - Sheng Li
- Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Suzhou Institute of Systems Medicine, Suzhou, China
| | - Ancha Baranova
- School of Systems Biology, George Mason University, Fairfax, VA, United States.,Research Centre for Medical Genetics, Moscow, Russia
| | - Fuquan Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Thormann K, Aubert H, Barbarot S, Britsch-Yilmaz A, Chernyshov P, Deleuran M, El-Hachem M, de Groot J, Heratizadeh A, Raymakers F, Stalder JF, Wollenberg A, Simon D. Position statement on the role of nurses in therapeutic patient education in atopic dermatitis. J Eur Acad Dermatol Venereol 2021; 35:2143-2148. [PMID: 34289187 DOI: 10.1111/jdv.17487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/28/2021] [Accepted: 06/23/2021] [Indexed: 11/29/2022]
Abstract
In chronic skin diseases such as atopic dermatitis (AD), therapeutic failure due to poor patient adherence to treatment is commonly reported. Therapeutic patient education (TPE) is an approach to improve self-management and adherence. Several studies demonstrated that TPE programmes have positive effects on disease management resulting in decreased disease severity and improved quality of life in AD patients. Various healthcare professionals (dermatologists, nurses, psychologists, dieticians) have been involved. TPE performed by trained dermatology nurses are highly efficient and improve various health-related outcomes. The aim of this position paper is to analyse the aims, modalities and efficacy of TPE in AD, to identify specific roles of dermatology nurses, to assess qualification requirements, and to propose practical recommendations. Potential activities of nurses in ongoing and future TPE programmes for AD patients will be discussed.
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Affiliation(s)
- K Thormann
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - H Aubert
- Dermatology Department, Nantes University Hospital, Nantes, France
| | - S Barbarot
- Dermatology Department, Nantes University Hospital, Nantes, France
| | - A Britsch-Yilmaz
- Department of Paediatric Dermatology, Children's Hospital Wilhelmstift, Hamburg, Germany
| | - P Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - M Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - M El-Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital- IRCCS, Rome, Italy
| | - J de Groot
- National Expertise Center Constitutioneel Eczeem, University Medical Center Utrecht, Utrecht, Netherlands
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - F Raymakers
- National Expertise Center Constitutioneel Eczeem, University Medical Center Utrecht, Utrecht, Netherlands
| | - J F Stalder
- Dermatology Department, Nantes University Hospital, Nantes, France
| | - A Wollenberg
- Department of Dermatology and Allergy, University Hospital, Ludwig-Maximilian University of Munich, Munich, Germany
| | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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da Fonseca CAR, Dos Reis AS, Pinz MP, Peglow TJ, Schumacher RF, Perin G, Martins AWDS, Domingues WB, Campos VF, Soares MP, Roehrs JA, Luchese C, Wilhelm EA. Bis-(3-amino-2-pyridine) diselenide improves psychiatric disorders -atopic dermatitis comorbidity by regulating inflammatory and oxidative status in mice. Chem Biol Interact 2021; 345:109564. [PMID: 34161785 DOI: 10.1016/j.cbi.2021.109564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/26/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
Suppressive effect of bis (3-amino-2-pyridine) diselenide (BAPD) on psychiatric disorders - atopic dermatitis (AD) comorbidity in mice was investigated. To sensitize the animals, 2,4-dinitrochlorobenzene (DNCB) was applied to their dorsal skin on days 1-3. Mice were challenged with DNCB on their ears and dorsal skin on days 14, 17, 20, 23, 26, and 29. BAPD and Dexamethasone were administered to the animals, from days 14-29, and skin severity scores and behavioral tests were determined. Oxidative stress and inflammatory parameters were evaluated on the dorsal skin of mice. Na+, K+-ATPase activity and corticosterone levels were determined in hippocampus/cerebral cortex and plasma of mice, respectively. BAPD improved cutaneous damage, scratching behavior, inflammatory and oxidative stress markers. BAPD showed anxiolytic- and antidepressant-like effects and restored Na+, K+-ATPase activity and corticosterone levels. The present study was performed using female mice due the susceptibility for this disease. But, the evaluation of AD model in male mice would help to verify whether the male gender has the same predisposition to present this pathology. Our data demonstrated the suppressive effect of BAPD on psychiatric disorders - AD comorbidity by regulating inflammatory and oxidative status in mice.
