Children and adolescents with atopic dermatitis are more inclined to exhibit aggressive behavior, which not only presents physical difficulties but additionally has a negative effect on their psychological well-being, according to the findings of a new cross-sectional study.
Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by recurrent eczematous lesions and itching. Although it affects people of all ages, children experience it most often. Skin irritation, inflammation, and cracks are some of the signs of AD that cause distress and can lead to social stigma. AD can have a serious negative impact on a person’s well-being, including sleep disturbances, anxiety, sadness, and other psychological difficulties.
The goals of AD treatment are to reduce inflammation, control symptoms, and improve patients’ general quality of life. The purpose of this research study was to investigate the characteristics and incidence of behavioral abnormalities in children and adolescents with AD in order to explain the relationships between these behavioral problems, clinical data, and disease severity. This single-center, cross-sectional study was published in the Jornal de Pediatria.
Baseline Characteristics
The study included 100 patients with AD; the mean age was 11.1 years, with the majority being male (56%). Specifically, moderate to severe AD was seen in 43%.
High Prevalence of Allergic Rhinitis and Asthma
The study reported that 97% of the patients showed symptoms of allergic rhinitis, and 61% had asthma. Moreover, a higher prevalence of asthma was observed in the mild AD group than in the moderate/severe AD group. The Eczema Area and Severity Index (EASI) scores ranged from 1 to 34.1, with 43% of patients classified in the moderate/severe category for AD.
Social Competence Abnormal in 75% of Patients
With respect to social competence, borderline or clinical values were found in 75% of the patients, internalization was found in 57%, externalization was found in 27%, and aggressive behavior was found in 18%. In contrast to those diagnosed with mild AD, a higher incidence of aggressiveness (10.5% vs. 27.9%, respectively) and trouble sleeping (15.8% vs. 32.6%, respectively) was reported in individuals with moderate to severe AD.
The T-scores obtained from the Child Behavior Checklist 6/18 varied between 22 and 57; 25% of individuals with AD had T-scores higher than 40, 10% had T-scores between 37 and 40, and 65% had T-scores below 37. The activity scale had the highest level of compromise, with changes noted in 32% of cases and borderline scores in 36% of cases when assessing social, school, and activity functioning individually.
Behavioral Issues and Sleep Disturbance
Children and adolescents with AD have been found to have a significant prevalence of behavioral issues, primarily depression and anxiety. In contrast to patients with mild AD, patients with moderate to severe AD show a greater incidence of aggressive behavior and difficulty sleeping. This suggests a relationship between the severity of the disease and certain behavioral problems. Sleep disturbance was reported by 15.8% of patients in the mild AD group and 32.6% in the moderate/severe AD group. Moreover, 8% of the respondents answered “yes” when asked about suicidal thoughts.
Previous Immunosuppressant or Immunobiological Therapy Affect Social Ability
Children who had previously or currently used immunosuppressant or immunobiological therapy exhibited more severe social disabilities, indicating that therapy may have an effect on social ability in AD patients (53% vs. 83%; p = 0.012).
Source:
Moraes, M. M., Vaz, F., Roque, R., Mallozi, M. C., Solé, D., & Wandalsen, G. F. (2024b). Behavioral disorders in children and adolescents with atopic dermatitis. Jornal De Pediatria, 100(1), 93–99. https://doi.org/10.1016/j.jped.2023.08.006
