LAUSR

The aim of this study was to assess the burden of atopic dermatitis (AD) in terms of disability adjusted life years (DALY), mental comorbidity, academic attainment, and ability to work. A population-based, cross-sectional questionnaire study was performed among 34,313 randomly selected adults from central Sweden in 2017. The prevalence of AD was 14% and DALY score 527 (uncertainty interval 305-826). Adults with mild AD had an increased relative risk ratio (RRR) of severe depression (adjusted RRR; aRRR 1.78, 95% confidence interval (95% CI) 1.50-2.12) and anxiety (aRRR 1.97, 95% CI 1.69-2.30), which was higher for severe AD (aRRR 6.22 95% CI 4.60-8.42, aRRR 5.62 95% CI 4.10-7.71, respectively). Adjustments (aRRR) were made for sex, age group and highest level of education achieved. Persons with severe AD were less likely to have a university degree (aRRR 0.55, 95% CI 0.34-0.90) and a lower annual income (238,000-324,000 SEK: aRRR 0.51, 95% CI 0.39-0.77; 325,000 SEK or more 0.36; 0.25-0.58) compared with individuals without AD. For individuals with both AD and asthma, the relationship with both diagnosed depression (adjusted odds ratio (aOR) 1.52, 95% CI 1.35-1.72; 3.51, 2.87-4.30) and anxiety (aOR 1.60, 95% CI 1.48-1.73; 2.31, 1.96-2.72) was stronger compared with those with AD only. These results suggest that AD implies an increased prevalence of comorbid mental conditions and an adverse impact on academic achievement and work. These adverse associations increase substantially for patients with severe AD and comorbid asthma.