title: Psychiatry outpatient visits by atopic dermatitis patients varying in the complexity of their prescriptions: A nationwide cohort study conducted from 2005 to 2013.
abstract: The uncomfortable symptoms of atopic dermatitis (AD) often trigger psychological stress.We investigated the association between AD severity and outpatient visits to psychiatrists using Korean National Health Insurance claims data from 2004 to 2013.This was a retrospective cohort analysis; we estimated hazard ratios (HRs).Of the 266,182 subjects, 18,290 (6.9%) had a history of visiting a psychiatrist, and 25,419 (9.5%) were diagnosed with AD. Compared with the subjects without AD, subjects with AD had a higher HR for visiting a psychiatrist (3.70, 95% confidence interval [CI]:48 3.43-3.98), and this significantly increased as the complexity of the AD medications increased. Subjects who received topical treatments plus a systematic steroid (HR: 4.88, 95% CI: 4.51-5.27) and those who received topical treatments plus a systematic steroid plus a systematic calcineurin inhibitor (HR: 9.56, 95% CI: 4.29-21.28) had higher HRs compared with those without AD.Severe AD patients exhibited greater psychological stress than those without AD or with mild AD symptoms. Moreover, medication diversity may represent an efficient and low-cost method by which to identify a vulnerable population.
authors.affiliation: Department of Preventive Medicine Institute of Health Services Research, College of Medicine Department of Public Health, Graduate School Department of Dermatology, Severance hospital, College of medicine Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Korea.
authors.forename: Jaeyong
authors.initials: J
authors.lastname: Shin
authors.forename: Young
authors.initials: Y
authors.lastname: Choi
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
authors.forename: Kwang Hoon
authors.initials: KH
authors.lastname: Lee
authors.forename: Seo Young
authors.initials: SY
authors.lastname: Hwang
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Oh
authors.forename: Sang Gyu
authors.initials: SG
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D003876:Dermatitis, Atopic / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000503:physiopathology; D015999:Multivariate Analysis; D009819:Office Visits / Q000706:statistics & numerical data*; D010045:Outpatients / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome; D055815:Young Adult