Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study.
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.
|ジャーナル名||The journal of allergy and clinical immunology. In practice|
|投稿者||Schonmann, Yochai; Mansfield, Kathryn E; Hayes, Joseph F; Abuabara, Katrina; Roberts, Amanda; Smeeth, Liam; Langan, Sinead M|
|組織名||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.;Kingdom. Electronic address: email@example.com.;Division of Psychiatry, University College London, London, United Kingdom; Camden;and Islington National Health Service (NHS) Foundation Trust, London, United;Kingdom.;Department of Dermatology, University of California San Francisco, San Francisco,;Calif.;Nottingham Support Group for Carers of Children with Eczema, Nottingham, 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.|