Risk factors for anxiety and depression in patients with atopic dermatitis and their impact on prognosis

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BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by visible lesions that can lead to anxiety and depression. These psychological impacts may severely affect the physical and mental health and the overall quality of life of the affected individuals. AIM To identify the risk factors for anxiety and depression among patients with AD and to assess their influence on prognosis. METHODS A cross-sectional study was conducted in 273 patients with AD who visited Shanghai Jinshan Tinglin Hospital between July 2021 and June 2023. Data were collected using standardized instruments, including the general information questionnaire, hospital anxiety and depression scale, scoring AD index, and dermatology life quality index. RESULTS Among the evaluated patients, 24.5% had symptoms of anxiety, and 19.8% had symptoms of depression. Independent risk factors for anxiety included lower education level [odds ratio (OR) = 0.338, 95% confidence interval (CI): 0.183-0.625], increased number of medical visits (OR = 2.300, 95%CI: 1.234-4.255), sleep disorders (OR = 2.013, 95%CI: 1.032-3.923), and allergic rhinitis (OR = 2.052, 95%CI: 1.097-3.839). Factors for depression included more severe pruritus (OR = 6.837, 95%CI: 1.330-35.132), higher number of medical visits (OR = 2.979, 95%CI: 1.430-6.205), sleep disorders (OR = 2.245, 95%CI: 1.033-5.024), and asthma (OR = 2.208, 95%CI: 1.003-4.859). Dermatology life quality index scores correlated positively with anxiety, depression, scoring AD index, sleep disorders, number of visits, and intensity of pruritus (P < 0.05). CONCLUSION In patients with AD, anxiety and depression are associated with educational level, frequency of medical visits, sleep disorders, allergic rhinitis, pruritus, and asthma, all of which exacerbate symptoms and reduce quality of life.