Why is there an association between eczema and common mental disorders?

Abstract

Aims

The objective of the study is to explore suggested explanatory models for the association between eczema, anxiety and depression, and examine the extent of impairment resulting from eczema by comparing it to impairment from mental disorders and asthma.

Methods

Data were gathered from the Health Study of Hordaland County (HUSK) in Norway including 18777 participants aged 41-48 years. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS), while information on eczema, asthma, socio-economical factors, somatic diagnoses and psychosomatic health variables was obtained by self-report. Immunoglobuline-E (IgE) concentration was measured in a female sub-sample (N=374). Impairment from eczema and asthma was assessed by registry information on long-term sick-leave during four years follow-up. Statistical methods included uni- and multivariate regression models, and Population Attributable Fractions (PAFs) were calculated.

Results

Significant associations were found between eczema and anxiety and depression (OR=1.48 for eczema and co-morbid anxiety/depression). Tendency of somatisation explained about 2/3 of the association between eczema, anxiety and depression. IgE did not contribute in the association. Eczema increased the risk of long-term sick-leave during follow-up. Impairment from eczema was partly explained by adjustment for psychosomatic and mental factors, which was not the case for asthma.

Conclusions

The tendency of somatisation seems to explain much of the association between eczema and common mental disorders. Tendency of somatisation and common mental disorders also explain much of the impairment following eczema, which is not found for impairment from asthma. In summary, our study underlines the relevance of psychosomatics in eczema.