Correlation between anxiety and depression risk and atopic dermatitis severity in Taiwan: A cross-sectional study

Chia-Jung Hsu; Dereck Shen; Tom C Chan; Yung-Tsu Cho; Chao-Hsiun Tang; Chia-Yu Chu

doi:10.1016/j.jdin.2021.12.008

Correlation between anxiety and depression risk and atopic dermatitis severity in Taiwan: A cross-sectional study

JAAD Int. 2022 Feb 22:7:22-30. doi: 10.1016/j.jdin.2021.12.008. eCollection 2022 Jun.

Authors

Chia-Jung Hsu¹, Dereck Shen², Tom C Chan¹, Yung-Tsu Cho¹, Chao-Hsiun Tang³, Chia-Yu Chu¹

Affiliations

¹ Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
² School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
³ School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan.

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.

Keywords: AD, atopic dermatitis; BMI, body mass index; HADS; HADS, Hospital Anxiety and Depression Scale; HADS-A, Hospital Anxiety and Depression Scale–anxiety; HADS-D, Hospital Anxiety and Depression Scale–depression; HADS-T, total Hospital Anxiety and Depression Scale; Hospital Anxiety and Depression Scale; SCORAD; SCORAD, scoring atopic dermatitis; anxiety; atopic dermatitis; depression; psycho-comorbidities.