Abstract
Dermatologic diseases have a well-documented association with depression and anxiety, which are in turn often comorbid with alcohol use disorder (AUD). Nonethleess, the relationship between dermatologic disease and AUD, and the relative contribution of depression and anxiety, are poorly understood. Here, we utilize the National Insittutes of Health All of Us Research Program to investigate the association between inflammatory and pigmentary dermatologic diseases with AUD. Furthermore, we investigate whether comorbid depression and anxiety mediates this relationship. We employed a matched case–control model with multivariable logistic regression. We also employed a mediation analysis. We found an increased odds of AUD among patients with atopic dermatitis, acne/rosacea, hidradenitis suppurativa, psoriasis, and pigmentary disorders (vitiligo, melasma, and post-inflammatory hyperpigmentation). This was partially mediated by anxiety and depression, especially for diseases with a significant cosmetic component. Overall, these findings highlight the profound psychological and physical health effects that inflammatory and pigmentary disease can have on patients, both independently and in combination with comorbid psychiatric disease.
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Data availability
The data that support the findings of this study are openly available in the All of Us Research Program at https://www.researchallofus.org/data-tools/workbench/
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Acknowledgements
The All of Us Research Program is supported by the National Institutes of Health, Office of the Director: Regional Medical Centers: 1 OT2 OD026549; 1 OT2 OD026554; 1 OT2 OD026557; 1 OT2 OD026556; 1 OT2 OD026550; 1 OT2 OD 026552; 1 OT2 OD026553; 1 OT2 OD026548; 1 OT2 OD026551; 1 OT2 OD026555; IAA #: AOD 16037; Federally Qualified Health Centers: HHSN 263201600085U; Data and Research Center: 5 U2C OD023196; Biobank: 1 U24 OD023121; The Participant Center: U24 OD023176; Participant Technology Systems Center: 1 U24 OD023163; Communications and Engagement: 3 OT2 OD023205; 3 OT2 OD023206; and Community Partners: 1 OT2 OD025277; 3 OT2 OD025315; 1 OT2 OD025337; 1 OT2 OD025276. In addition, the All of Us Research Program would not be possible without the partnership of its participants
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NT and KK conceived and designed the study. KK, DX, and KY collected and analyzed the data, and wrote the initial draft of the research letter. NT, DX, KY, JC, JB, and AM contributed to the study design, data analysis, and interpretation of results. NT, JC, JB, AM conducted critical revisions of the manuscript for important intellectual content, provided valuable insights during the analysis phase, and contributed to the final version of the research letter. KK and DX contributed to the literature review, data interpretation, and manuscript writing. All authors reviewed and approved the final version of the research letter and agreed to be accountable for the accuracy and integrity of the work.
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A.M. receives consulting fees from Pfizer, hims, Digital Diagnostics, Concert, Lilly, Abbvie, Equillium, and Boehringer Ingelheim. A.M. also owns equity in hims, Fig. 1, Acom, Seebe. He receives licensing fees and royalties from Pfizer, Concert, and Lilly. He serves on the medical advisory board for hims, Fig. 1, and Digital Diagnostics. A.M. oversees clinical trials for Lilly and Concert. J.M.C. serves on a data and safety moniroting board (DSMB) for Advarra. J.S.B. is an associate editor for JAMA Dermatology.
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Kamal, K., Xiang, D.H., Young, K. et al. Comorbid psychiatric disease significantly mediates increased rates of alcohol use disorder among patients with inflammatory and pigmentary skin disorders: a case–control study in the All of Us Research Program. Arch Dermatol Res 316, 79 (2024). https://doi.org/10.1007/s00403-023-02803-2
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DOI: https://doi.org/10.1007/s00403-023-02803-2