Eczema patients at higher risk of Suicide : JAMA

A new study published in the journal JAMA Dermatology has reported that patients with Atopic dermatitis (AD) commonly known as Eczema, have a significantly greater risk of suicidal ideation and suicide attempts.

Atopic dermatitis or Eczema is linked to multiple physical comorbidities, such as asthma, allergic rhinitis, metabolic syndrome, and sleep disturbances, which all contribute to the overall physical burden of the disease. Many patients with AD have a profound psychosocial burden. Because of the visibility of the disease, patients may experience shame and embarrassment. It is also reported that children with AD perform significantly worse in academics compared with healthy children.

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Atopic dermatitis or Eczema has been associated with depression and anxiety but there is no substantial evidence for an association between AD and suicidality. Suicidality encompasses the following 3 components: suicidal ideation, suicide attempts, and completed suicides. Suicidal ideation refers to having thoughts of or planning for suicide. Suicide attempts refer to acts of attempting suicide where the individual survives. Completed suicides refer to successful suicide attempts that lead to patient death.

Jeena K. Sandhu and associates performed a meta-analysis to find whether there is there an increased risk of suicidality among patients with atopic dermatitis.

The investigators extracted the data from PRISMA guidelines, PubMed, Embase, PsycINFO, and Cochrane databases from 1946 to May 25, 2018. The meta-analysis performed included observational studies that evaluated suicidal ideation, suicide attempts, and completed suicide among patients with AD. The researchers reviewed 15 studies conducted in Europe, Africa (n = 1), North America (n = 1), and Asia (n = 7) published over the past 20 years, including a total of 4,770,767 participants. Among them, 310,681 were AD patients (52.7% female) and 4,460,086 served as controls (50.9% female).

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The researchers found that when compared with individuals who did not have AD, patients with the condition had a 36% greater chance of attempting suicide as well as 44% greater chance of having suicidal thoughts.

Data from the analysis showed inconsistencies when it came to completed suicides in patients with AD.

Studies also showed varying results for suicidal thoughts and attempts, with some indicating significant risk associated with AD across the board, whiles others found increased risk only for certain subgroups such as female children.

The authors concluded that dermatologists should be aware of the potential risk, screen for suicidality in patients with AD, and make appropriate referrals to mental health professionals if required.

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https://jamanetwork.com/journals/jamadermatology/fullarticle/2717582