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Affiliation(s)
- Caren Aline Ramson da Fonseca
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil
| | - Angélica Schiavom Dos Reis
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil
| | - Mikaela Peglow Pinz
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil
| | - Thiago Jacobsen Peglow
- Programa de Pós-graduação em Química, Laboratório de Síntese Orgânica Limpa - LASOL - CCQFA - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Ricardo Frederico Schumacher
- Programa de Pós-graduação em Química, Laboratório de Síntese Orgânica Limpa - LASOL - CCQFA - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Gelson Perin
- Programa de Pós-graduação em Química, Laboratório de Síntese Orgânica Limpa - LASOL - CCQFA - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Amanda Weege da Silveira Martins
- Programa de Pós-Graduação em Biotecnologia, Laboratório de Genômica Estrutural do Centro de Desenvolvimento Tecnológico - CDTec - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - William Borges Domingues
- Programa de Pós-Graduação em Biotecnologia, Laboratório de Genômica Estrutural do Centro de Desenvolvimento Tecnológico - CDTec - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Vinicius Farias Campos
- Programa de Pós-Graduação em Biotecnologia, Laboratório de Genômica Estrutural do Centro de Desenvolvimento Tecnológico - CDTec - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Mauro Pereira Soares
- Laboratório Regional de Diagnóstico, Faculdade de Veterinária - Universidade Federal de Pelotas, UFPel, CEP - 96010-900, Pelotas, RS, Brazil
| | - Juliano Alex Roehrs
- Instituto Federal de Educação, Ciência e Tecnologia Sul-rio-grandense, IFSul, CEP - 96015-360, Pelotas, RS, Brazil
| | - Cristiane Luchese
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil.
| | - Ethel Antunes Wilhelm
- Programa de Pós-graduação em Bioquímica e Bioprospecção, Laboratório de Pesquisa em Farmacologia Bioquímica (LaFarBio), Grupo de Pesquisa em Neurobiotecnologia (GPN), Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Pelotas, CEP 96010-900, RS, Brazil.
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Geographic disparities in new onset of internalizing disorders in Pennsylvania adolescents using electronic health records. Spat Spatiotemporal Epidemiol 2021; 41:100439. [DOI: 10.1016/j.sste.2021.100439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/20/2021] [Accepted: 06/23/2021] [Indexed: 01/04/2023]
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Yang T, Huang X, Xu J, Situ M, Xiao Q, Kural KC, Kang Y. Explore the Underlying Mechanism Between Atopic Dermatitis and Major Depressive Disorder. Front Genet 2021; 12:640951. [PMID: 34122503 PMCID: PMC8194260 DOI: 10.3389/fgene.2021.640951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/06/2021] [Indexed: 02/05/2023] Open
Abstract
Adult patients with atopic dermatitis (AD) present relatively higher rates of major depressive disorder (MDD). However, the underlying mechanism is largely unknown. Here, we first conducted a systematic literature-based data mining to identify entities linking AD and MDD, including proteins, cells, functional classes, and small molecules. Then we conducted an AD-RNA expression data-based mega-analysis to test the expression variance of the genes that were regulators of MDD. After that, a Fisher Exact test-based pathway enrichment analysis (PEA) was performed to explore the AD-driven MDD-genetic regulators’ functionality. We identified 22 AD-driven entities that were up-stream MDD regulators, including 11 genes, seven small molecules, three functional classes, and one cell. AD could exert a promoting effect on the development of MDD. Four of the 11 genes demonstrated significant expression changes in AD patients in favor of the development of MDD. PEA results showed that AD mainly drives cytokine/chemokine regulation and neuroinflammatory response-related pathways to influence the pathological development of MDD. Our results supported the promotion role of AD in the pathological development of MDD, including the regulation of multiple genetic regulators of MDD involved in cytokine/chemokine regulation and inflammatory response.
