Maternal Anxiety and Psychosocial Burden in Childhood Atopic Dermatitis: A Comparative Study

Abstract

Background: Atopic dermatitis (AD) is among the most prevalent chronic pediatric skin diseases. Beyond its cutaneous manifestations, AD imposes substantial psychosocial and economic strain on families. We quantified this burden-i.e., maternal anxiety and quality of life (QoL)-and identified its clinical and sociodemographic determinants, comparing families of children with AD to those of healthy peers. Methods: This cross-sectional study enrolled 84 mothers of physician-diagnosed patients with AD aged 3-144 months and 90 mothers of age-matched healthy children attending routine visits. Disease severity was graded with the Scoring Atopic Dermatitis (SCORAD) index. Mothers completed the State-Trait Anxiety Inventory (STAI) and the 8-item European Health Impact Scale (EUROHIS-QoL). Additionally, the Dermatological Family Impact Scale (DeFIS) was administered to the AD group. Results: EUROHIS-QoL scores were lower in the AD group than in controls (p = 0.016), whereas The State-Anxiety Inventory (STAI-S) scores were higher (p < 0.001); the Trait-Anxiety Inventory (STAI-T) scores did not differ (p = 0.125). In multivariable models, patient status (p = 0.006), higher STAI-T (p = 0.002), and greater income (USD 750-1500: p = 0.014; >USD 1500: p = 0.010) were independently associated with QoL. Anxiety was driven by patient status, lower QoL, and higher STAI-T, while trait anxiety was driven by lower QoL and higher STAI-S. SCORAD correlated negatively with QoL (rho = -0.225; p = 0.040) and positively with STAI-S and DeFIS. Conclusions: Pediatric AD significantly impairs mothers' QoL and heightens maternal situational anxiety and these effects intensify with increasing disease severity and financial strain. Multidisciplinary, family-centered care, including psychological screening and targeted support for low-income households, is essential for comprehensive AD management.