The Psychiatric Comorbidities in Adolescents With Atopic Dermatitis: A Real-World Study of Propensity-Matched Cohorts.

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.