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Affiliation(s)
- Tao Yang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xuehua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiajun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Mingjing Situ
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qingqing Xiao
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kamil Can Kural
- School of Systems Biology, George Mason University, Fairfax, VA, United States
| | - Yan Kang
- Human Biochemical Genetics Section, National Institutes of Health, Bethesda, MD, United States
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[Psychiatric comorbidities in hidradenitis suppurativa/acne inversa]. Hautarzt 2021; 72:426-434. [PMID: 33398389 DOI: 10.1007/s00105-020-04742-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The findings of most studies suggest that depression and anxiety disorders are the most common psychiatric comorbidities in patients with hidradenitis suppurativa/acne inversa (HS/AI). METHODS In a prospective study, 51 patients with HS/AI were further examined for psychiatric comorbidity using a standardized interview and questionnaires. RESULTS In psychiatric examination, 29.4% of HS/AI patients had additional mental symptoms, mainly manifested as depressive disorder. The HS/AI patients were rather young and female, and they showed a high incidence of nicotine and alcohol use, and a positive family history of paternal alcohol dependence. In addition, HS/AI patients experienced more severe psychosocial impairments in the form of lack of partnership and lower school attainment. CONCLUSIONS Acne inversa is a severe chronic inflammatory skin disease that, like other inflammatory dermatoses, is associated with mental comorbidity and psychosocial impairments. Since especially young patients are affected, a psychiatric-psychotherapeutic cotreatment should be considered already at an early stage.
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Wollenberg A, Christen‐Zäch S, Taieb A, Paul C, Thyssen J, Bruin‐Weller M, Vestergaard C, Seneschal J, Werfel T, Cork M, Kunz B, Fölster‐Holst R, Trzeciak M, Darsow U, Szalai Z, Deleuran M, Kobyletzki L, Barbarot S, Heratizadeh A, Gieler U, Hijnen D, Weidinger S, De Raeve L, Svensson Å, Simon D, Stalder J, Ring J. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol 2020; 34:2717-2744. [DOI: 10.1111/jdv.16892] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/10/2020] [Accepted: 07/23/2020] [Indexed: 02/06/2023]
Affiliation(s)
- A. Wollenberg
- Department of Dermatology and Allergy Ludwig‐Maximilian‐University Munich Germany
| | - S. Christen‐Zäch
- Pediatric Dermatology Unit Departments of Dermatology and Pediatrics Centre Hospitalier Universitaire Vaudois Lausanne Switzerland
| | - A. Taieb
- University of Bordeaux Bordeaux France
| | - C. Paul
- Department of Dermatology and Allergy Toulouse University and CHU Toulouse France
| | - J.P. Thyssen
- Department of Dermatology and Allergy Herlev‐Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
| | - M. Bruin‐Weller
- National Expertise Center for Atopic Dermatitis Department of Dermatology and Allergology University Medical Center Utrecht The Netherlands
| | - C. Vestergaard
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - J. Seneschal
- Department of Dermatology National Reference Center for Rare Skin Diseases Bordeaux University Hospitals Bordeaux France
| | - T. Werfel
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - M.J. Cork
- Sheffield Dermatology Research IICDUniversity of Sheffield UK
| | - B. Kunz
- Dermatologikum Hamburg Hamburg Germany
| | - R. Fölster‐Holst
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - M. Trzeciak
- Department of Dermatology, Venereology and Allergology Medical University of Gdansk Gdansk Poland
| | - U. Darsow
- Department of Dermatology and Allergy Biederstein Technische Universität München Munich Germany
