Mental health impairment among children with atopic dermatitis: A United States population-based cross-sectional study of the 2013-2017 National Health Interview Survey

Abstract

Background: Atopic dermatitis (AD) is associated with mental health disorders, but its impact on global mental health symptoms is less clear.

Objective: To determine the association between pediatric AD and mental health impairment.

Methods: In a cross-sectional study using 2013-2017 United States National Health Interview Survey data, children with and without AD were assessed for mental disorder with impairment (MDI) using a validated behavioral screening questionnaire. Mental health services utilization was also reported.

Results: The prevalence of any MDI was 26.7% (95% confidence interval [CI], 25.1-28.3) among children with AD and 17.7% (95% CI, 17.2-18.2) among those without AD, with severe MDI being present in 10.9% (95% CI 9.9-12.1) and 6.2% (95% CI 5.9-6.5), respectively. Adjusted for sociodemographic factors, AD was associated with higher odds of MDI (odds ratio, 1.52; 95% CI, 1.39-1.67), including impairments in conduct, emotions, peer relationships, and attention. Among children with AD, 19.9% (95% CI, 16.6-23.8) and 53.5% (95% CI, 48.5-58.5) of those with mild or severe MDI, respectively, had seen a mental health professional in the last year.

Limitations: Misclassification bias may arise from self-reported data.

Conclusion: AD is associated with clinically significant mental health symptoms, but many affected children may not seek or receive care for their symptoms.

Keywords: anxiety; atopic dermatitis; attention; conduct; depression; eczema; emotion; health care utilization; mental health; psychiatry; psychology; relationships.