To Örebro University

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 to 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 semi-structured interview. The conscription assessment included a written cognitive function test. Highest level of achieved education was obtained through record linkage.

RESULTS: The study population included 234 715 men, 1 673 (0·7%) had an AD diagnosis. AD was associated with a greater risk of low stress resilience (adjusted relative risk ratio (RRR) 1·60; 95% confidence interval 1·38 to 1·86). AD was associated with higher cognitive function (b coefficient 0·15; 0·05 to 0·24) and higher educational level (RRR 1·29; 1·13 to 1·47) but adjustment for socioeconomic characteristics of the family of origin attenuated the magnitude of the associations and eliminated statistical significance (b coefficient 0·06; -0·03 to 0·15) and (RRR 1·16; 1·00 to 1·35).

CONCLUSIONS: Swedish males 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.