- ZAUM – Center of Allergy & Environment Munich Germany
| | - Z. Szalai
- Department of Dermatology Heim Pál National Children’s Institute Budapest Hungary
| | - M. Deleuran
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - L. Kobyletzki
- School of Medical Sciences Lund University Malmö Sweden
- School of Medical Sciences Örebro University Örebro Sweden
| | - S. Barbarot
- Department of Dermatology CHU Nantes UMR 1280 PhAN INRA, F‐44000 Nantes Université Nantes France
| | - A. Heratizadeh
- Division of Immunodermatology and Allergy Research Department of Dermatology and Allergy Hannover Medical School Hannover Germany
| | - U. Gieler
- Department of Dermatology University of Gießen and Marburg GmbH Gießen Germany
| | - D.J. Hijnen
- Department of Dermatology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - S. Weidinger
- Department of Dermatology and Allergy University Hospital Schleswig‐Holstein Kiel Germany
| | - L. De Raeve
- Department of Dermatology Universitair Ziekenhuis Brussel (UZB)Free University of Brussels (VUB) Brussels Belgium
| | - Å. Svensson
- Department of Dermatology Skane University Hospital Malmö Sweden
| | - D. Simon
- Department of Dermatology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - J.F. Stalder
- Department of Dermatology CHU Nantes UMR 1280 PhAN INRAE, F‐44000 Nantes Université Nantes France
| | - J. Ring
- Department of Dermatology and Allergy Biederstein Technische Universität München Munich Germany
- Christiane‐Kühne Center for Allergy Research and Education (CK‐Care) Davos Switzerland
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Gagliano A, Galati C, Ingrassia M, Ciuffo M, Alquino MA, Tanca MG, Carucci S, Zuddas A, Grossi E. Pediatric Acute-Onset Neuropsychiatric Syndrome: A Data Mining Approach to a Very Specific Constellation of Clinical Variables. J Child Adolesc Psychopharmacol 2020; 30:495-511. [PMID: 32460516 DOI: 10.1089/cap.2019.0165] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives: Pediatric acute onset neuropsychiatric syndrome (PANS) is a clinically heterogeneous disorder presenting with: unusually abrupt onset of obsessive compulsive disorder (OCD) or severe eating restrictions, with at least two concomitant cognitive, behavioral, or affective symptoms such as anxiety, obsessive-compulsive behavior, and irritability/depression. This study describes the clinical and laboratory variables of 39 children (13 female and 26 male) with a mean age at recruitment of 8.6 years (standard deviation 3.1). Methods: Using a mathematical approach based on Artificial Neural Networks, the putative associations between PANS working criteria, as defined at the NIH in July 2010 (Swedo et al. 2012), were explored by the Auto Contractive Map (Auto-CM) system, a mapping method able to compute the multidimensional association of strength of each variable with all other variables in predefined dataset. Results: The PANS symptoms were strictly linked to one another on the semantic connectivity map, shaping a central "diamond" encompassing anxiety, irritability/oppositional defiant disorder symptoms, obsessive-compulsive symptoms, behavioral regression, sensory motor abnormalities, school performance deterioration, sleep disturbances, and emotional lability/depression. The semantic connectivity map also showed the aggregation between PANS symptoms and laboratory and clinical variables. In particular, the emotional lability/depression resulted as a highly connected hub linked to autoimmune disease in pregnancy, allergic and atopic disorders, and low Natural Killer percentage. Also anxiety symptoms were shown to be strongly related with recurrent infectious disease remarking the possible role of infections as a risk factor for PANS. Conclusion: Our data mining approach shows a very specific constellation of symptoms having strong links to laboratory and clinical variables consistent with PANS feature.
