Mental health comorbidity in patients with atopic dermatitis.
Mental health comorbidity in patients with atopic dermatitis.
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DOI：
10.1016/j.jaci.2012.10.041
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发表时间：
2013-02
影响因子：
14.2
通讯作者：
Simpson, Eric L.
中科院分区：
文献类型：
--
作者：
Yaghmaie, Pouya;Koudelka, Caroline W.;Simpson, Eric L.
关键词：
最近主要来自欧洲的数据表明，患有特应性皮炎的儿童患精神疾病的风险可能会增加。我们的目的是量化与美国儿童特应性皮炎相关的心理健康负担。采用横断面研究设计分析了2007年全国儿童健康调查的数据，该调查报告了92,642名0-17岁非机构儿童的健康状况。计算了那些有和没有特应性皮炎病史的人一生中各种由医生诊断的精神健康状况的患病率。与非特应性皮炎对照组相比，患有特应性皮炎的儿童患注意力缺陷/多动障碍的几率显著增加，OR为1.87 (95% CI 1.54, 2.27)，即使在控制已知混杂因素后也是如此。抑郁症、焦虑症、品行障碍和自闭症的校正优势比分别为1.81 （95% CI 1.33,2.46）、1.77 （95% CI 1.36, 2.29）、1.87（1.46,2.39）和3.04 (95% CI 2.13, 4.34)，这些估计值均具有统计学意义。观察到精神健康障碍的患病率与报告的皮肤病严重程度之间存在明显的剂量依赖关系。我们的数据揭示了美国儿科人群中心理健康障碍和特应性皮炎之间惊人的关联。皮肤疾病的严重程度改变了这种联系的强度。需要前瞻性队列研究来验证这些关联并探索潜在的机制。预防特应性皮炎或积极治疗早期皮肤炎症的策略可能会改变高危儿童发生精神健康障碍的风险。
Recent data, primarily from Europe, suggest children with atopic dermatitis may be at increased risk of developing mental health disorders. We aimed to quantify the mental health burden associated with pediatric atopic dermatitis in the United States. A cross-sectional study design was used analyzing data from the 2007 National Survey of Children's Health – a survey reporting on the health status of 92,642 non-institutionalized children ages 0-17. The lifetime prevalence of various provider-diagnosed mental health conditions was calculated for those with and without a history of atopic dermatitis. The odds of having attention-deficit/hyperactivity disorder was significantly increased in children with atopic dermatitis compared to non-atopic dermatitis controls, OR 1.87 (95% CI 1.54, 2.27) even after controlling for known confounders. The adjusted odds ratios for depression, anxiety, conduct disorder, and autism were 1.81 (95% CI 1.33,2.46) , 1.77 (95% CI 1.36, 2.29), 1.87 (1.46, 2.39), and 3.04 (95% CI 2.13, 4.34), respectively, and these estimates were all statistically significant. A clear dose-dependent relationship was observed between the prevalence of a mental health disorder and the reported severity of the skin disease. Our data reveal a striking association between mental health disorders and atopic dermatitis in the U.S. pediatric population. The severity of the skin disease alters the strength of the association. Prospective cohort studies are needed to verify these associations and to explore underlying mechanisms. Strategies to prevent atopic dermatitis or to aggressively treat early skin inflammation may modify the risk of developing mental health disorders in at-risk children.
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