Self-Harm, Suicidality, and Psychiatric Visits in Children with Atopic Dermatitis: a TriNetX Cohort Study

Background Atopic dermatitis (AD) is a chronic skin condition associated with impaired psychosocial functioning and an elevated risk of mental health issues, with potential psychiatric symptoms emerging in early childhood. Method Using TriNetX medical record data, AD youth (n = 408,916) were matched to an equal number of non-AD controls. Psychiatric outcomes of self-harm, suicide attempts, psychotherapy, and psychiatric diagnostic evaluations were followed for 3 years. Outcomes were compared between ages 5–9, 10–14, and 15–18. Results Compared to controls, AD youth had a greater risk of all psychiatric outcomes. Across cohorts, AD youth exhibited a 1.26-fold increased risk of self-harm (95% CI, 1.10, 1.45) and a 1.45-fold risk of suicide attempts (95% CI, 1.26, 1.66). They also had a higher risk of utilizing psychiatric resources, as the relative risk for psychotherapy was 1.28 (95% CI, 1.11, 1.46) and 1.33 for psychiatric evaluations (95% CI, 1.17, 1.54). However, absolute risk reductions for each correlate were small (<1%). Conclusion Rather than separate screening protocols for atopic dermatitis, existing mental health screenings should consider AD-related distress. Clinician and caregiver education may help provide targeted support for this population.