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Affiliation(s)
- Antonella Gagliano
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, & "G. Brotzu" Hospital Trust, Cagliari, Italy
- Funding: The authors received no specific funding
| | - Cecilia Galati
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Messina, Messina, Italy
- Funding: The authors received no specific funding
| | - Massimo Ingrassia
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Funding: The authors received no specific funding
| | - Massimo Ciuffo
- Department of Cognitive Psychological Pedagogical Sciences and Cultural Studies, University of Messina, Messina, Italy
- Funding: The authors received no specific funding
| | - Maria Ausilia Alquino
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Messina, Messina, Italy
- Funding: The authors received no specific funding
| | - Marcello G Tanca
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, & "G. Brotzu" Hospital Trust, Cagliari, Italy
- Funding: The authors received no specific funding
| | - Sara Carucci
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, & "G. Brotzu" Hospital Trust, Cagliari, Italy
- Funding: The authors received no specific funding
| | - Alessandro Zuddas
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, & "G. Brotzu" Hospital Trust, Cagliari, Italy
- Funding: The authors received no specific funding
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Foundation, Tavernerio, Italy
- Funding: The authors received no specific funding
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Xie Q, Chan CL, Chan CH. The wounded self-lonely in a crowd: A qualitative study of the voices of children living with atopic dermatitis in Hong Kong. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:862-873. [PMID: 31828879 PMCID: PMC7187464 DOI: 10.1111/hsc.12917] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 10/27/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
Atopic dermatitis (AD) imposes significant physical and psychosocial burdens on affected children. However, little has been done to learn from the subjective experiences, perspectives and emotions of children living with AD. Their voices are not heard in healthcare settings. This study aims to share these children's voices and provide a deep understanding of the subjective experiences of children living with AD. We conducted qualitative research by conducting semi-structured interviews and analysing the drawings of 17 children in Hong Kong aged between 8 and 12 years who were diagnosed with AD. Using a phenomenological approach, we transcribed, coded and described the interviews. We found that for the children in this study, living with AD meant contending with an accumulation of challenges and crises. At the individual level, the essential experience of living with AD manifested a vicious cycle of skin and mental issues. At the family level, conflicts between children and parents concerning AD management coexisted with parental support. The children commonly experienced bullying and isolation in school and discrimination and stigmatisation in their neighbourhood, thereby making living with AD a traumatic experience. The synergy between individual and environmental factors contributed to shaping an incapable and wounded "self" living with AD. Based on our findings, we propose a child-centred biopsychosocial framework for understanding the living experiences of children with AD. This study suggests different practice strategies for healthcare professionals working with the individual challenges experienced by children living with AD and the challenges these children experience in their family, school, and neighbourhood. The needs of these children should be addressed through an integrated, holistic approach for improving their long-term health outcomes.
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Affiliation(s)
- Qian‐Wen Xie
- School of Public AffairsZhejiang UniversityHangzhouZhejiangChina
| | - Cecilia Lai‐wai Chan
- Department of Social Work and Social AdministrationThe University of Hong KongHong KongHong Kong
| | - Celia Hoi‐yan Chan
- Department of Social Work and Social AdministrationThe University of Hong KongHong KongHong Kong
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Atopic dermatitis induces anxiety- and depressive-like behaviors with concomitant neuronal adaptations in brain reward circuits in mice. Prog Neuropsychopharmacol Biol Psychiatry 2020; 98:109818. [PMID: 31743694 DOI: 10.1016/j.pnpbp.2019.109818] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/25/2019] [Accepted: 11/12/2019] [Indexed: 02/07/2023]
Abstract
Clinically, it has been reported that atopic dermatitis (AD) has been linked with negative emotional problems such as depression and anxiety, thereby reducing the quality of life, but little is known about the molecular mechanism that underlies AD-associated emotional impairments. We sought to determine whether AD could induce anxiety- and depressive-like symptoms in mice and to identify pertinent signaling changes in brain reward circuitry. AD-like lesions were induced by the repeated intradermal application of MC903 into the cheek of the mouse. We assessed dermatitis severity with scratching behavior, histopathological changes, anxiety- and depressive-like behaviors using the elevated plus maze, open field and tail suspension tests, and serum corticosterone levels. In the nucleus accumbens (NAc), dorsal striatum (DS) and ventral tegmental area (VTA), protein levels of dopamine- and plasticity-related signaling molecules were determined by Western immunoblotting assay. Intradermal administration of MC903 into mouse cheek provoked a strong hind limb scratching behavior as well as the robust skin inflammation with epidermal thickening. MC903-treated mice also displayed markedly increased anxiety- and depressive-like behaviors, along with elevated serum corticosterone levels. Under these conditions, enhanced cAMP response element binding protein (CREB) and dopamine and cAMP-regulated phosphoprotein, 32 kDa (DARPP32) phosphorylation, significantly higher brain-derived neurotrophic factor (BDNF) and ΔFosB, but reduced tyrosine hydroxylase (TH) and dopamine D1 receptor (D1R) protein expression were found in the NAc, DS and VTA. Striatal BDNF, phospho-DARPP32 and phospho-CREB levels were significantly associated with the levels of depressive-like behavior in these mice. Taken together, these findings demonstrate that AD-like skin lesion elicits anxiety- and depressive-like phenotypes that are associated with neuroplasticity-related changes in reward circuitry, providing a better understanding of AD-associated emotional impairments.
