Children with Atopic Dermatitis Do Not Have More Anxiety or Different Cortisol Levels Compared with Normal Children

Background: The hypothalamic-pituitary-adrenal axis has an important immunoregulatory role under stress, and stress-mediated anxiety has been reported to be associated with alterations in immune functions and attenuated cortisol levels in atopic dermatitis (AD) patients. Objective: We investigated serum basal cortisol and anxiety levels in pediatric AD patients and compared them with those of controls. Methods: Basal serum cortisol levels were measured in 36 pediatric AD patients (aged 9-16 years) and 36 control subjects (aged 9-15 years). Anxiety was assessed by the trait anxiety subscale (TAI-C) of the State-Trait Anxiety Inventory for Children. The severity of AD was assessed by the objective severity scoring of AD (SCORing Atopic Dermatitis [SCORAD]). Results: Data analysis showed no statistical difference for the basal serum cortisol levels (p = .383) and the TAI-C (p = .730) between the two groups. No significant correlation was found between the basal cortisol values and the TAI-C scores in the AD group (p = .290). The SCORAD index was correlated with the TAI-C scores (p < .05) but not correlated with the basal serum cortisol values in AD patients (p = .06). Conclusion: Children with AD do not have more anxiety or different cortisol levels when compared with normal children, but the severe symptomatology of AD itself may cause anxiety levels to increase in children with AD.