Intensity of itching in eczema linked to depression

May 30 2012

By Helen Albert

Itch intensity in atopic dermatitis (AD) is related to the stress level and emotional wellbeing of patients, say researchers.

"The exact mechanism of itch in AD is still not exactly understood," say Jacek Szepietowski (Wroclaw Medical University, Poland) and colleagues, adding that "alterations of skin barrier may result in a lower itch threshold, prolonged maintenance of itch and hypersensitivity to certain non-specific triggers."

Stress is known to exacerbate AD, but whether it also increases the intensity of itch is unclear.

Szepietowski and team therefore investigated links between stress and other psychosocial parameters such as symptoms of depression and itch intensity in 89 patients with AD.

Itch intensity was determined according to a 10-point Visual Analogue Scale (VAS) and the 4-Item Itch Questionnaire. Health related quality of life (HRQoL) was measured by the Dermatology Life Quality Index, and symptoms of depression according to the Beck's Depression Inventory (BDI).

Writing in the Journal of the European Academy of Dermatology and Venereology, the authors report that the mean itch intensity was 7.9 on the VAS and 14.0 points on the 4-Item Itch Questionnaire.

The intensity of itch was significantly related to the amount of stress experienced by patients before an exacerbation. HRQoL and BDI score were also significantly associated with itch intensity.

Patients who had symptoms suggesting depression according to the BDI scored 9.1 and 17.3 on the VAS and 4-Item Itch Questionnaire, respectively, compared with corresponding scores of 7.6 and 13.1 for patients without any signs of depression.

"Interestingly, the use of sleeping drugs significantly improved HRQoL and depression indicating that sleep deprivation due to itching is a very important aspect of AD," comment Szepietowski et al.

"It is of note that the use of sleeping drugs was also connected with less stress before AD exacerbation, suggesting that these therapeutics may have an additional beneficial effect on AD subjects related to their anxiolytic properties," they add.

The team says that the results suggest that people with AD "require an effective, long-term antipruritic therapy to improve their QoL and reduce the potential risk of depression."

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