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Bridgman AC, Fitzmaurice C, Dellavalle RP, Karimkhani Aksut C, Grada A, Naghavi M, Manafi N, Olagunju AT, Olagunju TO, Somayaji R, Drucker AM. Canadian Burden of Skin Disease From 1990 to 2017: Results From the Global Burden of Disease 2017 Study. J Cutan Med Surg 2020; 24:161-173. [PMID: 31994902 PMCID: PMC7109598 DOI: 10.1177/1203475420902047] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Skin diseases can have high morbidity that can be costly to society and individuals. To date, there has been no comprehensive assessment of the burden of skin disease in Canada. OBJECTIVES To evaluate the burden of 18 skin and subcutaneous diseases from 1990 to 2017 in Canada using the Global Burden of Disease (GBD) data. METHODS The 2017 GBD study measures health loss from 359 diseases and injuries in 195 countries; we evaluated trends in population health in Canada from 1990 to 2017 using incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Data are presented as rates (per 100 000), counts, or percent change with the uncertainty interval in brackets. RESULTS From 1990 to 2017 for all skin diseases, DALY rates increased by 8% to 971 per 100 000 (674-1319), YLD rates increased by 8% to 897 per 100 000 (616-1235), YLL rates increased by 4% to 74 per 100 000 (53-89), and death rates increased by 18% to 5 per 100 000 (3-6). DALY rates for melanoma increased by 2% to 54 per 100 000 (39-68), for keratinocyte carcinoma by 14% to 17 per 100 000 (16-19), and for skin and subcutaneous disease by 8% to 900 per 100 000 (619-1233). The observed over expected ratios were higher for skin and subcutaneous disease (1.37) and keratinocyte carcinoma (1.17) and were lower for melanoma (0.73). CONCLUSIONS The burden of skin disease has increased in Canada since 1990. These results can be used to guide health policy regarding skin disease in Canada.
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Affiliation(s)
| | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Division of Hematology, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert P. Dellavalle
- School of Medicine, University of Colorado Denver, Aurora, CO, USA
- Dermatology Service, US Department of Veterans Affairs (VA), Denver, CO, USA
- Department of Dermatology, University of Colorado School of Medicine, Denver, CO
| | - Chante Karimkhani Aksut
- Dermatology Service, US Department of Veterans Affairs (VA), Denver, CO, USA
- Department of Dermatology, University of Colorado School of Medicine, Denver, CO
| | - Ayman Grada
- School of Medicine, Boston University, Boston, MA, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Navid Manafi
- Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran
- Ophthalmology Department, University of Manitoba, Winnipeg, MB, Canada
| | - Andrew T. Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O. Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Ranjani Somayaji
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Aaron M. Drucker
- Division of Dermatology, University of Toronto, Toronto, ON, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
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Mento C, Rizzo A, Muscatello MRA, Zoccali RA, Bruno A. Negative Emotions in Skin Disorders: A Systematic Review. Int J Psychol Res (Medellin) 2020; 13:71-86. [PMID: 32952965 PMCID: PMC7498125 DOI: 10.21500/20112084.4078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The main purpose of this study is to describe how negative emotions were investigated in the sphere of dermatological diseases, in order (1) to summarize literature trends about skin disorders and emotions, (2) to highlight any imbalances between the most studied and neglected emotions, (3) and to offer directions for future research. A computerized literature search provided 41 relevant and potentially eligible studies. Results showed that the study of emotions in skin disease is limited to Sadness/depression and Fear/anxiety. The emotions of Anger and Disgust have been poorly explored in empirical studies, despite they could be theoretically considered a vulnerability factor for the development of skin disorders and the dermatological extreme consequences, as negative emotionality toward self and the pathological skin condition. The bibliometric qualitative analysis with VOSViewer software revealed that the majority of the studies have been focused on the relationships between vitiligo and Sadness/depression, dermatitis and Fear/anxiety, psoriasis, and Anger, suggesting the need of future research exploring Disgust and, in general, a wider emotional spectrum.
