Mental disorders and loneliness among adults with atopic dermatitis in the Dutch general population

Background Previous studies have demonstrated the positive association of atopic dermatitis (AD) with depression and anxiety. However, there is a lack of knowledge concerning other mental disorders and loneliness in patients with AD. 
Objectives To investigate the association of adult AD with several mental disorders and loneliness in the Dutch general population and to explore how the association with mental disorders and loneliness varies across AD severity.
 Methods This cross-sectional study was conducted within the Lifelines Cohort Study, by sending an add-on questionnaire, including (among others) questions on AD and atopic comorbidities (i.e. asthma and/or hay fever), to all adult participants (N=135 950) in 2020. Mental disorders were measured by a self-reported question and validated instrument (i.e. the M.I.N.I.) between 2006 and 2013. Loneliness was assessed by the validated 6-item De Jong Gierveld Loneliness Scale between 2016 and 2019. Binary logistic regression analysis was used. 
Results A total of 56 896 subjects (mean age 55.8 years, 39.7% males) were included. We found that AD showed positive associations with self-reported chronic fatigue syndrome, burnout, depression, social phobia, panic disorder, attention deficit hyperactivity disorder, and eating disorder in lifetime. Based on the M.I.N.I., AD was positively associated with panic disorder and at least one anxiety disorder(s). In addition, subjects with AD were more likely to experience loneliness compared to those without. Furthermore, these observed associations were stronger in the moderate-to-severe AD group than in the mild AD group.
Conclusions Our results raise awareness of a significant proportion of adults with AD being affected by several mental disorders and loneliness, especially those with moderate-to-severe AD. Further studies are required to evaluate if the collaboration between dermatologists and psychiatrists could optimize medical care for this vulnerable patient group.