Volume 180, Issue 3 pp. 559-564
Epidemiology

Atopic dermatitis, educational attainment and psychological functioning: a national cohort study

J. Smirnova

Corresponding Author

J. Smirnova

Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden

Department of Dermatology, Karlstad Central Hospital, Karlstad, Sweden

Correspondence

Jevgenija Smirnova.

E-mail: [email protected]

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L.B. von Kobyletzki

L.B. von Kobyletzki

Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden

Department of Dermatology, Skåne University Hospital, Malmö, Sweden

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M. Lindberg

M. Lindberg

Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden

Department of Dermatology, Örebro University, Örebro, Sweden

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Å. Svensson

Å. Svensson

Department of Dermatology, Skåne University Hospital, Malmö, Sweden

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S.M. Langan

S.M. Langan

Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, U.K.

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S. Montgomery

S. Montgomery

Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden

Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

Department of Epidemiology and Public Health, University College London, London, U.K.

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First published: 19 October 2018
Citations: 22
Funding sources This study received support from the U.K. Economic and Social Research Council (ESRC) as grants to the International Centre for Life Course Studies (grants RES-596-28-0001 and ES/JO19119/1). S.M.L. is funded by a Wellcome Senior Clinical Fellowship (205039/Z/16/Z). J.S. is supported by the Centre for Clinical Research, Värmland County Council.
Conflicts of interest None to declare.

Plain language summary available online

Summary

Background

Atopic dermatitis (AD) might adversely affect academic performance, possibly through influences on psychological functioning such as stress resilience.

Objectives

To investigate the association of atopic dermatitis with stress resilience, cognitive function and educational attainment.

Methods

We used data from a national cohort of men who underwent a military conscription examination at ages 17–20 years in Sweden between 1969 and 1976. All potential conscripts met a physician who assessed current or previous history of AD. Stress resilience was measured by a psychologist using a semistructured interview. The conscription assessment included a written cognitive function test. The highest level of education achieved was identified through record linkage.

Results

The study population included 234 715 men, 1673 (0·7%) of whom had a diagnosis of AD. AD was associated with a greater risk of low stress resilience [adjusted relative risk ratio (RRR) 1·60, 95% confidence interval (CI) 1·38–1·86]. AD was associated with higher cognitive function (β-coefficient 0·15, 95% CI 0·05–0·24) and higher educational level (RRR 1·29, 95% CI 1·13–1·47). However, adjustment for socioeconomic characteristics of the family of origin attenuated the magnitude of the associations and eliminated the statistical significance (β-coefficient 0·06, 95% CI −0·03 to 0·15; RRR 1·16, 95% CI 1·00–1·35).

Conclusions

Swedish men with AD had lower stress resilience in late adolescence but did not have lower cognitive function or poorer educational attainment. The lower stress resilience associated with AD is consistent with an increased risk of possible long-term adverse health outcomes.

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