Atopic dermatitis in adolescents: assessment of quality of life, anxiety, and depression levels
Main Article Content
Keywords
adolescents, anxiety, atopic dermatitis, depression, quality of life
Abstract
The current study evaluated the quality of life, anxiety, and depression in adolescents diagnosed with atopic dermatitis. Adolescents diagnosed with atopic dermatitis (AD) (n = 25) who were not receiving regular treatment were compared with 41 healthy adolescents. Disease severity in adolescents with AD was evaluated using the Scoring Atopic Dermatitis (SCORAD) index and the Children’s Dermatology Life Quality Index (CDLQI). In both groups, depression and anxiety were assessed using the Beck Depression and Anxiety Scales. Results indicated that quality of life was severely affected (Median = 16.0, AD group). The mean anxiety and depression scores were 34.0 and 16.0, respectively, in the AD group, and 35.0 and 11.0, respectively, in the control group. Pruritus severity was significantly correlated with both anxiety (r = 0.524, p = 0.01) and depression (r = 0.472, p = 0.02). Quality of life decreased in adolescents with AD, while signs and symptoms of anxiety and depression were more prevalent. The results also revealed a significant relationship between pruritus severity and psychological burden. These findings suggest that it is important to evaluate patients with AD using a holistic approach, not solely based on dermatological assessment but in concert with psychosocial needs.
References
1 Kim J, Kim BE, Leung DYM. Pathophysiology of atopic dermatitis: clinical implications. Allergy Asthma Proc. 2019. 10.2500/aap.2019.40.4202
2 Raimondo A, Lembo S. Atopic dermatitis: epidemiology and clinical phenotypes. Dermatol Pract Concept. 2021;11(4). 10.5826/dpc.1104a146
3 Langan SM, Mulick AR, Rutter CE, Silverwood RJ, Asher I, García-Marcos L, et al. Trends in eczema prevalence in children and adolescents: a Global Asthma Network Phase I Study. Clin Exp Allergy. 2023;53(3). 10.1111/cea.14276
4 Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: an analysis using the National Health and Wellness Survey. J Am Acad Dermatol. 2017;77(2). 10.1016/j.jaad.2017.04.019
5 Silverberg JI, Gelfand JM, Margolis DJ, Boguniewicz M, Fonacier L, Grayson MH, et al. Patient burden and quality of life in atopic dermatitis in US adults: a population-based cross-sectional study. Ann Allergy Asthma Immunol. 2018;121(3). 10.1016/j.anai.2018.07.006
6 Chamlin SL. The psychosocial burden of childhood atopic dermatitis. Dermatol Ther. 2006;19. 10.1111/j.1529-8019.2006.00060.x
7 Yaghmaie P, Koudelka CW, Simpson EL. Mental health comorbidity in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2). 10.1016/j.jaci.2012.10.041
8 Brown MM, Chamlin SL, Smidt AC. Quality of life in pediatric dermatology. Dermatol Clin. 2013;31. 10.1016/j.det.2012.12.010
9 Ma EZ, Hooper SR, Seegan PL, Wan J. Association of atopic dermatitis with emotional and behavioral problems in childhood. J Am Acad Dermatol. 2024;90(6). 10.1016/j.jaad.2024.01.068
10 LeBovidge JS, Elverson W, Timmons KG, Hawryluk EB, Rea C, Lee M, et al. Multidisciplinary interventions in the management of atopic dermatitis. J Allergy Clin Immunol. 2016;138. 10.1016/j.jaci.2016.04.003
11 Kim SH, Hur J, Jang JY, Park HS, Hong CH, Son SJ, et al. Psychological distress in young adult males with atopic dermatitis: a cross-sectional study. Medicine (Baltimore). 2015;94(23). 10.1097/MD.0000000000000949
