Salivary Cortisol Values and Personality Features of Atopic Dermatitis Patients: A Prospective Study.

Abstract

Atopic dermatitis (AD) patients commonly experience psychological stress and impaired psychosocial functioning. The aim of this study was to compare patients' salivary cortisol levels with AD severity and other associated stress-related psychological measures/parameters. This prospective study analyzed salivary cortisol levels (enzyme-linked immunosorbent assay) in 84 AD patients (42 symptomatic patients and 42 asymptomatic patients). Each subject filled out the Perceived Stress Scale (PSS), Brief Illness Perception Questionnaire, and the Crown-Crisp Experiential Index, which concerns personality features. Increased cortisol values were found in both groups and were not dependent on disease severity (Scoring Atopic Dermatitis [SCORAD]) and PSS. Patients with severe AD had significantly lower cortisol levels than those with moderate and mild AD ( P = 0.042). The PSS levels were not dependent on SCORAD but correlated with the perceived effect of AD on emotional states (Illness Perception Questionnaire 8), personality traits, anxiety, and depression ( P < 0.001). The severity of perceived stress in AD patients is not adequately measured by salivary cortisol levels nor SCORAD; it does, however, correlate with the impact of AD on patients' emotional states and personality features (anxiety, depression). All AD patients, regardless of disease severity, should be assessed for impacts of stress, and a multidisciplinary approach should address mental wellness.