Mental Health Symptoms and Functional Impairment in Children With Atopic Dermatitis

The impact of childhood atopic dermatitis (AD) on social and behavioral issues is not well understood. This study sought to determine the prevalence and predictors of social and behavioral symptoms and functional impairment among US children with AD. The 1996 to 2015 Medical Expenditure Panel Surveys were analyzed, including a representative, cross-sectional study of 2553 US children with AD. Behavioral and functional issues were examined using Columbia Impairment Scale (CIS) scores. Childhood AD was associated with behavioral and functional problems, particularly nervousness (odds ratio [OR], 1.18; 95% confidence interval [95% CI], 1.06-1.31), home behavior (OR, 1.18; 95% CI, 1.06-1.32), staying out of trouble (OR, 1.18; 95% confidence interval, 1.06-1.31), and relationships with other kids (OR, 1.17; 95% CI, 1.05-1.31) and with siblings (OR, 1.14; 95% CI, 1.02-1.28). Higher CIS scores were present in children with AD versus without AD (adjusted β, 0.62; 95% CI, 0.22-1.02) and with psoriasis (adjusted β, 0.86; 95% CI, 0.22-1.49). Among children with AD, higher CIS scores were notably associated with male sex, older age, lower household income, public insurance, and comorbid depression and anxiety. AD was associated with behavioral and functional impairment, similar to psoriasis and other common chronic conditions. There are significant sociodemographic differences in CIS scores.