The role of insomnia in the vulnerability to depressive and anxiety symptoms in atopic dermatitis adult patients.
Anxiety
Atopic dermatitis
Depression
Insomnia
Mediation
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
21
07
2022
accepted:
16
01
2023
revised:
26
10
2022
medline:
14
7
2023
pubmed:
8
2
2023
entrez:
7
2
2023
Statut:
ppublish
Résumé
Atopic dermatitis (AD) is a common inflammatory chronic skin disease typically associated with atopic comorbidities and other non-atopic conditions such as sleep disturbances, and mood/anxiety disorders. A growing literature proposed a crucial role of sleep disturbances in the development of mental health problems in AD. We tested this assumption by mediation model analyses in adult AD patients.A total of 57 patients (mean age ± std. dev., 34.28 ± 13.07 years; 27 males; range 18-67 years) diagnosed with AD participated in a cross-sectional study. We evaluated self-perceived severity of AD, insomnia, depression, and anxiety symptoms using validated questionnaires: the Patient-Oriented Eczema Measure (POEM), the Insomnia Severity Index (ISI), the Beck Depression Inventory-second edition (BDI-II), and the Generalized Anxiety Disorder-7 scale (GAD-7), respectively. Two mediation models were performed, testing the mediation effect of insomnia symptoms on the relationship between AD severity and depression (model 1) and anxiety (model 2). AD symptoms, as expressed by POEM, were positively associated with insomnia, depression, and anxiety severity. Insomnia fully mediated the effect of AD severity on depression and anxiety. Specifically, insomnia accounted for 81.64% of the relationship between atopic eczema severity and depression, and for 81.84% of the effect of AD severity on anxiety symptoms. The present study proposed a critical role of insomnia in predisposing adult AD patients to experience depression and anxiety. Early interventions focused on treating sleep disturbances could indirectly be beneficial on mental health of patients with AD, counteracting the onset and exacerbation of anxiety and depression disorders.
Identifiants
pubmed: 36749389
doi: 10.1007/s00403-023-02538-0
pii: 10.1007/s00403-023-02538-0
pmc: PMC10338550
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1577-1582Informations de copyright
© 2023. The Author(s).
Références
Bieber T (2008) Atopic dermatitis. N Engl J Med 358:1483–1494. https://doi.org/10.1056/NEJMRA074081
doi: 10.1056/NEJMRA074081
pubmed: 18385500
Sen CY, Chiang BL (2018) Sleep disorders and atopic dermatitis: a 2-way street? J Allergy Clin Immunol 142:1033–1040. https://doi.org/10.1016/J.JACI.2018.08.005
doi: 10.1016/J.JACI.2018.08.005
Jeon C, Yan D, Nakamura M et al (2017) Frequency and management of sleep disturbance in adults with atopic dermatitis: a systematic review. Dermatol Ther 7:349–364. https://doi.org/10.1007/S13555-017-0192-3
doi: 10.1007/S13555-017-0192-3
Yano C, Saeki H, Ishiji T et al (2013) Impact of disease severity on sleep quality in Japanese patients with atopic dermatitis. J Dermatol Sci 72:195–197. https://doi.org/10.1016/J.JDERMSCI.2013.06.010
doi: 10.1016/J.JDERMSCI.2013.06.010
pubmed: 23876306
Sánchez-Pérez J, Daudén-Tello E, Mora AM, Lara Surinyac N (2013) Impact of atopic dermatitis on health-related quality of life in Spanish children and adults: the PSEDA study. Actas Dermosifiliogr 104:44–52. https://doi.org/10.1016/J.AD.2012.03.008
doi: 10.1016/J.AD.2012.03.008
pubmed: 22841507
Bender BG, Ballard R, Canono B et al (2008) Disease severity, scratching, and sleep quality in patients with atopic dermatitis. J Am Acad Dermatol 58:415–420. https://doi.org/10.1016/J.JAAD.2007.10.010
doi: 10.1016/J.JAAD.2007.10.010
pubmed: 18280338
Sandoval LF, Huang K, O’Neill JL et al (2014) Measure of atopic dermatitis disease severity using actigraphy. J Cutan Med Surg 18:49–55. https://doi.org/10.2310/7750.2013.13093
doi: 10.2310/7750.2013.13093
pubmed: 24377474
Silverberg JI (2017) Selected comorbidities of atopic dermatitis: atopy, neuropsychiatric, and musculoskeletal disorders. Clin Dermatol 35:360–366. https://doi.org/10.1016/j.clindermatol.2017.03.008
doi: 10.1016/j.clindermatol.2017.03.008
pubmed: 28709566
pmcid: 5512438
Silverberg JI, Garg NK, Paller AS et al (2015) Sleep disturbances in adults with eczema are associated with impaired overall health: a US population-based study. J Invest Dermatol 135:56–66. https://doi.org/10.1038/jid.2014.325
doi: 10.1038/jid.2014.325
pubmed: 25078665
Beikert FC, Langenbruch AK, Radtke MA et al (2014) Willingness to pay and quality of life in patients with atopic dermatitis. Arch Dermatol Res 306:279–286. https://doi.org/10.1007/S00403-013-1402-1