12 Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol. 1980;60. 10.2340/00015555924447
13 Stalder JF, Taïeb A, Atherton DJ, Bieber P, Bonifazi E, Broberg A, et al. Severity scoring of atopic dermatitis: the SCORAD index: consensus report of the European Task Force on Atopic Dermatitis. Dermatology. 1993;186(1). 10.1159/000247298
14 Yosipovitch G, Reaney M, Mastey V, Eckert L, Abbé A, Nelson L, et al. Peak pruritus numerical rating scale: psychometric validation and responder definition for assessing itch in moderate-to-severe atopic dermatitis. British Journal of Dermatology. 2019;181(4). 10.1111/bjd.17744
15 Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3). 10.1111/j.1365-2230.1994.tb01167.x
16 Öztürkcan S, Ermertcan AT, Eser E, Turhan Şahin M. Cross validation of the Turkish version of the Dermatology Life Quality Index. Int J Dermatol. 2006;45(11). 10.1111/j.1365-4632.2006.02881.x
17 Lewis-Jones MS, Finlay AY. The Children’s Dermatology Life Quality Index (CDLQI): initial validation and practical use. Br J Dermatol. 1995;132(6). 10.1111/j.1365-2133.1995.tb16953.x
18 Van Geel MJ, Maatkamp M, Oostveen AM, De Jong EMGJ, Finlay AY, Van De Kerkhof PCM, et al. Comparison of the Dermatology Life Quality Index and the Children’s Dermatology Life Quality Index in assessment of quality of life in patients with psoriasis aged 16–17 years. Br J Dermatol. 2016;174(1). 10.1111/bjd.14163
19 Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6). 10.1001/archpsyc.1961.01710120031004
20 Hisli N. Beck Depresyon Envanteri’nin geçerliği üzerine bir çalışma. Psikoloji Dergisi. 1988;11.
21 Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother. 1998;12(2).
22 Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6). 10.1037/0022-006X.56.6.893
23 Landis ET, Davis SA, Taheri A, Feldman SR. Top dermatologic diagnoses by age. Dermatol Online J. 2014;20(4). 10.5070/D3204022368
24 Salava A, Rieppo R, Lauerma A, Salo V. Age-dependent distribution of atopic dermatitis in primary care: a nationwide population-based study from Finland. Acta Derm Venereol. 2022;102. 10.2340/actadv.v102.2287
25 Aynalem MW, Berha AB. Assessment of quality of life, treatment practices, and associated factors among children of atopic dermatitis patients at All Africa Leprosy, TB and Rehabilitation Training Center (A.L.E.R.T): a prospective observational study. BMC Pediatr. 2025;25(1). 10.1186/s12887-025-05616-6
26 El Achkar Mello ME, Simoni AG, Rupp ML, de Azevedo Simões PWT, de Souza Pires MM. Quality of life of pediatric patients with atopic dermatitis and their caregivers. Arch Dermatol Res. 2023;315(6). 10.1007/s00403-023-02544-2
27 Ben-Gashir MA, Seed PT, Hay RJ. Quality of life and disease severity are correlated in children with atopic dermatitis. Br J Dermatol. 2004;150(2). 10.1111/j.1365-2133.2004.05776.x
28 Kim DH, Li K, Seo SJ, Jo SJ, Yim HW, Kim CM, et al. Quality of life and disease severity are correlated in patients with atopic dermatitis. J Korean Med Sci. 2012;27(11). 10.3346/jkms.2012.27.11.1327
29 Monti F, Agostini F, Gobbi F, Neri E, Schianchi S, Arcangeli F. Quality of life measures in Italian children with atopic dermatitis and their families. Ital J Pediatr. 2011;37(1). 10.1186/1824-7288-37-59
30 Kiebert G, Sorensen SV, Revicki D, Fagan SC, Doyle JJ, Cohen J, et al. Atopic dermatitis is associated with a decrement in health-related quality of life. Int J Dermatol. 2002. 10.1046/j.1365-4362.2002.01436.x
