Pediatric Somatic Symptoms, Behavioral Issues in Eczema

Baby with atopic dermatitis (infantile eczema).
Baby with atopic dermatitis (infantile eczema).
The relationship between eczema phenotypes and school-age emotional and behavioral problems, as well as the bidirectional relationship between eczema and emotional and behavioral problems in children between birth and age 10 years, was analyzed in this study.

Children with eczema may be more likely to demonstrate somatic symptoms, as well as attention and behavioral problems, than children without eczema, according to study results published in the British Journal of Dermatology suggest.

The study included 5265 children and was embedded in the prospective population-based Generation R Study from The Netherlands. Investigators obtained data regarding physician-diagnosed eczema from parental-reported questionnaires when children reached the age of 6 months, 1 year, 2 years, 3 years, 4 years, and 10 years. According to these data, children were assigned to an eczema phenotype, including never, early transient, mid-transient, late transient, and persistent eczema. In addition, researchers assessed parent-reported child emotional and behavioral problems using the Child Behavior Checklist from age 1.5 years to 10 years.

Relative to children without eczema or a history of eczema, children who ever had eczema had more internalizing problems (range Z score difference 0.14; 95% CI, 0.01-0.27) and persistent somatic symptoms (range Z score difference 0.39; 95% CI, 0.18-0.6) at age 10 years. In addition, children with early transient eczema demonstrated more aggressive behaviors at age 10 years (Z score difference 0.16; 95% CI, 0.04-0.27; P <.05). Children with eczema between the age of 0 and 2 years had more internalizing problems at age 3 to 6 years (Z score difference 0.08; 95% CI, 0.02-0.15) and 10 years (Z score difference 0.09; 95% CI, 0.02-0.16) compared with children without eczema at age 0 to 2 years.

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Study limitations were the inclusion of healthier and more affluent children and the reliance on parental questionnaire data for identifying each child’s behavioral and attention problems.

The researchers concluded that “future research should focus on the effect of early optimal eczema management on mental health disorders in children later in life.”


Hu C, Nijsten T, Pasmans SGMA, et al. Associations of eczema phenotypes with emotional and behavioural problems from birth until school age. The Generation R Study [published online November 15, 2019]. Br J Dermatol. doi:10.1111/bjd.18705

This article originally appeared on Dermatology Advisor