Maternal Anxiety and Psychosocial Burden in Childhood Atopic Dermatitis: A Comparative Study

Abstract

Background: Atopic dermatitis (AD) is among the most prevalent chronic pediatric skin diseases. Beyond its cutaneous manifestations, AD imposes substantial psychosocial and economic strain on families. We quantified this burden—i.e., maternal anxiety and quality of life (QoL)—and identified its clinical and sociodemographic determinants, comparing families of children with AD to those of healthy peers.

Methods: This cross-sectional study enrolled 84 mothers of physician-diagnosed patients with AD aged 3–144 months and 90 mothers of age-matched healthy children attending routine visits. Disease severity was graded with the Scoring Atopic Dermatitis (SCORAD) index. Mothers completed the State-Trait Anxiety Inventory (STAI) and the 8-item European Health Impact Scale (EUROHIS-QoL). Additionally, the Dermatological Family Impact Scale (DeFIS) was administered to the AD group.

Results: EUROHIS-QoL scores were lower in the AD group than in controls (p = 0.016), whereas The State-Anxiety Inventory (STAI-S) scores were higher (p < 0.001); the Trait-Anxiety Inventory (STAI-T) scores did not differ (p = 0.125). In multivariable models, patient status (p = 0.006), higher STAI-T (p = 0.002), and greater income (USD 750–1500: p = 0.014; >USD 1500: p = 0.010) were independently associated with QoL. Anxiety was driven by patient status, lower QoL, and higher STAI-T, while trait anxiety was driven by lower QoL and higher STAI-S. SCORAD correlated negatively with QoL (ρ = –0.225; p = 0.040) and positively with STAI-S and DeFIS.

Conclusions: Pediatric AD significantly impairs mothers' QoL and heightens maternal situational anxiety and these effects intensify with increasing disease severity and financial strain. Multidisciplinary, family-centered care, including psychological screening and targeted support for low-income households, is essential for comprehensive AD management.