31 Ng MSY, Tan S, Chan NHQ, Foong AYW, Koh MJA. Effect of atopic dermatitis on quality of life and its psychosocial impact in Asian adolescents. Australas J Dermatol. 2018;59(2). 10.1111/ajd.12632
32 Rea CJ, Tran KD, Jorina M, Wenren LM, Hawryluk EB, Toomey SL. Associations of eczema severity and parent knowledge with child quality of life in a pediatric primary care population. Clin Pediatr (Phila). 2018;57(13). 10.1177/0009922818787295
33 Đurović MR, Janković J, Spirić VT, Relić M, Timotijević ZS, Ćirković A, et al. Does age influence the quality of life in children with atopic dermatitis? PLoS One. 2019;14(11). 10.1371/journal.pone.0224618
34 Xu X, van Galen LS, Koh MJA, Bajpai R, Thng S, Yew YW, et al. Factors influencing quality of life in children with atopic dermatitis and their caregivers: a cross-sectional study. Sci Rep. 2019;9(1). 10.1038/s41598-019-51129-5
35 World Health Organization. Adolescent mental health [Internet]. World Health Organization; 2025 Sep 1 [cited 2025 Sep 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
36 Mann C, Wollenberg A, Ständer S, Staubach P, Thaçi D, Zirpel H. Risk of developing sleep disorders and psychologic comorbidity in children with inflammatory skin diseases: a population-based study. J Am Acad Dermatol. 2025. 10.1016/j.jaad.2025.02.001
37 Yaghmaie P, Koudelka CW, Simpson EL. Mental health comorbidity in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2). 10.1016/j.jaci.2012.10.041
38 Slattery MJ, Essex MJ, Paletz EM, Vanness ER, Infante M, Rogers GM, et al. Depression, anxiety, and dermatologic quality of life in adolescents with atopic dermatitis. J Allergy Clin Immunol. 2011;128(3). 10.1016/j.jaci.2011.05.003
39 Hashiro M, Okumura M. Anxiety, depression and psychosomatic symptoms in patients with atopic dermatitis: comparison with normal controls and among groups of different degrees of severity. J Dermatol Sci. 1997;14(1). 10.1016/S0923-1811(96)00553-1
40 Ahn HJ, Shin MK, Seo JK, Jeong SJ, Cho AR, Choi SH, et al. Cross-sectional study of psychiatric comorbidities in patients with atopic dermatitis and nonatopic eczema, urticaria, and psoriasis. Neuropsychiatr Dis Treat. 2019;15. 10.2147/NDT.S191509
41 Ullman KC, Moore RW, Reidy M. Atopic eczema: a clinical psychiatric study. J Asthma Res. 1977;14(2). 10.3109/02770907709098955
42 Gupta MA, Gupta AK, Schork NJ, Ellis CN. Depression modulates pruritus perception: a study of pruritus in psoriasis, atopic dermatitis, and chronic idiopathic urticaria. Psychosom Med. 1994;56(1). 10.1097/00006842-199401000-00005
43 Zachariae R, Lei U, Haedersdal M, Zachariae C. Itch severity and quality of life in patients with pruritus: preliminary validity of a Danish adaptation of the itch severity scale. Acta Derm Venereol. 2012;92(5). 10.2340/00015555-1221
44 Scheich G, Florin I, Rudolph R, Wilhelm S. Personality characteristics and serum IgE level in patients with atopic dermatitis. J Psychosom Res. 1993;37(6). 10.1016/0022-3999(93)90058-N
45 Blanco Sequeiros A, Sinikumpu SP, Jokelainen J, Huilaja L. Psychiatric comorbidities of childhood-onset atopic dermatitis in relation to eczema severity: a register-based study among 28,000 subjects in Finland. Acta Derm Venereol. 2024; 104:adv40790. 10.2340/actadv.v104.40790
46 Kern C, Wan J, Lewinn KZ, Ramirez FD, Lee Y, McCulloch CE, et al. Association of atopic dermatitis and mental health outcomes across childhood: a longitudinal cohort study. JAMA Dermatol. 2021;157(10). 10.1001/jamadermatol.2021.2657
