Slattery MJ, Essex MJSpecificity in the association of anxiety, depression, and atopic disorders in a community sample of adolescents. J Psychiatr Res 45:788-795

Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Journal of Psychiatric Research (Impact Factor: 3.96). 11/2010; 45(6):788-95. DOI: 10.1016/j.jpsychires.2010.11.003
Source: PubMed


The specificity of relationships between anxiety and depressive symptoms, with each of the major atopic disorders of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) was systematically investigated within a single study sample. Participants included 367 adolescents who participated in a community, longitudinal study investigating risk factors for the development of psychiatric and physical health problems. Mental health symptoms were assessed at 7, 9, 11, and 13 years of age. Lifetime history of atopic disorders was assessed by parent report at age 13. Analysis of variance was used to investigate the specificity of the associations between anxiety and depression, and each of the atopic disorders. Results indicated that anxiety was associated with a lifetime history of atopic disorders as a group. The association was significantly strengthened when controlling for depression and externalizing psychiatric symptoms. Among atopic disorders, "pure" anxiety was associated with asthma and AR, and having both asthma and AR strengthened the association compared to having either disorder alone. The association of "pure" anxiety with asthma and AR is consistent with existing data suggesting a relationship between anxiety and respiratory disorders. Having both asthma and AR appeared to confer an additive "dose effect" on the strength of the association. The lack of an association with depression suggests that other factors may contribute to the differential expression of anxiety and depression with atopic disorders. Findings demonstrate the importance of assessing the impact of co-morbid psychiatric symptoms and atopic disorders within individual studies to determine the specificity of underlying relationships between these conditions.

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    • "A few studies are available on adolescents and these have found increased levels of psychological problems in those with eczema; but these studies have not controlled for socioeconomic factors (Saunes et al., 2007; Lien et al., 2010), or they have been performed in patients (Brenninkmeijer et al., 2009). Some publications show no association between eczema and increased anxiety/depression in adolescents (Magin et al., 2008; Slattery and Essex, 2011). "
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    ABSTRACT: There are few studies of psycho-social problems in adolescents with eczema. We performed a cross-sectional, questionnaire-based study to explore the relationship of suicidal ideation, mental health problems, and social functioning with eczema. A total of 4,744 adolescents (18-19 years) were invited and 3,775 (80%) participated. The overall prevalence of current eczema was 9.7%. Among those with current eczema, 15.5% reported suicidal ideation compared to 9.1% among those without eczema, significantly associated in a multivariate model (odds ratio 1.87, 95% confidence interval 1.31-2.68). In a subgroup analyses the prevalence of suicidal ideation in those with both eczema and itch was 23.8%, and was significantly associated compared to those witout eczema (3.57, 2.46-5.67). Eczema was associated with mental health problems assessed by Strength and Difficulties Questionnaire (1.72, 1.21-2.45) and Hopkins Symptom Checklist 10 (1.63, 1.23-2.16). Five questions assessed social function: feeling attached to family and friends, thriving at school, experiencing bullying, and romantic relationship. Boys with current eczema were less likely to have had romantic relationship (1.93, 1.21-3.08). Eczema in late adolescence is associated with suicidal ideation and mental health problems, but rarely with social problems. Our findings point to the importance of addressing mental health issues in adolescents with eczema.Journal of Investigative Dermatology accepted article preview online, 4 February 2014; doi:10.1038/jid.2014.70.
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    • "However, other studies show weak or no relations between anxiety/depression and atopy (Hart, Lahey, Hynd, Loeber, & McBurnett, 1995). In another study, anxiety was found to be associated with allergic asthma and allergic rhinitis, but not with atopic dermatitis, and depression was not associated with any of these three atopies (Slattery & Essex, 2011). Taken together, anxiety seems more likely than depression to be associated with atopy. "
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    ABSTRACT: With the aim to better understand the association between asthma/allergy and psychological distress, it was hypothesized that levels of stress, exhaustion, anxiety, depression, and health worries for environmental pollution would be higher in allergic asthma, allergic rhinitis, and atopic dermatitis than in non-allergic asthma and in referents without asthma or allergy. Taking part in the population-based Västerbotten Environmental Health Study (aged 18-79 years), 76 respondents reported a physician-based diagnosis of allergic asthma, 86 reported non-allergic asthma, 190 reported allergic rhinitis, and 46 reported atopic dermatitis as the only form of asthma/allergy. A group of 2876 respondents without an asthma/allergy diagnosis constituted as referents. The participants responded to the Perceived Stress Scale, the Shirom-Melamed Burnout Questionnaire, the Hospital Anxiety and Depression Scale, and the Environmental Pollution subscale of the Modern Health Worries Scale. Levels of stress, exhaustion, and anxiety were higher in allergic asthma and atopic dermatitis than in non-allergic asthma, allergic rhinitis, and among referents, and there was a strong tendency of such group differences for depression and health worries. The results imply that stress reduction and treatment of negative affect may in certain cases be fruitful interventions in patients with atopy.
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    ABSTRACT: Atopic dermatitis (AD) is a chronic inflam-matory skin disorder that typically occurs dur-ing childhood especially in the first year of life, with a variable frequency from 10% to 30%. Recent studies have shown that in Europe among 10-20% of children with AD suffer from this disorder also in adolescence. AD is a chronic inflammatory skin disease with a typi-cal onset in the first years of life and with a 10-30% prevalence among young children. AD prevalence in adolescence has been estimated around 5-15% in European countries. AD per-sists from childhood through adolescence in around 40% of cases and some risk factors have been identified: female sex, sensitization to inhalant and food allergens, allergic asthma and/or rhinoconjunctivitis, the practice of cer-tain jobs. During adolescence, AD mainly appears on the face and neck, often associated with overinfection by Malassezia, and on the palms and soles. AD persistence during adoles-cence is correlated with psychological diseases such as anxiety; moreover, adolescents affect-ed by AD might have problems in the relation-ship with their peers. Stress and the psycho-logical problems represent a serious burden for adolescents with AD and cause a signifi-cant worsening of the patients' quality of life (QoL). The pharmacological treatment is simi-lar to other age groups. Educational and psy-chological approaches should be considered in the most severe cases.
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