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Eczema patients at 36% higher risk of suicide attempts, study says

Eczema is a common skin condition that can pack a profound psychological punch: People with eczema are more ...

Posted: Dec 12, 2018 2:37 PM
Updated: Dec 12, 2018 2:37 PM

Eczema is a common skin condition that can pack a profound psychological punch: People with eczema are more likely to have suicidal thoughts and suicide attempts than others without the condition, according to new research published Wednesday in the journal JAMA Dermatology.

Eczema, also known as atopic dermatitis, is a skin disease that's chronic and inflammatory -- meaning it involves an immune system reaction. It affects 18 million adults (more than 7%) and 9.6 million children (13%) in the United States, according to the researchers from University of Southern California Keck School of Medicine.

Chronic diseases

Dermatology

Diseases and disorders

Eczema

Health and medical

Medical fields and specialties

Skin disorders

Societal issues

Society

Suicide

They analyzed 15 previous studies that included 310,681 eczema patients and about 4.4 million patients without eczema. Study locations were in North America, Asia, Europe and Africa.

The researchers found that patients with eczema were 44% more likely to have suicidal thoughts and 36% more likely to attempt suicide compared to people without the skin condition. However, due to incomplete data or inconsistent results, the researchers did not find a difference in the risk of completed suicide between eczema patients and others.

Suicide 'crisis' in the US

So what explains the higher rate of self-destructive thoughts and actions?

The study authors explain that eczema is associated with an increase in proinflammatory cytokines, a type of immune system molecule found at high levels wherever there is an infection. Higher levels of proinflammatory cytokines in the central nervous system may disrupt the balance of neurotransmitters in the brain and lead to negative thoughts, they theorized.

Dr. Joel M. Gelfand, a professor of dermatology and of epidemiology and medical director of the Dermatology Clinical Studies Unit at the University of Pennsylvania Perelman School of Medicine, told CNN the possibility of cytokines disrupting brain chemistry is only "a theory."

"The causal role of inflammation and suicidal activity and outcomes is not established yet," said Gelfand who was not involved in the analysis. Still, he believes the new research is "important."

"The country is facing an epidemic in suicide, it's really a public health crisis, and the more we can understand what conditions and behaviors lead to suicidal thinking, behavior and actions, the more we can figure out ways to identify people at risk and hopefully prevent these really terrible outcomes for people," Gelfand said.

Suicide and suicidal behavior are "challenging to study -- sometimes they are statistically rare so pooling a number of studies to get better insight is appropriate scientifically," noted Gelfand, who was not involved in the new study. "The study reminds us that there is clearly an association here but there is a lot more we need to figure out."

Dr. Eric Simpson, a professor of dermatology at Oregon Health & Science University's School of Medicine, told CNN in an email that the new research is "consistent" with previous studies which "demonstrate a strong association, in children and adults, between having atopic dermatitis (eczema) and mental health conditions such as anxiety and depression."

He agrees with Gelfand that the cause of this connection between eczema and mental health conditions is not yet known. It might be explained by the negative impacts of a chronic disease, poor sleep due to the itch, or even "the effect of inflammation on the developing brain," said Simpson, who was not involved in the new analysis. "Shared genetic risk factors could be another explanation," he said.

Eczema, a 'serious chronic disease'

"Atopic dermatitis is not 'just eczema,' but is a serious chronic disease that can greatly impact a person's entire life," he said, adding that mental health specialists could help patients manage depression and help "care for the whole patient."

Last year, an eczema patient in Hong Kong killed herself and her parents, police said. At the time, Hong Kong police suggested her skin condition might have motivated the attack. But that case does not "fairly illustrate" the role played by eczema in mental health, said Simpson. "This patient appeared to be a deeply troubled person in many ways," said Simpson, who did not treat the patient in the Hong Kong case.

Gelfand's message for people living with eczema and their families, friends and health care providers is awareness.

"They face a lot of discomfort in their skin, a lot of sleep disturbance from their disease, a lot of social isolation and stigma, so being supportive of people suffering with eczema is really important," he said.

Still, there is hope, said Gelfand: "Therapies are rapidly evolving and there's a lot of new ways to help people with this disease."

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 343505

Reported Deaths: 7543
CountyCasesDeaths
Hinds23932444
DeSoto23229283
Harrison20527329
Rankin15411291
Jackson15232252
Madison10959227
Lee10719179
Jones9047169
Forrest8723159
Lauderdale7884244
Lowndes7054151
Lamar702989
Lafayette6548124
Washington5595139
Pearl River5196152
Bolivar4954134
Oktibbeha494398
Panola4771112
Warren4728128
Marshall4701106
Pontotoc447773
Union433279
Monroe4330137
Neshoba4281181
Hancock428088
Lincoln4176116
Pike3667113
Leflore3627125
Tate353388
Alcorn350974
Sunflower347694
Scott341176
Adams340988
Yazoo339376
Copiah324968
Simpson322891
Itawamba314680
Coahoma314085
Tippah306568
Prentiss298863
Covington293484
Leake285475
Marion284181
Wayne277543
George272251
Grenada269488
Newton262364
Tishomingo239770
Winston236784
Jasper230648
Stone229637
Attala226373
Chickasaw219060
Holmes200174
Clay197654
Clarke186880
Tallahatchie183742
Calhoun181332
Smith179235
Yalobusha171540
Walthall145748
Lawrence142826
Greene140134
Amite137543
Noxubee135235
Perry133538
Montgomery133044
Carroll126431
Webster121232
Jefferson Davis116734
Tunica114227
Benton106725
Claiborne105331
Kemper102429
Humphreys100133
Franklin87923
Quitman84719
Choctaw82619
Wilkinson78032
Jefferson71328
Sharkey51618
Issaquena1736
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Alabama Coronavirus Cases

Cases: 587405

Reported Deaths: 11536
CountyCasesDeaths
Jefferson853851591
Mobile48932864
Madison37517533
Shelby27280257
Tuscaloosa27171465
Montgomery26172627
Baldwin25399329
Lee17224181
Calhoun15401334
Morgan15170291
Etowah14954370
Marshall13116235
Houston12077293
Elmore10915219
St. Clair10763252
Limestone10725158
Cullman10546205
Lauderdale10255254
DeKalb9508192
Talladega8949188
Walker7793288
Autauga7563114
Jackson7400117
Blount7362139
Colbert6703142
Coffee6365132
Dale5650117
Russell480243
Chilton4771117
Covington4749125
Franklin458181
Tallapoosa4519156
Escambia441383
Chambers3949125
Dallas3743163
Clarke371263
Marion3463107
Pike332579
Lawrence3263100
Winston298773
Bibb290465
Geneva283983
Marengo262467
Barbour250961
Pickens245562
Butler240872
Hale235578
Fayette227065
Henry213945
Monroe202141
Randolph201144
Cherokee199248
Washington185239
Macon170552
Crenshaw168358
Clay166259
Cleburne161345
Lamar151038
Lowndes145455
Wilcox132331
Bullock126542
Conecuh121332
Coosa118329
Perry110528
Sumter110333
Greene99137
Choctaw64425
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