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A growing literature proposed a crucial role of sleep disturbances in the development of mental health problems in AD. We tested this assumption by mediation model analyses in adult AD patients.<\/jats:p><jats:p>A total of 57 patients (mean age\u2009\u00b1\u2009std. dev., 34.28\u2009\u00b1\u200913.07\u00a0years; 27 males; range 18\u201367\u00a0years) diagnosed with AD participated in a cross-sectional study. We evaluated self-perceived severity of AD, insomnia, depression, and anxiety symptoms using validated questionnaires: the Patient-Oriented Eczema Measure (POEM), the Insomnia Severity Index (ISI), the Beck Depression Inventory-second edition (BDI-II), and the Generalized Anxiety Disorder-7 scale (GAD-7), respectively. Two mediation models were performed, testing the mediation effect of insomnia symptoms on the relationship between AD severity and depression (model 1) and anxiety (model 2). AD symptoms, as expressed by POEM, were positively associated with insomnia, depression, and anxiety severity. Insomnia fully mediated the effect of AD severity on depression and anxiety. Specifically, insomnia accounted for 81.64% of the relationship between atopic eczema severity and depression, and for 81.84% of the effect of AD severity on anxiety symptoms. The present study proposed a critical role of insomnia in predisposing adult AD patients to experience depression and anxiety. Early interventions focused on treating sleep disturbances could indirectly be beneficial on mental health of patients with AD, counteracting the onset and exacerbation of anxiety and depression disorders.<\/jats:p>","DOI":"10.1007\/s00403-023-02538-0","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T11:23:08Z","timestamp":1675768988000},"page":"1577-1582","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The role of insomnia in the vulnerability to depressive and anxiety symptoms in atopic dermatitis adult patients"],"prefix":"10.1007","volume":"315","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1961-286X","authenticated-orcid":false,"given":"Federico","family":"Salfi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9975-6497","authenticated-orcid":false,"given":"Giulia","family":"Amicucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2304-7576","authenticated-orcid":false,"given":"Michele","family":"Ferrara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6942-5336","authenticated-orcid":false,"given":"Daniela","family":"Tempesta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"De Berardinis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6739-0387","authenticated-orcid":false,"given":"Andrea","family":"Chiricozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1957-6600","authenticated-orcid":false,"given":"Ketty","family":"Peris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7249-2556","authenticated-orcid":false,"given":"Maria Concetta","family":"Fargnoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4773-6993","authenticated-orcid":false,"given":"Maria","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"2538_CR1","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1056\/NEJMRA074081","volume":"358","author":"T Bieber","year":"2008","unstructured":"Bieber T (2008) Atopic dermatitis. 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Chiricozzi served as advisory board member and consultant and has received fees and speaker's honoraria or has participated in clinical trials for AbbVie, Almirall, Leo Pharma, Lilly, Janssen, Novartis, Pfizer, and Sanofi Genzyme. K. Peris has served on advisory boards and received honoraria for lectures from Almirall, Abbvie, Lilly, Galderma, Leo Pharma, Pfizer, Pierre Fabre, Janssen, Novartis, Sanofi, Sun Pharma. MC Fargnoli has served on advisory boards, received honoraria for lectures and research grants from AMGEN, Almirall, Abbvie, BMS, Galderma, Kyowa Kyrin, Leo Pharma, Pierre Fabre, UCB, Lilly, Pfizer, Janssen, MSD, Novartis, Sanofi-Regeneron, Sunpharma. M. Esposito has served as a speaker\/board member for Abbvie, Almirall, Biogen, Celgene, Eli Lilly, Janssen, Leo Pharma, Novartis. F. Salfi, G. Amicucci, M. Ferrara, D. Tempesta, A. De Berardinis declared no conflicts of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}