Beyond Anxiety and Depression: Loneliness and Psychiatric Disorders in Adults with Atopic Dermatitis

Abstract

There is a lack of knowledge concerning loneliness and psychiatric disorders other than anxiety and depression in patients with atopic dermatitis. This cross-sectional study was conducted within the Lifelines Cohort Study, in the Netherlands, by sending an atopic dermatitis questionnaire to adult participants (n = 135,950) in 2020. Psychiatric disorders were measured with a self-reported question and validated instrument (Mini International Neuropsychiatric Interview; M.I.N.I.), and loneliness was assessed with the validated 6-item De Jong Gierveld Loneliness Scale. In total, 56,896 subjects (mean age 55.8 years, 39.7% males) were included. Atopic dermatitis showed positive associations with self-reported chronic fatigue syndrome, burnout, depression, social phobia, panic disorder, attention deficit hyperactivity disorder, and eating disorder in the participants' lifetimes. Based on the M.I.N.I., atopic dermatitis was positively associated with panic disorder and at least 1 anxiety disorder. In addition, subjects with atopic dermatitis were more likely to experience loneliness compared with those without atopic dermatitis. These associations were observed only in the moderate-to-severe, but not mild, atopic dermatitis group. This study raises awareness that a significant proportion of adults with atopic dermatitis feel lonely and are affected by several psychiatric disorders, especially those severely affected by atopic dermatitis. Further studies are required to evaluate if interdisciplinary care, such as the collaboration between dermatologists and psychiatrists, could optimize medical care for this vulnerable patient group.

Fig. 1

Proportion of subjects with psychiatric disorders and loneliness among the non-, mild, and moderate-to-severe atopic dermatitis (AD) group. M.I.N.I.: Mini International Neuropsychiatric Interview; ADHD: attention deficit hyperactivity disorder.

Fig. 2

Adjusted* (odds ratios) ORs for psychiatric disorders and loneliness stratified by severity of atopic dermatitis (AD) among those with vs without AD. ^*Adjusted for age, sex, asthma and/or hay fever. ADHD: attention deficit hyperactivity disorder; 95% CI: 95% confidence interval; M.I.N.I.: Mini International Neuropsychiatric Interview.