2 Raimondo A, Lembo S. Atopic dermatitis: epidemiology and clinical phenotypes. Dermatol Pract Concept. 2021;11(4). 10.5826/dpc.1104a146
3 Langan SM, Mulick AR, Rutter CE, Silverwood RJ, Asher I, García-Marcos L, et al. Trends in eczema prevalence in children and adolescents: a Global Asthma Network Phase I Study. Clin Exp Allergy. 2023;53(3). 10.1111/cea.14276
4 Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: an analysis using the National Health and Wellness Survey. J Am Acad Dermatol. 2017;77(2). 10.1016/j.jaad.2017.04.019
5 Silverberg JI, Gelfand JM, Margolis DJ, Boguniewicz M, Fonacier L, Grayson MH, et al. Patient burden and quality of life in atopic dermatitis in US adults: a population-based cross-sectional study. Ann Allergy Asthma Immunol. 2018;121(3). 10.1016/j.anai.2018.07.006
6 Chamlin SL. The psychosocial burden of childhood atopic dermatitis. Dermatol Ther. 2006;19. 10.1111/j.1529-8019.2006.00060.x
7 Yaghmaie P, Koudelka CW, Simpson EL. Mental health comorbidity in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2). 10.1016/j.jaci.2012.10.041
8 Brown MM, Chamlin SL, Smidt AC. Quality of life in pediatric dermatology. Dermatol Clin. 2013;31. 10.1016/j.det.2012.12.010
9 Ma EZ, Hooper SR, Seegan PL, Wan J. Association of atopic dermatitis with emotional and behavioral problems in childhood. J Am Acad Dermatol. 2024;90(6). 10.1016/j.jaad.2024.01.068
10 LeBovidge JS, Elverson W, Timmons KG, Hawryluk EB, Rea C, Lee M, et al. Multidisciplinary interventions in the management of atopic dermatitis. J Allergy Clin Immunol. 2016;138. 10.1016/j.jaci.2016.04.003
11 Kim SH, Hur J, Jang JY, Park HS, Hong CH, Son SJ, et al. Psychological distress in young adult males with atopic dermatitis: a cross-sectional study. Medicine (Baltimore). 2015;94(23). 10.1097/MD.0000000000000949
12 Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol. 1980;60. 10.2340/00015555924447
13 Stalder JF, Taïeb A, Atherton DJ, Bieber P, Bonifazi E, Broberg A, et al. Severity scoring of atopic dermatitis: the SCORAD index: consensus report of the European Task Force on Atopic Dermatitis. Dermatology. 1993;186(1). 10.1159/000247298
14 Yosipovitch G, Reaney M, Mastey V, Eckert L, Abbé A, Nelson L, et al. Peak pruritus numerical rating scale: psychometric validation and responder definition for assessing itch in moderate-to-severe atopic dermatitis. British Journal of Dermatology. 2019;181(4). 10.1111/bjd.17744
15 Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3). 10.1111/j.1365-2230.1994.tb01167.x
16 Öztürkcan S, Ermertcan AT, Eser E, Turhan Şahin M. Cross validation of the Turkish version of the Dermatology Life Quality Index. Int J Dermatol. 2006;45(11). 10.1111/j.1365-4632.2006.02881.x
17 Lewis-Jones MS, Finlay AY. The Children’s Dermatology Life Quality Index (CDLQI): initial validation and practical use. Br J Dermatol. 1995;132(6). 10.1111/j.1365-2133.1995.tb16953.x
18 Van Geel MJ, Maatkamp M, Oostveen AM, De Jong EMGJ, Finlay AY, Van De Kerkhof PCM, et al. Comparison of the Dermatology Life Quality Index and the Children’s Dermatology Life Quality Index in assessment of quality of life in patients with psoriasis aged 16–17 years. Br J Dermatol. 2016;174(1). 10.1111/bjd.14163
19 Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6). 10.1001/archpsyc.1961.01710120031004
20 Hisli N. Beck Depresyon Envanteri’nin geçerliği üzerine bir çalışma. Psikoloji Dergisi. 1988;11.
21 Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother. 1998;12(2).
