Association between atopic dermatitis, depression, and suicidal ideation: A systematic review and meta-analysis

Background Atopic dermatitis (AD) is associated with psychologic distress. However, previous studies found conflicting results about whether AD is associated with increased depression or suicidality. Objectives To determine the complex relationship between AD and depression. Methods A systematic review of all published observational studies in the MEDLINE, PubMed, Embase, Global Resource for Eczema Trials (GREAT), Latin American and Caribbean Health Sciences (LILACS), the Cochrane Library, Scopus, and PsychInfo databases that analyzed depression in AD was performed. Two reviewers performed study title and/or abstract review and data abstraction. Pooled meta-analysis was performed by using random-effects weighting. Results Overall, 106 studies met the inclusion criteria; 36 had sufficient data for meta-analysis. The prevalence of any depression was higher in persons with versus without AD (20.1% vs 14.8%). Similar results were found in sensitivity analyses of studies assessing clinical depression, depressive symptoms, and adults; studies with healthy controls; and studies of low and high study quality. AD was associated with significantly higher depression scale scores, parental depression, antidepressant use, and suicidality. No publication bias was detected. Limitations Individual-level data were not available. Conclusions Patients with AD have higher odds of depression and suicidality. Atopic dermatitis (AD) is associated with psychologic distress. However, previous studies found conflicting results about whether AD is associated with increased depression or suicidality. To determine the complex relationship between AD and depression. A systematic review of all published observational studies in the MEDLINE, PubMed, Embase, Global Resource for Eczema Trials (GREAT), Latin American and Caribbean Health Sciences (LILACS), the Cochrane Library, Scopus, and PsychInfo databases that analyzed depression in AD was performed. Two reviewers performed study title and/or abstract review and data abstraction. Pooled meta-analysis was performed by using random-effects weighting. Overall, 106 studies met the inclusion criteria; 36 had sufficient data for meta-analysis. The prevalence of any depression was higher in persons with versus without AD (20.1% vs 14.8%). Similar results were found in sensitivity analyses of studies assessing clinical depression, depressive symptoms, and adults; studies with healthy controls; and studies of low and high study quality. AD was associated with significantly higher depression scale scores, parental depression, antidepressant use, and suicidality. No publication bias was detected. Individual-level data were not available. Patients with AD have higher odds of depression and suicidality.