doi: 10.1007/S00403-013-1402-1
pubmed: 23982630
Yu SH, Attarian H, Zee P, Silverberg JI (2016) Burden of sleep and fatigue in US adults with atopic dermatitis. Dermatitis 27:50–58. https://doi.org/10.1097/DER.0000000000000161
doi: 10.1097/DER.0000000000000161
pubmed: 26983091
Hertenstein E, Feige B, Gmeiner T et al (2019) Insomnia as a predictor of mental disorders: a systematic review and meta-analysis. Sleep Med Rev 43:96–105. https://doi.org/10.1016/j.smrv.2018.10.006
doi: 10.1016/j.smrv.2018.10.006
pubmed: 30537570
Baglioni C, Battagliese G, Feige B et al (2011) Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord 135:10–19. https://doi.org/10.1016/J.JAD.2011.01.011
doi: 10.1016/J.JAD.2011.01.011
pubmed: 21300408
Buysse DJ, Angst J, Gamma A et al (2008) Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep 31:473–480. https://doi.org/10.1093/sleep/31.4.473
doi: 10.1093/sleep/31.4.473
pubmed: 18457234
pmcid: 2279748
Neckelmann D, Mykletun A, Dahl AA (2007) Chronic insomnia as a risk factor for developing anxiety and depression. Sleep 30:873. https://doi.org/10.1093/SLEEP/30.7.873
doi: 10.1093/SLEEP/30.7.873
pubmed: 17682658
pmcid: 1978360
Bao Q, Chen L, Lu Z et al (2018) Association between eczema and risk of depression: a systematic review and meta-analysis of 188,495 participants. J Affect Disord 238:458–464. https://doi.org/10.1016/J.JAD.2018.05.007
doi: 10.1016/J.JAD.2018.05.007
pubmed: 29929155
Patel KR, Immaneni S, Singam V et al (2019) Association between atopic dermatitis, depression, and suicidal ideation: a systematic review and meta-analysis. J Am Acad Dermatol 80:402–410. https://doi.org/10.1016/J.JAAD.2018.08.063
doi: 10.1016/J.JAAD.2018.08.063
pubmed: 30365995
Schonmann Y, Mansfield KE, Hayes JF et al (2020) Atopic eczema in adulthood and risk of depression and anxiety: a population-based cohort study. J Allergy Clin Immunol Pract 8:248-257.e16. https://doi.org/10.1016/J.JAIP.2019.08.030
doi: 10.1016/J.JAIP.2019.08.030
pubmed: 31479767
pmcid: 6947493
Silverberg JI, Gelfand JM, Margolis DJ et al (2019) Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults. Br J Dermatol 181:554–565. https://doi.org/10.1111/BJD.17683
doi: 10.1111/BJD.17683
pubmed: 30838645
pmcid: 6850653
Baurecht H, Welker C, Baumeister S-E et al (2021) Relationship between atopic dermatitis, depression and anxiety: a two-sample Mendelian randomization study. Br J Dermatol 185:781–786. https://doi.org/10.1111/bjd.20092
doi: 10.1111/bjd.20092
pubmed: 33817779
Charman CR, Venn AJ, Williams HC et al (2004) The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients’ perspective. Arch Dermatol 140:1513–1519. https://doi.org/10.1001/ARCHDERM.140.12.1513
doi: 10.1001/ARCHDERM.140.12.1513
pubmed: 15611432
Castronovo V, Galbiati A, Marelli S et al (2016) Validation study of the Italian version of the Insomnia Severity Index (ISI). Neurol Sci 37:1517–1524. https://doi.org/10.1007/s10072-016-2620-z
doi: 10.1007/s10072-016-2620-z
pubmed: 27234459
Ghisi M, Flebus G, Montano A et al (2006) Beck Depression Inventory-II: Edizione Italiana. Giunti Editore, Firenze
Spitzer RL, Kroenke K, Williams JBW, Löwe B (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166:1092–1097
doi: 10.1001/archinte.166.10.1092
pubmed: 16717171
Hayes AF (2017) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Methodology in the Social Sciences, 2nd edn. Guilford Publications Inc, New York
MacKinnon DP (2008) Introduction to statistical mediation analysis. Taylor & Francis Inc, Abingdon
Rønnstad ATM, Halling-Overgaard AS, Hamann CR, Skov L, Egeberg A, Thyssen JP (2018) Association of atopic dermatitis with depression, anxiety, and suicidal ideation in children and adults: a systematic review and meta-analysis. J Am Acad Dermatol 79(3):448–456. https://doi.org/10.1016/j.jaad.2018.03.017
doi: 10.1016/j.jaad.2018.03.017
pubmed: 30119868
Silverberg JI, Chiesa-Fuxench Z, Margolis D et al (2021) Sleep disturbances in atopic dermatitis in US adults. Dermatitis. https://doi.org/10.1097/der.0000000000000731
doi: 10.1097/der.0000000000000731
pubmed: 34807542
pmcid: 10115559
Bawany F, Northcott CA, Beck LA, Pigeon WR (2021) Sleep disturbances and atopic dermatitis: relationships, methods for assessment, and therapies. J Allergy Clin Immunol Pract 9(4):1488–1500. https://doi.org/10.1016/j.jaip.2020.12.007
doi: 10.1016/j.jaip.2020.12.007
pubmed: 33321263
Alvaro PK, Roberts RM, Harris JK, Shao A (2013) A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep 36:1059–1068. https://doi.org/10.5665/sleep.2810
doi: 10.5665/sleep.2810
pubmed: 23814343
pmcid: 3669059