International journal of dermatology · 2026
The Psychiatric Comorbidities in Adolescents With Atopic Dermatitis: A Real-World Study of Propensity-Matched Cohorts.
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Szepietowska Marta, Krajewski Piotr K, Pacan Przemyslaw, Wojas-Pelc Anna, Jaworek Andrzej K
Аннотация
BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease that significantly impairs quality of life, particularly in adolescents, a period marked by intense physical and psychosocial development. The burden of AD extends beyond dermatological symptoms, with growing evidence linking the condition to mental health disorders. As real-world data focused specifically on adolescent populations is scarce, this study aimed to evaluate the risk of psychiatric comorbidities among AD adolescents using a large electronic health records database.
METHODS: A retrospective cohort study utilizing the TriNetX Analytics platform, including adolescents aged 10-18 years diagnosed with AD was conducted. Individuals with pre-existing psychiatric disorders were excluded. A matched control group was identified; propensity score matching (1:1) accounted for demographic, socioeconomic, and major systemic comorbidities. Incident psychiatric outcomes were captured using ICD-10 codes and analyzed with Cox proportional hazards models. Sensitivity and sex-stratified analyses were performed.
RESULTS: After matching, 262,558 adolescents were included in each cohort. AD was associated with a significantly increased risk of any psychiatric disorder (17.3% vs. 6.2%; hazard ratio [HR] = 3.00, 95% confidence interval [CI]: 2.95-3.06). Anxiety (HR = 2.72), depression (HR = 2.66), sleep disorders (HR = 1.49), personality disorders (HR = 4.31), suicidality (HR = 1.62), and self-harm (HR = 1.47) were notably elevated. Findings remained consistent across sensitivity analyses. Female adolescents showed disproportionately higher risks of depression, anxiety, eating disorders, and self-harm.
CONCLUSIONS: Adolescents with AD exhibit a markedly elevated risk of diverse psychiatric disorders, with pronounced vulnerability among girls. These results highlight the importance of integrated dermatologic and psychological care to support mental health in this population.
METHODS: A retrospective cohort study utilizing the TriNetX Analytics platform, including adolescents aged 10-18 years diagnosed with AD was conducted. Individuals with pre-existing psychiatric disorders were excluded. A matched control group was identified; propensity score matching (1:1) accounted for demographic, socioeconomic, and major systemic comorbidities. Incident psychiatric outcomes were captured using ICD-10 codes and analyzed with Cox proportional hazards models. Sensitivity and sex-stratified analyses were performed.
RESULTS: After matching, 262,558 adolescents were included in each cohort. AD was associated with a significantly increased risk of any psychiatric disorder (17.3% vs. 6.2%; hazard ratio [HR] = 3.00, 95% confidence interval [CI]: 2.95-3.06). Anxiety (HR = 2.72), depression (HR = 2.66), sleep disorders (HR = 1.49), personality disorders (HR = 4.31), suicidality (HR = 1.62), and self-harm (HR = 1.47) were notably elevated. Findings remained consistent across sensitivity analyses. Female adolescents showed disproportionately higher risks of depression, anxiety, eating disorders, and self-harm.
CONCLUSIONS: Adolescents with AD exhibit a markedly elevated risk of diverse psychiatric disorders, with pronounced vulnerability among girls. These results highlight the importance of integrated dermatologic and psychological care to support mental health in this population.