Ethnic differences in depression and anxiety among adults with atopic eczema: Population-based matched cohort studies within UK primary care.

Journal: Clinical and translational allergy

Volume: 14

Issue: 3

Year of Publication: 

Affiliated Institutions:  Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. Division of Psychiatry, University College London, London, UK. Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK. Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK. St John's Institute of Dermatology, Guys and St Thomas' Foundation Trust and King's College London, London, UK.

Abstract summary 

Evidence demonstrates that individuals with atopic eczema (eczema) have increased depression and anxiety; however, the role of ethnicity in these associations is poorly understood. We aimed to investigate whether associations between eczema and depression or anxiety differed between adults from white and minority ethnic groups in the UK.We used UK Clinical Practice Research Datalink GOLD to conduct matched cohort studies of adults (≥18 years) with ethnicity recorded in primary care electronic health records (April 2006-January 2020). We matched (age, sex, practice) adults with eczema to up to five adults without. We used stratified Cox regression with an interaction between eczema and ethnicity, to estimate hazard ratios (HRs) for associations between eczema and incident depression and anxiety in individuals from white ethnic groups and a pooled minority ethnic group (adults from Black, South Asian, Mixed and Other groups).We identified separate cohorts for depression (215,073 with eczema matched to 646,539 without) and anxiety (242,598 with eczema matched to 774,113 without). After adjusting for matching variables and potential confounders (age, sex, practice, deprivation, calendar period), we found strong evidence (p < 0.01) of ethnic differences in associations between eczema and depression (minority ethnic groups: HR = 1.33, 95% CI = 1.22,1.45; white ethnic groups: HR = 1.15, 95% CI = 1.12,1.17) and anxiety (minority ethnic groups: HR = 1.41, 95% CI = 1.28,1.55; white ethnic groups: HR = 1.17, 95% CI = 1.14,1.19).Adults with eczema from minority ethnic groups appear to be at increased depression and anxiety risk compared with their white counterparts. Culturally adapted mental health promotion and prevention strategies should be considered in individuals with eczema from minority ethnic groups.

Authors & Co-authors:  Adesanya Henderson Hayes Lewin Mathur Mulick Morton Smith Langan Mansfield

Study Outcome 

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Statistics
Citations :  Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020;396(10247):345‐360. 10.1016/S0140-6736(20)31286-1
Authors :  10
Identifiers
Doi : e12348
SSN : 2045-7022
Study Population
Male,Female
Mesh Terms
Other Terms
anxiety;atopic eczema;depression;epidemiology;ethnicity
Study Design
Study Approach
Country of Study
Publication Country
England