Atopic dermatitis, psychiatric disorders and medication use in childhood

Linked Article:   Vittrup et al . Br J Dermatol 2021; 185 :91–100. Atopic dermatitis (AD) is a very common skin condition, affecting around 15% of children. Symptoms, often beginning in early childhood, include itch and interrupted sleep. Children with AD have a higher risk of social isolation and reduced quality of life. Studies from adult patients have shown that depression and anxiety are related to AD. However, in children with AD, besides a connection to attention deficit hyperactivity disorder (ADHD), the occurrence of psychiatric disorders has not been thoroughly investigated. In this study, we used the large national registries that cover the entire Danish population. They contain a wide range of information on, for example, ethnicity, education and health. We created a population of children diagnosed with AD at a hospital (14,283 children) and matched each of them with 10 children (of the same sex and age) without AD. We followed the two populations over time and compared the occurrence of different psychiatric measures in the two groups. In children with AD, we found higher risks of antidepressant and anxiolytic (anti‐anxiety) medication use, of medication used for treating ADHD, of consulting a psychiatrist or psychologist and of being diagnosed with ADHD. No difference in the occurrence of a hospital diagnosis of depression, anxiety or self‐harming behaviour was found in the two groups. In conclusion, the increased risk of treatment for psychiatric symptoms but not of a hospital diagnosis of psychiatric disorders in children with AD that we found suggests the psychiatric issues in these children could be of a transient, reversible or mild–moderate nature, and that most can be handled in the primary healthcare sector and do not lead to specialist hospital care.