An exploration of quality of life and mental health in adults with atopic dermatitis

Abstract

Atopic dermatitis (AD) is a common, often persistent skin disease that is characterised by severe itching and inflammation of the skin. Although it is most common in children, AD in adults is often a serious condition and poses a significant social issue, with a number of studies suggesting a significant negative impact of AD on quality of life (QoL) and mental health in adults. This multi-method thesis aimed to explore QoL and mental well-being in adults living within the UK. After conducting a systematic review and meta-analysis of studies investigating QoL in adults, the first empirical study (chapter 4) qualitatively explored the daily experiences and perceptions of adults with AD. Additionally, in order to measure quality of life and mental health, psychometric questionnaires were completed by a large UK sample (chapter 5). Finally, this research aimed to measure the temporal relationship between psychological stress and AD severity over time in a feasibility study (chapter 6). The qualitative study found that participants with the condition experienced many challenges such as living with the visibility of AD, physical and psychological distress, and lack of support from others. The quantitative study built on these findings and established that AD patients reported lower health-related QoL and higher levels of anxiety compared to healthy adults. Several psychological, clinical and demographic variables also significantly predicted QoL in this study. Finally, the feasibility study found that psychological stress experienced one week significantly predicted disease severity the following week. The opposite was also found where AD severity measured one week significantly predicted stress the following week. The findings of this thesis will facilitate better understanding of living with the condition and enables recommendations for clinical practice which include support from health care professionals and increased public awareness of the condition.