Associations of Anxiety and Depression With Skin Symptoms and Inflammatory Cytokines in Patients With Atopic Dermatitis

Abstract

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease frequently associated with psychological comorbidities such as anxiety and depression.

Objective: This study aimed to analyse the influence of anxiety and depression on dermatological symptoms and inflammatory cytokines in patients with AD.

Methods: A retrospective cross-sectional analysis was conducted on the clinical records of 241 patients with AD treated at our hospital from December 2022 to December 2024, selected from an initial pool of 320 patients with AD. Sixty-one patients with anxiety/depression comprised the study group, whereas the remaining 180 served as controls. The patients were evaluated using the visual analogue scale (VAS) for pruritus and the Scoring Atopic Dermatitis (SCORAD), and the correlations of anxiety and depression levels with VAS and SCORAD scores were analysed. In addition, inflammatory cytokine levels (interleukin-6 [IL-6] and tumour necrosis factor-α [TNF-α]) were measured in both groups, and their associations with anxiety/depression scores were analysed.

Results: Among the 241 patients with AD, the study identified 19 cases of anxiety, 16 cases of depression and 26 cases of comorbid anxiety and depression. The study group presented significantly higher Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale, Depression Self-Rating Scale for Children (DSRSC) and Screen for Child Anxiety Related Emotional Disorders scores than the control group (p < 0.05). The study group had notably higher VAS and SCORAD scores than the control group (p < 0.05). Significant moderate positive correlations of anxiety/depression scores with VAS/SCORAD scores were found (p < 0.05). All anxiety/depression scores showed significant but generally weak to moderate positive correlations with IL-6 levels (all p < 0.05). For TNF-α, only HAMD demonstrated a moderate correlation (r = 0.4228, p < 0.0001), and DSRSC showed a weak but significant association (r = 0.2424, p = 0.0040).

Conclusion: Anxiety and depression are common among patients with AD, and these emotional states are significantly associated with skin rash and pruritus symptoms and inflammatory responses in patients. Therefore, the psychological well-being of patients should be given due consideration.