Depression and Serum Content of Serotonin in Adult Patients with Atopic Dermatitis.

Atopic dermatitis (AD) is a chronic skin disease with the etiology not yet conclusively established. Recent reports demonstrate the role of serotonin (5-hydroxytryptamine; 5-HT) in the pathogenesis of AD. The aim of this study was to investigate the relationship between the serum content of serotonin and depression in adult patients suffering from severe AD. There were 31 patients of the median age of 41 years enrolled into the study, who suffered from AD since childhood, and a control group that consisted of 14 healthy subjects. AD was diagnosed on the basis of Hanifin and Rajka criteria. The severity of skin lesions was assessed with the SCORing Atopic Dermatitis (SCORAD) index and that of depression with the Montgomery-Åsberg Depression Rating Scale (MADRS) questionnaire. We found that all of the patients with severe AD characterized by SCORAD >50 had depression. Depression was classified as mild and moderate according to the MADRS score. Serotonin content was significantly lower in the patients with severe AD (MADRS >12), and there was an adverse relation between the serotonin content and the score of depression, the features not noticed in the control group. We conclude that severe AD, as expressed by the intensification of skin lesions, associates with depression and with the lowering of serum serotonin content. The findings point attention to the cognitive and affective problems in AD patients which could worsen the course of the skin disease.