Katie Kosko

Urban Health Today

Children with inflammatory skin diseases, such as acute or chronic urticaria, are at greater risk for sleep and psychological disorders, according to recent research. 
The retrospective analysis, which was published in the Journal of the American Academy of Dermatology, examined mental health and sleep function in a pediatric population who had received a diagnosis of atopic dermatitis (AD), psoriasis, or urticaria (acute or chronic). 
Researchers used electronic health records from the US Collaborative Network to collect data from patients aged 5 to 17 from 55 health care providers. They established 4 cohorts: AD, psoriasis, urticaria, or control.
All patients were matched for age, race, ethnicity, gender, overweight/obesity, family history of mental and behavioral disorders, and family history of intellectual disabilities. 
Children with psoriasis were a mean age of 11.7 years, followed by 10.1 years in children with urticaria and 9.9 years with AD. More than half of the population were female (55%) and 60% were non-Hispanic or Latino. Propensity score matching resulted in 79,673 matched children with AD, 28,365 with psoriasis, and 82,452 with urticaria.
Researchers observed that children with psoriasis had a 2.1-fold higher risk for sleep apnea and a 1.8-fold higher risk for fatigue. 
In children with urticaria and AD, the risk for sleep disorders was 1.7-fold higher and 1.4-fold higher for insomnia. Moreover, hypersomnia displayed an increased risk in all 3 diseases (psoriasis 3.2-fold; urticaria 1.9-fold; and AD 1.4-fold). 
Regarding psychological diseases, all cohorts showed an increased risk for depression and anxiety. Children with psoriasis had the highest risk of depression (1.9-fold), while anxiety was highest in children with urticaria (1.6-fold). Furthermore, patients with urticaria had the highest incidence of pain compared with the other cohorts. 
In addition, differences were also seen among genders. Girls were at higher risk of developing insomnia, depression, fatigue, and pain compared with boys. Specifically, girls with urticaria suffered more from depression and anxiety disorders.
“Children, in particular, have a significant need for screenings of these comorbidities, which should be implemented in routine care,” the researchers said. “Untreated sleep disorders can not only cause cardiovascular and psychological disorders, but also possibly result in reduced school performance, underachievement, and overall reduced quality of life.”
Regular screenings and appropriate treatment may help prevent mental and health consequences because of these inflammatory skin diseases, the researchers said.

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