Atopic Dermatitis Is Associated With Multiple Behavioral Problems in US Children and Adolescents.

BACKGROUND

Atopic dermatitis (AD) is a chronic, inflammatory skin disease associated with itch, sleep disturbance, psychosocial distress, anxiety, and depression.

OBJECTIVE

We aimed to understand the association between AD and aberrant childhood behaviors.

METHODS

We used data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of 4898 urban children.

RESULTS

Atopic dermatitis was associated with the 75th or greater percentile of mean behavioral scores at 5 years (multivariable logistic regression; adjusted odds ratio [aOR] [95% confidence interval {95% CI}] = 1.51 [1.18-1.93]), 9 years (1.62 [1.32-1.99]), and 15 years (1.44 [1.17-1.76]). There were significantly increased behavioral problems at age of 15 years when AD persisted at ages of 5, 9, and 15 years (Poisson regression; adjusted risk ratio [95% CI] = 1.17 [1.01-1.35]). Atopic dermatitis was associated with 12 aberrant behaviors, particularly fighting (repeated-measures logistic regression; aOR [95% CI] = 1.40 [1.15-1.70]), physically attacking people (1.38 [1.09-1.76]), being sullen (1.31 [1.15-1.49]), worrying (1.41 [1.23-1.61]), and threatening others (1.35 [1.08-1.70]). Significant 2-way interactions were present between AD and sleep as predictors of underactivity (4.31 [3.06-6.08]), being threatening (aOR [95% CI] = 3.42 [2.20-5.34]), being sullen (3.86 [2.74-5.43]), and nervousness (4.56 [3.29-6.32]).

CONCLUSIONS

Childhood AD, particularly persistent disease with sleep disturbances, was associated with a wide range of behavioral problems in childhood and adolescence.