22 Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6). 10.1037/0022-006X.56.6.893
23 Landis ET, Davis SA, Taheri A, Feldman SR. Top dermatologic diagnoses by age. Dermatol Online J. 2014;20(4). 10.5070/D3204022368
24 Salava A, Rieppo R, Lauerma A, Salo V. Age-dependent distribution of atopic dermatitis in primary care: a nationwide population-based study from Finland. Acta Derm Venereol. 2022;102. 10.2340/actadv.v102.2287
25 Aynalem MW, Berha AB. Assessment of quality of life, treatment practices, and associated factors among children of atopic dermatitis patients at All Africa Leprosy, TB and Rehabilitation Training Center (A.L.E.R.T): a prospective observational study. BMC Pediatr. 2025;25(1). 10.1186/s12887-025-05616-6
26 El Achkar Mello ME, Simoni AG, Rupp ML, de Azevedo Simões PWT, de Souza Pires MM. Quality of life of pediatric patients with atopic dermatitis and their caregivers. Arch Dermatol Res. 2023;315(6). 10.1007/s00403-023-02544-2
27 Ben-Gashir MA, Seed PT, Hay RJ. Quality of life and disease severity are correlated in children with atopic dermatitis. Br J Dermatol. 2004;150(2). 10.1111/j.1365-2133.2004.05776.x
28 Kim DH, Li K, Seo SJ, Jo SJ, Yim HW, Kim CM, et al. Quality of life and disease severity are correlated in patients with atopic dermatitis. J Korean Med Sci. 2012;27(11). 10.3346/jkms.2012.27.11.1327
29 Monti F, Agostini F, Gobbi F, Neri E, Schianchi S, Arcangeli F. Quality of life measures in Italian children with atopic dermatitis and their families. Ital J Pediatr. 2011;37(1). 10.1186/1824-7288-37-59
30 Kiebert G, Sorensen SV, Revicki D, Fagan SC, Doyle JJ, Cohen J, et al. Atopic dermatitis is associated with a decrement in health-related quality of life. Int J Dermatol. 2002. 10.1046/j.1365-4362.2002.01436.x
31 Ng MSY, Tan S, Chan NHQ, Foong AYW, Koh MJA. Effect of atopic dermatitis on quality of life and its psychosocial impact in Asian adolescents. Australas J Dermatol. 2018;59(2). 10.1111/ajd.12632
32 Rea CJ, Tran KD, Jorina M, Wenren LM, Hawryluk EB, Toomey SL. Associations of eczema severity and parent knowledge with child quality of life in a pediatric primary care population. Clin Pediatr (Phila). 2018;57(13). 10.1177/0009922818787295
33 Đurović MR, Janković J, Spirić VT, Relić M, Timotijević ZS, Ćirković A, et al. Does age influence the quality of life in children with atopic dermatitis? PLoS One. 2019;14(11). 10.1371/journal.pone.0224618
34 Xu X, van Galen LS, Koh MJA, Bajpai R, Thng S, Yew YW, et al. Factors influencing quality of life in children with atopic dermatitis and their caregivers: a cross-sectional study. Sci Rep. 2019;9(1). 10.1038/s41598-019-51129-5
35 World Health Organization. Adolescent mental health [Internet]. World Health Organization; 2025 Sep 1 [cited 2025 Sep 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
36 Mann C, Wollenberg A, Ständer S, Staubach P, Thaçi D, Zirpel H. Risk of developing sleep disorders and psychologic comorbidity in children with inflammatory skin diseases: a population-based study. J Am Acad Dermatol. 2025. 10.1016/j.jaad.2025.02.001
