Abstract
INTRODUCTION: Atopic dermatitis (AD) is a common chronic inflammatory skin disorder associated with psychological burdens, including sadness and suicidality. Yet, little is known about long-term trends in these mental health outcomes among adolescents with AD. This study examined temporal trends in suicidal ideation and sadness in South Korean adolescents with and without AD. METHODS: Nationwide data from the Korean Youth Risk Behavior Web-based Survey, comprising middle and high school adolescents, were utilized, covering the period from 2007 to 2024. Weighted prevalence estimates were calculated to evaluate trends of questionnaire-based suicidal ideation and sadness by AD status. To examine the impacts of the COVID-19 pandemic, the study period was categorized into three periods, including pre-pandemic (2007-2019), intra-pandemic (2020-2022), and post-pandemic (2023-2024). For analyzing the β coefficients and β differences (β(diff)) between three periods, binary logistic regression and linear regression were used. In addition, we utilized logistic regression models for calculating weighted odds ratio (wOR) with 95% confidence intervals (CIs). RESULTS: Among 1,140,402 adolescents (553,213 [48.51%] female), those with AD reported a higher prevalence of suicidal ideation (17.51% [95% CI: 17.32-17.70]) and sadness (33.11% [32.88-33.34]) compared to those without AD. Weighted prevalence rates showed an increase during the intra-pandemic period, both in suicidal ideation (β(diff), 3.67 [3.32-4.03]) and sadness (β(diff), 4.88 [4.45-5.32]). Statistically significant sex-specific differences were observed, with females displaying a higher risk of suicidal ideation (wOR, 1.69 [1.65-1.73]) and sadness (wOR, 1.61 [1.57-1.64]). Other risk factors associated with heightened prevalence included high levels of stress, smoking and drinking status, lower levels of education and economic status, and in-facility residential environments. CONCLUSION: This is the first comprehensive study to display the association of AD with suicidal ideation and sadness in Korean adolescents. Our findings can provide insights into identifying vulnerable populations and seek to guide the public health strategies for minimizing disparities in the mental health burdens of AD.