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Affiliation(s)
- Carmela Mento
- Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
| | - Amelia Rizzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
| | - Rocco Antonio Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Università degli Studi di Messina University of Messina Italy
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Treudler R, Zeynalova S, Riedel-Heller SG, Zuelke AE, Roehr S, Hinz A, Glaesmer H, Kage P, Loeffler M, Simon JC. Depression, anxiety and quality of life in subjects with atopic eczema in a population-based cross-sectional study in Germany. J Eur Acad Dermatol Venereol 2020; 34:810-816. [PMID: 31838777 DOI: 10.1111/jdv.16148] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Atopic eczema (AE) may be associated with several mental health problems. In Germany, existing data from selected patient cohorts may lead to misestimation of the problem. OBJECTIVES We aimed to cross-sectionally determine associations of AE with depression, anxiety, quality of life (QoL) and social interactions in subjects from the population-based LIFE-Adult-Study. METHODS Subjects underwent standardized interviews (medical history) and answered standardized questionnaires [Centre of Epidemiologic studies-Depression scale (CES-D), Generalized Anxiety Disorder (GAD-7), Lubben Social Network Scale (LSNS), Short Form Health Survey (SF-8)]. We compared data from subjects with AE with those from subjects with selected other chronic/disabling diseases (cardiovascular, diabetes, cancer) and adjusted for selected sociodemographic parameters. Multivariate binary logistic regression was used for categorical variables, linear regression for continuous variables. RESULTS Out of 9104 adults included (57% female, median age 54 years), 372 (4.1%) had a history of AE. Compared with controls, subjects with AE showed higher scores for depressive symptoms (9.3% vs. 6.3%; P < 0.001) and anxiety (8.4% vs. 5.6%, P < 0.001). Odds ratio (OR) was 1.5 [CI 1.0; 2.3] (P = 0.031) for depression, which was comparable to OR in patients with a history of cancer (OR 1.6 [1-2.3], P = 0.001. OR for anxiety in AE was 1.5 [1.0; 2.2], P < 0.049, which was slightly higher than in diabetes mellitus (OR 1.2) and stroke (OR 1.4). Other than in diabetes and/or stroke, we did not find a significant association between AE and social isolation. QoL scores were lower in AE than in controls (mean 46.9 vs. 48.0, P < 0.001 for physical and 50.6 vs. 52.5, P < 0.001 for mental components). CONCLUSIONS Subjects with AE showed higher values for depression and anxiety as well as lower QoL scores compared to controls. With regard to depression, odds in AE and cancer were hardly different. Medical care of AE patients should therefore include mental health evaluation and treatment if indicated.
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Affiliation(s)
- R Treudler
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - S Zeynalova
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - S G Riedel-Heller
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - A E Zuelke
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - S Roehr
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - A Hinz
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - H Glaesmer
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - P Kage
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany
| | - M Loeffler
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
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Schonmann Y, Mansfield KE, Hayes JF, Abuabara K, Roberts A, Smeeth L, Langan SM. Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2020; 8:248-257.e16. [PMID: 31479767 PMCID: PMC6947493 DOI: 10.1016/j.jaip.2019.08.030] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/16/2019] [Accepted: 08/16/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Atopic eczema is a common and debilitating condition associated with depression and anxiety, but the nature of this association remains unclear. OBJECTIVE To explore the temporal relationship between atopic eczema and new depression/anxiety. METHODS This matched cohort study used routinely collected data from the UK Clinical Practice Research Datalink, linked to hospital admissions data. We identified adults with atopic eczema (1998-2016) using a validated algorithm, and up to 5 individuals without atopic eczema matched on date of diagnosis, age, sex, and general practice. We estimated the hazard ratio (HR) for new depression/anxiety using stratified Cox regression to account for age, sex, calendar period, Index of Multiple Deprivation, glucocorticoid treatment, obesity, smoking, and harmful alcohol use. RESULTS We identified 526,808 adults with atopic eczema who were matched to 2,569,030 without. Atopic eczema was associated with increased incidence of new depression (HR, 1.14; 99% CI, 1.12-1.16) and anxiety (HR, 1.17; 99% CI, 1.14-1.19). We observed a stronger effect of atopic eczema on depression with increasing atopic eczema severity (HR [99% CI] compared with no atopic eczema: mild, 1.10 [1.08-1.13]; moderate, 1.19 [1.15-1.23]; and severe, 1.26 [1.17-1.37]). A dose-response association, however, was less apparent for new anxiety diagnosis (HR [99% CI] compared with no atopic eczema: mild, 1.14 [1.11-1.18]; moderate, 1.21 [1.17-1.26]; and severe, 1.15; [1.05-1.25]). CONCLUSIONS Adults with atopic eczema are more likely to develop new depression and anxiety. For depression, we observed a dose-response relationship with atopic eczema severity.
