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Family burden of hospital-managed pediatric atopic dermatitis: A nationwide registry-based study
Ida Vittrup1,2,3, Catherine Droitcourt1,2,4,5, Yuki M F Andersen1,2
1Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.
Insights
Parents of children with atopic dermatitis (AD) experience increased risks for mental health issues and divorce. The family
Area of Science:
- Dermatology
- Psychiatry
- Public Health
Background:
- Atopic dermatitis (AD) significantly impacts parental quality of life and stress.
- Parental stress associated with AD may elevate risks for psychiatric disorders, pain conditions, and increased medication use.
Purpose of the Study:
- To investigate the association between pediatric atopic dermatitis (AD) and mental health outcomes, medication use, and divorce in family members.
- To assess the impact of AD on parents and siblings, utilizing Danish national registry data.
Main Methods:
- Utilized Danish national registries to identify families of children diagnosed with hospital-managed AD.
- Matched cases (children with AD) 1:10 with control families (children without AD).
- Followed cohorts over time to analyze risks for psychiatric diagnoses, medication prescriptions, and divorce.
Main Results:
- Mothers of children with AD showed higher risks for prescriptions for depression, anxiety, pain, and sleep issues, and psychologist consultations, though most associations attenuated after adjustment.
- Siblings had an increased risk of adjustment disorder diagnoses.
- Fathers exhibited increased risks for pain medication prescriptions and divorce in unadjusted models.
Conclusions:
- The heightened risks observed in mothers of children with AD are not solely attributable to pediatric AD but are influenced by the overall family burden, including parental and child morbidity and socioeconomic factors.
- The comprehensive family burden associated with childhood AD may impact the overall management of the child's condition.
Background:
Parents of children with atopic dermatitis (AD) report reduced quality of life and higher stress level, which could increase risk of psychiatric and pain disorders, and medication use.
Methods:
By use of Danish national registries, we identified family members of all first-born Danish children born between 1 January 1995 and 31 December 2013 with a hospital diagnosis of AD, matched them 1:10 with family members of children without AD, and followed the cohorts over time.
Results:
Mothers of children with hospital-managed AD had higher risk of filling a prescription for medications for depression, anxiety, pain and sleep problems, and of consulting a psychologist, but most associations disappeared after full adjustment. Siblings had higher risk of receiving a diagnosis for adjustment disorder, and fathers showed increased risk of filling a prescription for pain medication and of divorce, in crude but not adjusted models.
Conclusions:
The increased risk of study endpoints seen in mothers of children with hospital-managed AD was not explained by pediatric AD alone. Rather, the total burden in these families including parent and child morbidity and socioeconomic resources seems to explain these observations. The burden in families of children with AD may potentially affect the overall management of their child's AD.
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