| Abstract [eng] |
Atopic dermatitis is a chronic inflammatory skin disease that most commonly begins in childhood and is characterized not only by skin lesions but also by a significant burden of symptoms. The main features of the disease are pruritus and sleep disturbances, which may affect both physical and psychosocial well being. Although the associations between atopic dermatitis, sleep quality, and emotional and behavioral difficulties are increasingly addressed in the literature, the nature of these relationships remains unclear. Aim of the study. To assess the prevalence of behavioral difficulties, pruritus, and sleep disturbance and their relationships among children with atopic dermatitis. Objectives. To evaluate the severity of pruritus and sleep disturbance; to compare these symptoms between different atopic dermatitis severity groups; to assess associations between subjective symptom burden and emotional and behavioral difficulties using the Scoring Atopic Dermatitis Index and the Patient-Oriented Eczema Measure; and to separately evaluate the relationships between pruritus, sleep disturbance and behavioral difficulties. Methods. A cross-sectional study included 52 children with atopic dermatitis. Disease severity was assessed using Atopic Dermatitis Index and the Patient-Oriented Eczema Measure. Participants were divided into two groups by disease severity. Pruritus and sleep disturbance were evaluated using quality-of-life index questions, eczema measure questions, and 0–10 rating scales. Emotional and behavioral difficulties were assessed using a standardized child behavior questionnaire. Statistical analysis was performed using IBM SPSS software. Results. As disease severity increased, the intensity and frequency of pruritus and sleep disturbance significantly augmented. Children with moderate-to-severe disease had more pronounced sleep problems and pruritus compared to those with mild disease. Higher subjective symptom burden was associated with higher overall emotional and behavioral problem scores, particularly in the domains of social, internalizing, withdrawn, and thought difficulties. However, when pruritus and sleep disturbance indicators were analyzed separately, no statistically significant associations with emotional and behavioral difficulties were found. Additionally, no statistically significant differences in psychological indicators were observed between groups stratified by atopic dermatitis severity. Conclusions. Pruritus was most commonly of moderate intensity and significantly increased in intensity and frequency with worsening disease. Sleep disturbance was more pronounced in the moderate-to-severe group. Greater overall subjective symptom burden was linked to a higher emotional and behavioral burden, whereas individual symptoms were not. Psychological indicators did not differ between groups based on the atopic dermatitis severity score. Therefore, in assessing a child’s psychosocial status, it is important to consider not only objective disease severity but also the symptoms subjectively experienced by the child. |
