Impact of atopic eczema on attention

Alena Hricová ORCID logo
Stanislav Ondrášek
Matyáš Hric

Abstract

PROBLEM: Atopic eczema is linked with several other psychosomatic diseases and disorders like sleeping disorders or low quality, chronic itching, etc. First, it is important to define two related terms that are important not to confuse, namely ADHD and ADD. Both of these attention disorders are inherited neurodevelopmental disorders. ADD is characterized by loss of concentration, distraction, and emotional hypersensitivity. ADHD is an attention deficit hyperactivity disorder. It is characterized by inattention, hyperactivity, and impulsivity. The survey study aims at describing the relation of two variables – atopic eczema and attention. Based on the results of the available studies dealing with the said relation, the topic will be presented to the reader and the existing pieces of knowledge will be summarized.

METHODS: The study worked with sources from available scientific databases: PubMed, PsycInfo, Scopus, and Web of Science. The following keywords were entered for search: atopic eczema, ADHD, ADD, attention, relation. Another criterion selected for search was the period of observation, which we set without determination; that decision was based on the fact that the topic in question is specific. The studies were selected based on their relevance for the goal set. 10 studies were analyzed in total.

RESULTS: The analysis results show that studies dealing with the issue of the effect of atopic eczema can be divided into two groups. The first group consists of studies which state, based on research, that persons with diagnosed atopic eczema are endangered by attention disorders. While comparing them with healthy population, i.e., with persons without atopic eczema, it was found that persons with atopic eczema have higher proportional chance of attention disorders, and other health problems linked with the said disease, like low quality of sleep, anxieties, depressions or behaviour disorders were registered as well. The studies under analysis also mention a risk period that may be essential for the development of attention disorder. The other group consists of studies which did not demonstrate a direct causal relation between attention eczema and attention disorders, which, if demonstrated, could lead to setting of preventive and therapeutic plans. The results of some of these studies show the coexistence of atopic eczema and ADHD, but the authors state that both disorders may not have causal relation and that they may be influenced by other factors; they recommend other studies which could clarify the prevalence of ADHD in persons with atopic eczema.

DISCUSSION AND CONCLUSION: In conclusion, it can be stated that there is a higher risk of attention disorder, ADHD, in individuals with atopic eczema. However, as studies show, a causal relation between the two variables in question has not been found yet. The results have also shown that this issue is still little explored, in spite of the fact that a number of studies had a large research set. Therefore, further extensive interdisciplinary studies are needed, in order to prove or disprove their mutual causal relation. In case of proving the causal relation, it is further recommended to proceed to determine preventive and therapeutic strategies for attention disorders caused by atopic eczema, in order to positively influence the resulting quality of life of the individuals with the said disorder type.

https://doi.org/10.29364/epsy.411

(Fulltext in Czech)

Keywords

atopic eczema, attention, ADHD, ADD

Literature

Absolon, C. M., Cottrell, D., Eldridge, S. M., & Glover, M. T. (1997). Psychological disturbance in atopic eczema: The extent of the problem in school‐aged children. British Journal of Dermatology, 137(2), 241–245. https://doi.org/…7.18121896.x

National Institute for Health and Care Excellence. (2018, update September 2019). Attention deficit hyperactivity disorder: Diagnosis and management. NICE Guideline, No. 87. https://www.ncbi.nlm.nih.gov/…s/NBK493361/

Buske-Kirschbaum, A., Schmitt, J., Plessow, F., Romanos, M., Weidinger, S., & Roessner, V. (2013). Psychoendocrine and psychoneuroim­munological mechanisms in the comorbidity of atopic eczema and attention deficit/hyperac­tivity disorder. Psychoneuroen­docrinology, 38(1), 12–23. https://doi,org/….2012.09.017

Buske-Kirschbaum, A., Trikojat, K., Tesch, F., Schmitt, J, Roessner, V., Luksch, H., Rösen-Wolff, A., & Plessow, F. (2018). Altered hypothalamus-pituitary-adrenal axis function: A relevant factor in the comorbidity of atopic eczema and attention deficit/hyperac­tivity disorder? Psychoneuroen­docrinology, 105, 178–186. https://doi.org/….2018.12.005

Genuneit, J., Braig, S., Brandt, S., Wabitsch, M., Florath, I., Brenner, H., & Rothenbacher, D. (2014). Infant atopic eczema and subsequent attention-deficit/hyperac­tivity disorder – A prospective birth cohort study. Pediatric Allergy and Immunology, 25(1), 51–56. https://doi.org/…11/pai.12152

Grönhagen, C., Lidén, C., Wahlgren, C., Ballardini, N., Bergström, A., Kull, I., & Meding, B. (2015). Hand eczema and atopic dermatitis in adolescents: A prospective cohort study from the BAMSE project. British Journal of Dermatology, 173(5), 1175–1182. https://doi.org/…11/bjd.14019

Hallowell, E. M., & Ratey, J. J. (2010). Answers to distraction. Anchor Books.

Lee, C., Chen, M., Jeng, M., Hsu, J., Tsai, S., Bai, Y., Hung, G., Yen, H., Chen, T., & Su, T. (2016). Longitudinal association between early atopic dermatitis and subsequent attention-deficit or autistic disorder. Medicine, 95(39). https://doi.org/…000000005005

Meng, J., & Steinhoff, M. (2016). Molecular mechanisms of pruritus. Current Research in Translational Medicine, 64(4), 203–206. https://doi.org/….2016.08.006

MKN-10: Mezinárodní statistická klasifikace nemocí a přidružených zdravotních problémů: Desátá revize: Obsahová aktualizace k 1. 1. 2018. (2020). Ústav zdravotnických informací a statistiky ČR.

