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. 2023 Feb 22;188(3):341-349.
doi: 10.1093/bjd/ljac058.

The association between atopic dermatitis, cognitive function and school performance in children and young adults

Ida Vittrup  1   2 , Yuki M F Andersen  1 , Lone Skov  1 , Jashin J Wu  3 , Tove Agner  2 , Simon F Thomsen  2 , Alexander Egeberg  2 , Jacob P Thyssen  2
Affiliations

The association between atopic dermatitis, cognitive function and school performance in children and young adults

Ida Vittrup et al. Br J Dermatol. .

Abstract

Background: Children with atopic dermatitis (AD) may have disturbed sleep, affected self-esteem and decreased quality of life, likely interfering with performance in school.

Objectives: To examine the association between hospital-managed paediatric AD, school performance and cognitive function.

Methods: In this cross-sectional study we linked data from the Danish national registers and identified three populations between 2001 and 2019. Population 1 comprised children with graduation grades registered from lower secondary school, population 2 comprised adolescents with registration of an upper secondary graduation mean, and population 3 comprised male conscripts with registration of an IQ test score. AD was defined as a hospital diagnostic code (inpatient or outpatient) prior to the exam or conscription date, and was stratified according to severity, activity and atopic comorbidity. Outcomes included graduation mean from lower and upper secondary school, special educational assistance in primary and lower secondary school, and IQ at conscription.

Results: In total, 770 611 (12 137 with AD), 394 193 (6261 with AD) and 366 182 (4539 with AD) children and adolescents were included in populations 1 (lower secondary graduation), 2 (upper secondary graduation) and 3 (conscription), respectively. In lower secondary school, children with severe AD had significantly lower overall, written and oral graduation grade means compared with children with mild AD: respectively, difference -0.29 [95% confidence interval (CI) -0.45 to -0.13, P < 0.001], difference -0.26 (95% CI -0.42 to -0.10, P = 0.0016) and difference -0.30 (95% CI -0.49 to -0.11, P = 0.0018). In upper secondary school, adolescents with AD performed similarly to their peers without AD. Young men with AD scored significantly lower IQ test means at conscription examination than male conscripts without AD: difference -0.60 (95% CI -0.87 to -0.32, P < 0.001).

Conclusions: AD, in particular when severe, is associated with lower school performance in childhood and IQ in young men, which can interfere with academic achievements in life. Optimization of treatment of children with AD and specific educational support to children with severe AD could be needed.

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Conflict of interest statement

Conflicts of interest I.V. has received salary from research funding from Sanofi and Regeneron Pharmaceuticals, Inc., and honoraria for lecturing from Pfizer Denmark. Y.M.F.A. has received research funding from the AP Møller Foundation and the Kgl Hofbundtmager Aage Bang Foundation. L.S. has been a paid speaker for AbbVie, Eli Lilly, Novartis and LEO Pharma; has been a consultant for or has served on advisory boards with AbbVie, Janssen-Cilag, Novartis, Eli Lilly, LEO Pharma, UCB, Almirall and Sanofi; has served as an investigator for AbbVie, Sanofi, Janssen-Cilag, Boehringer Ingelheim, AstraZeneca, Eli Lilly, Novartis, Regeneron and LEO Pharma; and has received research and educational grants from Novartis, Sanofi, Janssen-Cilag and LEO Pharma. J.J.W. is or has been an investigator, consultant or speaker for AbbVie, Almirall, Amgen, Arcutis, Aristea Therapeutics, Bausch Health, Boehringer Ingelheim, Bristol Myers Squibb, Dermavant, DermTech, Dr Reddy’s Laboratories, Eli Lilly, EPI Health, Galderma, Janssen, LEO Pharma, Mindera, Novartis, Pfizer, Regeneron, Samsung Bioepis, Sanofi, Solius, Sun Pharma, UCB and Zerigo Health. T.A. reports consulting fees and honoraria for lectures from Sanofi, LEO Pharma, Lilly, Pfizer and AbbVie; has received support for attending meetings and/or travel support from AbbVie; and has been an investigator for Sanofi, LEO Pharma and AbbVie. S.F.T. has been a consultant and/or served on advisory boards for AbbVie, Almirall, Celgene, Eli Lilly, Janssen, LEO Pharma, Novartis, Pfizer, Roche and Sanofi; has been a speaker for AbbVie, Eli Lilly, LEO Pharma, Novartis, Sanofi and UCB; and has received research support from AbbVie, LEO Pharma, Janssen, Novartis, Sanofi and UCB. A.E. has received research funding from Pfizer, Eli Lilly, the Danish National Psoriasis Foundation and the Kgl Hofbundtmager Aage Bang Foundation; and honoraria as a consultant and/or speaker for AbbVie, Almirall, LEO Pharma, Samsung Bioepis Co Ltd, Pfizer, Eli Lilly and Company, Novartis, Galderma, Dermavant, Bristol Myers Squibb, Mylan, UCB, Union Therapeutics and Janssen Pharmaceuticals. J.P.T. is an advisor for AbbVie, Almirall, Arena Pharmaceuticals, Coloplast, OM Pharma, Aslan Pharmaceuticals, Union Therapeutics, Eli Lilly & Co, LEO Pharma, Pfizer, Regeneron and Sanofi; is a speaker for AbbVie, Almirall, Eli Lilly & Co, LEO Pharma, Pfizer, Regeneron and Sanofi; and has received research grants from Pfizer, Regeneron and Sanofi.

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