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Affiliation(s)
- Yochai Schonmann
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; Clalit Health Services, Department of Family Medicine, Rabin Medical Center, Petah Tikva, Israel; Department of Family Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Kathryn E Mansfield
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Joseph F Hayes
- Division of Psychiatry, University College London, London, United Kingdom; Camden and Islington National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Katrina Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, Calif
| | - Amanda Roberts
- Nottingham Support Group for Carers of Children with Eczema, Nottingham, United Kingdom
| | - Liam Smeeth
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sinéad M Langan
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; St John's Institute of Dermatology, Guy's & St Thomas' Hospital National Health Service (NHS) Foundation Trust and King's College London, London, United Kingdom; Health Data Research UK, London, United Kingdom
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Jaworek AK, Jaworek M, Makara-Studzińska M, Szafraniec K, Doniec Z, Szepietowski J, Wojas-Pelc A, Pokorski M. Depression and Serum Content of Serotonin in Adult Patients with Atopic Dermatitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1271:83-88. [DOI: 10.1007/5584_2019_470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Hong CH, Joseph M, Kim VHD, Lansang P, Lara-Corrales I. Approach to the Assessment and Management of Pediatric Patients with Atopic Dermatitis: A Consensus Document. Section II: Comorbid Disease in Pediatric Atopic Dermatitis. J Cutan Med Surg 2019; 23:12S-18S. [DOI: 10.1177/1203475419882655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Pediatric atopic dermatitis (AD) is one of the most common skin conditions encountered by health-care providers caring for infants, children, and adolescents. Pediatric patients with AD may present with other allergic and nonallergic comorbidities that require appropriate treatment and referral. They may also experience a trajectory of allergic diseases known as the atopic march, which depends on a complex interaction between genetic and environmental factors and likely involves early epidermal barrier dysfunction. Here we provide a review and clinical recommendations on the assessment and referral of comorbidities in pediatric AD.
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Affiliation(s)
- Chih-ho Hong
- Dr. Chih-ho Hong Medical Inc., Surrey, BC, Canada
- Probity Medical Research, Waterloo, ON, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Marissa Joseph
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Dermatology, Women's College Hospital, Toronto, ON, Canada
| | - Vy HD Kim
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Immunology & Allergy, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Perla Lansang
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Dermatology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Irene Lara-Corrales
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
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Tsai TF, Rajagopalan M, Chu CY, Encarnacion L, Gerber RA, Santos-Estrella P, Llamado LJQ, Tallman AM. Burden of atopic dermatitis in Asia. J Dermatol 2019; 46:825-834. [PMID: 31436343 DOI: 10.1111/1346-8138.15048] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 07/22/2019] [Indexed: 11/28/2022]
Abstract
Atopic dermatitis is a chronic, inflammatory skin disease characterized by intense pruritus and eczematous lesions. It is considered one of the most common chronic conditions, with an estimated global prevalence of nearly 230 million. As in the rest of the world, prevalence of atopic dermatitis has been increasing in Asian countries over the last few decades. This increased prevalence in Asian countries has been attributed to factors such as rapid urbanization, increasingly Westernized lifestyles, and improved standards of living and education. As a result, it is important to understand the increasing burden of disease in Asian countries and the differences between the countries in terms of epidemiology, diagnostic criteria, management, quality of life and economic burden.
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Affiliation(s)
- Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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