Mild to moderate AD was not associated with symptoms of depression.

Severe atopic dermatitis (AD) travels with depression, a new study shows.

In a study of 11, 181 kids, severe AD was associated with an approximately 2-fold increase in the likelihood of symptoms of depression and internalizing symptoms across childhood, compared to eczema-free kids. Sleep quality mediated some of this association, but it was not explained by differences in sleep duration, asthma/rhinitis, or levels of inflammatory markers (interleukin 6 and C-reactive protein), the researchers report.

Mild to moderate AD was not associated with symptoms of depression, it was associated with internalizing behaviors as early as 4 years of age, the study found. Roughly 22  percent to 40 percent developed a moderate or severe form of the disease; the rest of the cases in the study were mild.

The findings appear in JAMA Dermatology.

“Within this population-based birth cohort study in the UK, severe AD was associated with symptoms of depression and internalizing behaviors throughout childhood and adolescence,” the study authors conclude. “Risk of internalizing symptoms was increased even for children with mild AD beginning early in childhood, highlighting the importance of behavioral and mental health awareness in this population.”