37 Yaghmaie P, Koudelka CW, Simpson EL. Mental health comorbidity in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2). 10.1016/j.jaci.2012.10.041
38 Slattery MJ, Essex MJ, Paletz EM, Vanness ER, Infante M, Rogers GM, et al. Depression, anxiety, and dermatologic quality of life in adolescents with atopic dermatitis. J Allergy Clin Immunol. 2011;128(3). 10.1016/j.jaci.2011.05.003
39 Hashiro M, Okumura M. Anxiety, depression and psychosomatic symptoms in patients with atopic dermatitis: comparison with normal controls and among groups of different degrees of severity. J Dermatol Sci. 1997;14(1). 10.1016/S0923-1811(96)00553-1
40 Ahn HJ, Shin MK, Seo JK, Jeong SJ, Cho AR, Choi SH, et al. Cross-sectional study of psychiatric comorbidities in patients with atopic dermatitis and nonatopic eczema, urticaria, and psoriasis. Neuropsychiatr Dis Treat. 2019;15. 10.2147/NDT.S191509
41 Ullman KC, Moore RW, Reidy M. Atopic eczema: a clinical psychiatric study. J Asthma Res. 1977;14(2). 10.3109/02770907709098955
42 Gupta MA, Gupta AK, Schork NJ, Ellis CN. Depression modulates pruritus perception: a study of pruritus in psoriasis, atopic dermatitis, and chronic idiopathic urticaria. Psychosom Med. 1994;56(1). 10.1097/00006842-199401000-00005
43 Zachariae R, Lei U, Haedersdal M, Zachariae C. Itch severity and quality of life in patients with pruritus: preliminary validity of a Danish adaptation of the itch severity scale. Acta Derm Venereol. 2012;92(5). 10.2340/00015555-1221
44 Scheich G, Florin I, Rudolph R, Wilhelm S. Personality characteristics and serum IgE level in patients with atopic dermatitis. J Psychosom Res. 1993;37(6). 10.1016/0022-3999(93)90058-N
45 Blanco Sequeiros A, Sinikumpu SP, Jokelainen J, Huilaja L. Psychiatric comorbidities of childhood-onset atopic dermatitis in relation to eczema severity: a register-based study among 28,000 subjects in Finland. Acta Derm Venereol. 2024; 104:adv40790. 10.2340/actadv.v104.40790
46 Kern C, Wan J, Lewinn KZ, Ramirez FD, Lee Y, McCulloch CE, et al. Association of atopic dermatitis and mental health outcomes across childhood: a longitudinal cohort study. JAMA Dermatol. 2021;157(10). 10.1001/jamadermatol.2021.2657
Article Sidebar
Published
Mar 1, 2026
Article Details
How to Cite
Berivan Topçak, A., Güzeloğlu, E., Kökcü Karadag, S. I., Çalışkan, N., Yıldırım, G., Bologur, H., Güngör, H., Karaca Şahin, M., Fatih Erbay, M., Tunç Şarman, H., Dağ, H., & Ozceker, D. (2026). Atopic dermatitis in adolescents: assessment of quality of life, anxiety, and depression levels. Allergologia Et Immunopathologia, 54(2), 85–92. https://doi.org/10.15586/aei.v54i2.1561
Section
Original Articles
How to Cite
Berivan Topçak, A., Güzeloğlu, E., Kökcü Karadag, S. I., Çalışkan, N., Yıldırım, G., Bologur, H., Güngör, H., Karaca Şahin, M., Fatih Erbay, M., Tunç Şarman, H., Dağ, H., & Ozceker, D. (2026). Atopic dermatitis in adolescents: assessment of quality of life, anxiety, and depression levels. Allergologia Et Immunopathologia, 54(2), 85–92. https://doi.org/10.15586/aei.v54i2.1561