{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:28:46Z","timestamp":1790310526926,"version":"4.1.0"},"reference-count":42,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Derm Venereol"],"abstract":"<jats:p>Atopic dermatitis (AD) is a heterogeneous disease characterized by unpredictable flares, potentially leading to impaired mental health. Adult patients with a dermatologist-verified AD diagnosis received after their 18th birthday were grouped according to patient-reported flare activity between 2018 and 2023. The k-means clustering algorithm was used in combination with dynamic time warping and barycenter averaging. Clusters were analysed according to current levels of anxiety and depression and severity across the 4 time points. The clustering method divided the 262 patients into 4 groups. Cluster 1 was characterized by a disease course with an average of &lt; 6 annual flares, a median (interquartile range) anxiety and depression score of 3.0 (1.0\u20136.3), and 1.0 (0.0\u20134.0), respectively. Clusters 2 and 3 were characterized by annual flares ranging from 4 to 16 and anxiety scores of 6.0 (3.0\u20138.5) and 4.0 (2.0\u20137.0) and depression scores of 3.0 (1.0\u20136.0) and 2.0 (1.0\u20135.0), respectively. Cluster 4 was characterized by an unstable disease course with an average of \u2265 14 yearly flares, and anxiety and depression scores similar to cluster 2. Patients characterized by an unstable moderate disease course were more burdened compared with patients with a stable disease course (p\u2009=\u20090.03). This emphasizes the importance of long-term flare patterns in clinical decision-making.<\/jats:p>","DOI":"10.2340\/actadv.v105.43071","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:54:01Z","timestamp":1751360041000},"page":"adv43071","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Long-term Stability on Mental Health in Adults with Atopic Dermatitis: A Cohort Study with Unsupervised Cluster Analysis"],"prefix":"10.2340","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7202-0607","authenticated-orcid":false,"given":"Lea K.","family":"Nymand","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1562-8568","authenticated-orcid":false,"given":"Mia-Louise","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7177-1054","authenticated-orcid":false,"given":"Maria Oberl\u00e4nder","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-300X","authenticated-orcid":false,"given":"Simon F.","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3770-1743","authenticated-orcid":false,"given":"Jacob P.","family":"Thyssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8257-1816","authenticated-orcid":false,"given":"Alexander","family":"Egeberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"116747","doi-asserted-by":"crossref","unstructured":"Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, et al. 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