Beyond Anxiety and Depression: Loneliness and Psychiatric Disorders in Adults with Atopic Dermatitis 2023 Zhang et al

ABSTRACT

There is a lack of knowledge concerning loneliness and psychiatric disorders other than anxiety and depression in patients with atopic dermatitis. This cross-sectional study was conducted within the Lifelines Cohort Study, in the Netherlands, by sending an atopic dermatitis questionnaire to adult participants (n = 135,950) in 2020. Psychiatric disorders were measured with a self-reported question and validated instrument (Mini International Neuropsychiatric Interview; M.I.N.I.), and loneliness was assessed with the validated 6-item De Jong Gierveld Loneliness Scale.

In total, 56,896 subjects (mean age 55.8 years, 39.7% males) were included. Atopic dermatitis showed positive associations with self-reported chronic fatigue syndrome, burnout, depression, social phobia, panic disorder, attention deficit hyperactivity disorder, and eating disorder in the participants’ lifetimes. Based on the M.I.N.I., atopic dermatitis was positively associated with panic disorder and at least 1 anxiety disorder. In addition, subjects with atopic dermatitis were more likely to experience loneliness compared with those without atopic dermatitis. These associations were observed only in the moderate-to-severe, but not mild, atopic dermatitis group.

This study raises awareness that a significant proportion of adults with atopic dermatitis feel lonely and are affected by several psychiatric disorders, especially those severely affected by atopic dermatitis. Further studies are required to evaluate if interdisciplinary care, such as the collaboration between dermatologists and psychiatrists, could optimize medical care for this vulnerable patient group.

Open access, https://medicaljournalssweden.se/actadv/article/view/9378

 

"Psychiatric disorder

Data on psychiatric disorders were extracted from the baseline assessment. Two definitions of psychiatric disorders were used: self-reported psychiatric disorders in lifetime and the validated Mini International Neuropsychiatric Interview (M.I.N.I.) (15).Self-reported psychiatric disorders in lifetime. The lifetime pre-valence of self-reported psychiatric disorders was assessed by asking participants if they have (ever had) each of the following psychiatric disorders or related conditions, including chronic fatigue syndrome (CFS), burnout, depression, social phobia, ago-raphobia, panic disorder, (other) anxiety disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and eating disorders."

 

This is why people in general and drs in particular literally (I’ve lost count) laugh in our faces when we ask for investigation or simply symptom management for our physical symptoms.

It’s everywhere in black and white print written by lots of names with letters after them.

So of course why not assume that a person, a patient who keeps pleading for physical help for a psychiatric condition is displaying a delusional behaviour right in front you.

The fact you then decide to laugh at this person, who according to your own assessment, is as you sit before them displaying signs of psychological distress, is another matter. One that convinces me that the HCPs ‘mean well they just don’t understand.’ Isn’t a straight forward statement of fact.

Edit:typing issues.

 

I'm really not sure if these people understand the difference between associative and causative data.

Intellectually they obviously do, but I don't think they really understand what it means beyond the basic definition and how to do statistical analysis. Probably because almost all their data is purely associative, and they routinely claim causality anyway, which suggests that it's more of an issue of not caring much about the difference. Or, as our BPS overlords put it, simply preferring one outcome over another.

This is a lot like political polls asking generic questions like "Do you feel the country is heading in the right direction?", and lots of people give the same answer out of a restricted set, but for completely opposite reasons, and many variously non-overlapping ones. But the question is reduced to a simple number that means nothing, but gets endlessly analyzed. Frankly, most of this type of research isn't any better. And it's not even any better at making predictions.

I've even seen MDs whine about how "correlation is not causation" is killing their buzz when it comes to exactly this kind of data. The problems are really deeper here, this is way too close to things like numerology to my taste. The numbers may be real, but they may as well be reading entrails for all that their conclusions have anything to do with what the numbers mean.

And then obviously there are decades of mislabeled data, and self-reinforcing mislabeled data where the previously mislabeled data is used to justify doing it again, and again, and again. So many layers to this failure cake.