Summary:
Atopic dermatitis is a common chronic inflammatory skin condition affecting approximately 20% of children and 10% of adults worldwide, and is characterised by persistent itch and recurrent eczema-like lesions. It has been associated with increased likelihood of conditions including attention-deficit/hyperactivity disorder (ADHD), depression, and in some cases suicidal ideation. ADHD itself is one of the most prevalent neurodevelopmental disorders in childhood, affecting over 5% of children globally. This meta-analysis looked at observational evidence to examine the relationship between atopic dermatitis and ADHD across both children and adults, while also evaluating potential modifying factors such as disease severity, age, and comorbid conditions. The review included 49 studies. Overall, the findings demonstrated a consistent bidirectional association between the two conditions. Individuals with atopic dermatitis were more likely to have ADHD, and those with ADHD showed an increased likelihood of atopic dermatitis. The strength of this relationship was more pronounced in populations with severe atopic dermatitis, coexisting allergic diseases, and concurrent sleep disturbances. In summary, this meta-analysis indicates that atopic dermatitis and ADHD are mutually associated conditions, with each appearing to increase the likelihood of the other. The results highlight the importance of considering both conditions in clinical assessment, particularly in individuals with severe allergic disease or sleep disruption, where the relationship appears strongest.
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Abstract:
Background: Our objective is to elucidate the reciprocal association between atopic dermatitis (AD) and attention deficit hyperactivity disorder (ADHD) by prespecified subgroups and determine potential modified factors. Materials and Methods: Adhering to PRISMA 2020, we conducted a comprehensive database search up until March 11, 2024. Observational studies reporting on AD and ADHD as either exposure or outcome variables were included. A random-effects model meta-analysis was conducted to calculate pooled estimates. Subgroup and meta-regression analyses were undertaken to explore heterogeneity. Publication bias was investigated via funnel plots and Egger’s test. Results: Overall, 49 studies were determined to meet the inclusion criteria after rigorous screening. Patients with AD were more likely to have ADHD (ORs = 1.34, 95% CI 1.25–1.44, p < 0.01; HRs = 1.42, 95% CI 1.20–1.68, p < 0.01), while patients with ADHD also had an increased risk of developing AD (ORs = 1.45, 95% CI 1.21–1.73, p < 0.01). Subgroup analyses indicated that the associations were particularly pronounced among studies that assessed patients with severe AD (ORs = 2.62, 95% CI 1.76–3.92, p < 0.01), suffered from multiple allergic conditions (ORs = 2.89, 95% CI 1.18–7.10, p < 0.01) and sleep disturbances (ORs = 2.43, 95% CI 2.14–2.76, p < 0.01) simultaneously. Conclusion: This review substantiates the significant bidirectional association between AD and ADHD, indicating that they serve as mutually independent risk factors and may either exacerbate each other. These findings underscore the necessity for heightened awareness and early targeted interventions, especially in individuals with severe AD manifestations, sleep problems, and multiple allergic diseases.
Article Publication Date: 30/03/2025
DOI: 10.1080/07853890.2025.2483370