Noda, S., Suárez-Fariñas, M., Ungar, B., Kim, S. J., Strong, C. D., Xu, H., & Guttman-Yassky, E. (2015). The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization. Journal of Allergy and Clinical Immunology, 136(5), 1254–1264. https://doi:10.1016/j.jaci.2015.08.015

Paller, A., Jaworski, J. C., Simpson, E. L., Boguniewicz, M., Russell, J. J., Block, J. K., Tofte, S., Dunn, J. D., Feldman, S. R., Clark, A. R., Schwartz, G., & Eichenfield, L. F. (2018). Major comorbidities of atopic dermatitis: Beyond allergic disorders. American Journal of Clinical Dermatology, 19(6), 821–838. https://doi.org/…7-018-0383-4

Pelletier, E. (2014). Porucha pozornosti bez hyperaktivity: Pomoc rodičům a učitelům. Portál.

Riis, J. L., Vestergaard, C., Deleuran, M. S., & Olsen, M. (2016). Childhood atopic dermatitis and risk of attention deficit/hyperac­tivity disorder: A cohort study. Journal of Allergy and Clinical Immunology, 138(2), 608–610. https://doi.org/….2016.01.027

Schmitt, J. (2009). Atopic eczema and attention-deficit/hyperac­tivity disorder in a population-based sample of children and adolescents. Jama, 301(7), 724. https://doi.org/…ama.2009.136

Schmitt, J., Buske-Kirschbaum, A., & Roessner, V. (2010). Is atopic disease a risk factor for attention-deficit/hyperac­tivity disorder? A systematic review. Allergy, 65(12), 1506–1524. https://doi.org/…2010.02449.x

Schmitt, J., Spuls, P. I., Thomas, K. S., Simpson, E., Furue, M., Deckert, S., & Williams, H. C. (2014). The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials. Journal of Allergy and Clinical Immunology, 134(4), 800–807. https://doi.org/….2014.07.043

Schmitt, J., Buske-Kirschbaum, A., Tesch, F., Trikojat, K., Stephan, V., Abraham, S., & Roessner, V. (2017). Increased attention-deficit/hyperac­tivity symptoms in atopic dermatitis are associated with history of antihistamine use. Allergy, 73(3), 615–626. https://doi.org/…11/all.13326

Silverberg, J. I. (2017). Selected comorbidities of atopic dermatitis: Atopy, neuropsychiatric, and musculoskeletal disorders. Clinics in Dermatology, 35(4), 360–366. https://doi.org/….2017.03.008

Silverberg, J. I. (2019). Comorbidities and the impact of atopic dermatitis. Annals of Allergy, Asthma & Immunology, 123(2), 144–151. https://doi.org/….2019.04.020

Simpson, E. L. (2012). Comorbidity in atopic dermatitis. Current dermatology reports, 1(1), 29–38. https://doi.org/…1-011-0003-5

Simpson, E. L., Villarreal, M., Jepson, B., Rafaels, N., David, G., Hanifin, J., & Beck, L. A. (2018). Patients with atopic dermatitis colonized with staphylococcus aureus have a distinct phenotype and endotype. Journal of Investigative Dermatology, 138(10), 2224–2233. https://doi.org/…2018.03.1517

Strom, M. A., Fishbein, A. B., Paller, A. S., & Silverberg, J. I. (2016). Association between atopic dermatitis and attention deficit hyperactivity disorder in U.S. children and adults. British Journal of Dermatology, 175(5), 920–929. https://doi.org/…11/bjd.14697

Theiner, P. (2012). ADHD od dětství do dospělosti. Psychiatrie pro praxi, 13(4), 148–150.

Tsai, J., Chang, S., Mou, C., Sung, F., & Lue, K. (2013). Association between atopic diseases and attention-deficit/hyperac­tivity disorder in childhood: A population-based case-control study. Annals of Epidemiology, 23(4), 185–188. https://doi.org/….2012.12.015

Tsakok, T., Woolf, R., Smith, C.H., Weidinger, S., & Flohr, C. (2019). Atopic dermatitis: The skin barrier and beyond. British Journal of Dermatology, 180(3), 464–474. https://doi.org/…11/bjd.16934

Vachiramon, V., Tey, H., Thompson, A. E., & Yosipovitch, G. (2012). Atopic dermatitis in African American children: Addressing unmet needs of a common disease. Pediatric Dermatology, 29(4), 395–402. https://doi.org/…2012.01740.x

van der Schans, J., Cicek, R., de Vries. T.W. et al. (2017). Association of atopic diseases and attention-deficit/hyperac­tivity disorder: A systematic review and meta-analyses. Neuroscience and Biobehavioral Reviews, 74, 139–148. https://doi.org/….2017.01.011

Weidinger, S., Beck, L. A., Bieber, T., Kabashima, K., & Irvine, A. D. (2018). Atopic dermatitis. Nature Reviews Disease Primers, 4(1). https://doi.org/…2-018-0001-z

Yaghmaie, P., Koudelka, C. W., & Simpson, E. L. (2013). Mental health comorbidity in patients with atopic dermatitis. Journal of Allergy and Clinical Immunology, 131(2), 428–433. https://doi.org/….2012.10.041

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