The Impact of Systemic Treatment of Atopic Dermatitis on Depressive Symptoms: A Prospective Clinical Cohort Study

Abstract

Information on depressive symptoms among patients with atopic dermatitis (AD) undergoing systemic treatment in a real-world setting is scarce. This prospective real-world clinical cohort study analysed data from SwedAD, a Swedish national register comprising patients with AD undergoing systemic treatment. Data were collected at baseline (n = 120) and at follow-up at 6 months (range 3-9 months, n = 59), and 12 months (10 months or later, n = 36). Depression was assessed with the Montgomery-Åsberg Depression Rating Scale-Self-report (MADRS-S) and AD with the Eczema Area Severity Index, the Patient-Oriented Eczema Measure, the Dermatology Life Quality Index and evaluation of pruritus. More than half of patients with moderate-to-severe AD had depressive symptoms at baseline, 24% presented with moderate-to-severe depression and 3% had pronounced suicidal ideation. Systemic treatment of AD significantly reduced both depression and AD symptoms at 6 months, and this positive effect remained at 12 months. In conclusion, depressive symptoms are common among adults with moderate-to-severe AD. Systemic treatment of AD significantly reduced depressive symptoms in parallel with AD symptoms.

Fig. 1

Boxplot showing medians, interquartile ranges and ranges of Montgomery-Åsberg Depression Rating Scale-Self-report (MADRS-S, y-axis) at baseline and follow-up at 6 months among 59 adults with atopic dermatitis on systemic treatment. Means marked with ×.

Fig. 2

Boxplot showing medians, interquartile ranges and ranges of items in Montgomery-Åsberg Depression Rating Scale-Self-report (MADRS-S) at baseline and follow-up at 6 months among 58 adults^a with atopic dermatitis on systemic treatment. Means marked with x. ^aOne patient excluded since only total score of MADRS-S was recorded, not scores on each item.