New Paper Finds Adults, Children and Teens with Eczema Experience Significant Mental Health Symptoms

Research has already shown that atopic dermatitis (eczema) is strongly associated with symptoms of psychological distress, including anxiety and depression. But patient and caregiver’ perceptions of this correlation haven’t really been studied — until now. 

The research team at the National Eczema Association (NEA) recently conducted a project to evaluate patient-reported mental health symptoms, their correlation with eczema severity and patient-perceived associations of eczema and its impacts on mental health. The results were published in the journal Dermatitis in March 2024.

“We wanted to find out what our community has experienced and their perceptions of how mental health relates to eczema symptoms,” said Jessica Johnson, co-author of the study and director of community research and engagement at NEA. “It’s important to understand patients’ and caregivers’ perspectives on this topic, because when people are aware of the connection between mental health and eczema symptoms they may be more likely to seek support.”

Research methods

As part of the study, adult eczema patients (18 years or older) as well as the primary caregivers of younger eczema patients (children and teens ages 8 to 17 years) completed a survey about mental health and eczema’s relationship to mental health. Participants were recruited through the NEA website, NEA email and social media as well as the EczemaWise app. In total, 795 adults with eczema and 159 caregivers of children and teens with eczema completed the survey.

The survey included questions about eczema symptoms, mental health symptoms, perceptions of the connection between eczema and mental health and experiences accessing mental health services. In the survey, mental health symptoms were defined as (but not limited to): 

• Trouble sleeping
• Difficulty concentrating
• Poor appetite
• Feeling tired 
• Little interest or pleasure in activities 
• Feeling hopeless

A standardized scale called the Hospital Anxiety and Depression Scale (HADS) was also used to measure anxiety and depression in adult survey respondents. 

Key takeaways

Through the study, the team illustrated that adults, children and teens with eczema experience a significant mental health burden that increases with eczema severity:

• 70% of respondents reported that either their own or their child’s mental health was impacted by eczema during the past year. 
• Around one fourth of respondents reported that they (or their child) had symptoms of poor mental health more than 10 days in the past month. Those with more severe eczema symptoms were more likely to have 10+ days of poor mental health than those with less severe eczema symptoms. 
• Most adults (65.5%) with eczema had anxiety HADS scores that were “borderline abnormal” or “abnormal,” and nearly half (46.4%) had “borderline abnormal” or “abnormal” depression HADS scores. 
• More than one third (37.1%) of respondents said their or their child’s mood and emotions were affected “a lot” or “extremely” by eczema in the past month. 
• 84% of those with severe eczema reported that their or their child’s mood and emotions were affected “a lot” or “extremely” by eczema in the past month. 
• Both adults with eczema and caregivers of children and teens with eczema reported worsening mental health symptoms during flares and right before flares, and many also reported apprehension about future flares. 

Why this research matters

The data confirms that many patients and caregivers are aware of the impact eczema has on their mental health and that they may need or want additional support. 

“This study highlights the mental health impact eczema can have on patients despite the ever-growing pipeline of treatments and patient resources,” said Johnson. “There’s an opportunity for patients and healthcare providers to acknowledge and raise mental health considerations as part of a holistic and integrative approach to treatment.” 

In the future, Johnson added, it would be great to have more collaboration between healthcare providers who treat eczema and those who treat mental health to increase access to mental health resources. “We know there’s an association between mental health symptoms and eczema, however, a standard of care for diagnosis and discussion around mental health and eczema does not currently exist,” said Johnson.

Future research may look at barriers to accessing mental health services for people with eczema, the extent to which healthcare providers who treat eczema monitor and follow-up on their patients’ mental health and factors that may or may not lead someone with eczema to seek mental health care.