Atopic Dermatitis Associated With Increased Suicidal Ideation in Adolescents

Suicidal behavior was prevalent in adolescents with atopic dermatitis (AD), finds study data published in the Annals of Allergy, Asthma and Immunology. Mental health screening of patients with AD may be important to preventing adverse outcomes.

Investigators extracted data from the Korean Youth Risk Behavior Web-based Surveys (KYRBS) for the years 2007 to 2017. The KYRBS is a cross-sectional, self-reported, online survey conducted annually in a nationally representative sample of Korean youths aged 13 to 18 years. Participants are selected using a complex stratification and clustering design, whereby metropolitan areas, medium and small cities, and rural areas are appropriately represented. The present analysis assessed self-reported suicidality and its relationship to AD diagnosis. Students who answered “Yes” to the question “Have you ever been diagnosed with AD by a doctor?” were considered to have AD. Logistic regression was performed to identify predictors of suicidality in patients with AD, expressed as odds ratios (ORs). Analyses were adjusted for relevant covariates, including socioeconomic status, academic achievement, residential type, self-perceived health status, and other demographic factors.

Of 818,684 adolescents invited to participate from 2007 to 2017, 788,411 (96.3%) provided complete survey data. The overall percentage with AD was 22.2%, with prevalence increasing from 2007 (17.3%) to 2017 (25.1%). Adolescents with AD were more often girls (54.6%) and in high school (50.5%). A total of 18.97% of respondents with AD reported suicidal ideation, compared with 16.51% of respondents without AD (P <.001). Similarly, a greater percentage of adolescents with AD reported suicide attempts compared with their counterparts without AD (4.51% vs 3.83%; P <.001). In adolescents with AD, strong predictors of suicidal ideation included self-reported suicide attempt (adjusted OR [aOR], 46.54; 95% confidence interval [CI], 41.41-52.28), perceived unhappiness (OR, 4.90; 95% CI, 4.31-5.57), high self-perceived stress (OR, 4.88; 95% CI, 4.40-5.43; P <.001), and self-reported depressed mood (aOR, 4.71; 95% CI, 4.53-4.89; P <.001). In the same cohort, suicidal attempts were predicted by suicidal ideation (aOR, 48.01; 95% CI, 42.69-53.99; P <.001), self-reported depression (aOR, 1.81; 95% CI, 1.67-1.96; P <.001) and perceived unhappiness (OR, 1.99; 95% CI, 1.69-2.15; P <.001). Low vs high self-perceived stress also appeared to increase risk for suicide attempt (aOR, 2.42; 95% CI, 1.84-3.18).

Suicidality was reported by nearly a fifth of studied adolescents with AD. Predictors of suicide ideation and attempt included depressed mood and self-perceived stress. Efforts to target poor mental health in youth with AD may be essential to reducing suicidality, the investigators believe. As study limitations, they noted the cross-sectional design, through which causality cannot be established. Further longitudinal research is needed to confirm the influence of AD on suicidality.

Reference

Kyung Y, Choi MH, Jeon YJ, et al. Association of atopic dermatitis with suicide risk among 788,411 adolescents: a Korean cross-sectional study [published online March 30, 2020]. Ann Allergy Asthma Immunol. doi: 10.1016/j.anai.2020.03.023