{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:58:41Z","timestamp":1785560321703,"version":"3.56.0"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2024-00341916"],"award-info":[{"award-number":["RS-2024-00341916"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"award":["RS-2024-00341916"],"award-info":[{"award-number":["RS-2024-00341916"]}],"id":[{"id":"https:\/\/ror.org\/013aysd81","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","award":["2015-ER660010"],"award-info":[{"award-number":["2015-ER660010"]}],"id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2015-ER660010"],"award-info":[{"award-number":["2015-ER660010"]}],"id":[{"id":"https:\/\/ror.org\/00qdsfq65","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Atopic dermatitis (AD) and food allergy (FA) frequently coexist in the concept of atopic march; however, their combined associations with psychological problems remain poorly understood. This study aimed to investigate the associations of AD and FA with psychological outcomes at age 7 and evaluate whether respiratory allergies account for part of these associations. Methods: We enrolled 1577 children aged 7 years from the Panel Study of Korean Children. The Korean version of the Child Behavior Checklist was used to assess psychological and behavioral problems. Multivariable regression and parallel mediation analyses were used to evaluate independent and interactive associations. Results: AD and FA were associated with psychological and behavioral problems, most consistently with somatic problems on the Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scale. These associations were more pronounced in children with comorbid AD and FA than in those with single allergies. Among the 9 children with concurrent AD and FA, an interaction between the two conditions on somatic problems was observed (P for interaction = 0.033). The comorbid group showed higher eosinophil counts and total IgE levels, but no differences in SCORAD indices or C-reactive protein levels. Mediation analysis identified a direct association of AD with somatic problems (B = 1.062; 95% CI, 0.601\u20131.562), with a portion accounted for by allergic rhinitis (AR) (B = 0.656; 95% CI, 0.306\u20131.241). Conclusions: Comorbid AD and FA were associated with higher odds of somatic problems than either condition alone in 7-year-old children, with a portion of the AD association accounted for by AR. Because exposures and outcomes were assessed concurrently, these associations are exploratory and hypothesis-generating rather than causal. Clinical attention may be warranted for children with both AD and FA.<\/jats:p>","DOI":"10.3390\/children13081017","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:15:00Z","timestamp":1785428100000},"page":"1017","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Comorbid Atopic Dermatitis, Food Allergy, and Respiratory Allergic Diseases with Somatic Problems in Children: A Birth Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Sungsu","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jisun","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Asan Medical Center, Seoul 05505, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungmo","family":"Hong","sequence":"additional","affiliation":[{"name":"Psychotherapy, Graduate School of Health and Welfare, Baekseok University, Cheonan 31065, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hea Young","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Humidifier Disinfectant Health Center, National Medical Center, Seoul 04564, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eom Ji","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul 06135, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0891-1311","authenticated-orcid":false,"given":"Min Jee","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song-I","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1928-722X","authenticated-orcid":false,"given":"Hyo-Bin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So-Yeon","family":"Lee","sequence":"additional","affiliation":[{"name":"PHI Digital Healthcare, Seoul 03722, Republic of Korea"},{"name":"Institute for Innovation in Digital Healthcare, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo-Jong","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Humidifier Disinfectant Health Center, National Medical Center, Seoul 04564, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the PSKC Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"The increase in allergic conditions based on a review of literature","volume":"40","year":"2023","journal-title":"Postep. Dermatol. Alergol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.mucimm.2024.06.005","article-title":"Atopic dermatitis and food allergy: More than sensitization","volume":"17","author":"Davis","year":"2024","journal-title":"Mucosal Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.jaip.2020.12.007","article-title":"Sleep Disturbances and Atopic Dermatitis: Relationships, Methods for Assessment, and Therapies","volume":"9","author":"Bawany","year":"2021","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.jpeds.2022.04.027","article-title":"The Family Impact of Atopic Dermatitis in the Pediatric Population: Results from an International Cross-sectional Study","volume":"246","author":"Barbarot","year":"2022","journal-title":"J. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.anai.2019.01.014","article-title":"Economic burden of food allergy: A systematic review","volume":"122","author":"Bilaver","year":"2019","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1111\/j.1398-9995.2010.02449.x","article-title":"Is atopic disease a risk factor for attention-deficit\/hyperactivity disorder? A systematic review","volume":"65","author":"Schmitt","year":"2010","journal-title":"Allergy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.anai.2017.12.011","article-title":"Allergic disorders and risk of depression: A systematic review and meta-analysis of 51 large-scale studies","volume":"120","author":"Lu","year":"2018","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_8","first-page":"360","article-title":"Anxiety and depression risk in patients with allergic rhinitis: A systematic review and meta-analysis","volume":"59","author":"Rodrigues","year":"2021","journal-title":"Rhinology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S150","DOI":"10.1513\/AnnalsATS.201503-133AW","article-title":"The Gut-Lung Axis in Respiratory Disease","volume":"12","author":"Marsland","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/imr.12556","article-title":"The nutrition-gut microbiome-physiology axis and allergic diseases","volume":"278","author":"McKenzie","year":"2017","journal-title":"Immunol. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.3389\/fpsyg.2019.01773","article-title":"Risk of Mental Disorders in Children and Adolescents With Atopic Dermatitis: A Systematic Review and Meta-Analysis","volume":"10","author":"Xie","year":"2019","journal-title":"Front. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.jaci.2024.10.030","article-title":"Association between allergic diseases and mental health conditions: An umbrella review","volume":"155","author":"Xu","year":"2025","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100891","DOI":"10.1016\/j.waojou.2024.100891","article-title":"The mental health burden of food allergies: Insights from patients and their caregivers from the Food Allergy Research & Education (FARE) Patient Registry","volume":"17","author":"Casale","year":"2024","journal-title":"World Allergy Organ. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.jad.2018.05.007","article-title":"Association between eczema and risk of depression: A systematic review and meta-analysis of 188,495 participants","volume":"238","author":"Bao","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"674","DOI":"10.4168\/aair.2022.14.6.674","article-title":"Phenotype of Atopic Dermatitis With Food Allergy Predicts Development of Childhood Asthma via Gut Wnt Signaling","volume":"14","author":"Lee","year":"2022","journal-title":"Allergy Asthma Immunol. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jaci.2018.11.006","article-title":"The atopic march and atopic multimorbidity: Many trajectories, many pathways","volume":"143","author":"Paller","year":"2019","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_17","first-page":"202","article-title":"The Atopic March: Progression from Atopic Dermatitis to Allergic Rhinitis and Asthma","volume":"5","author":"Bantz","year":"2014","journal-title":"J. Clin. Cell. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s12884-015-0505-4","article-title":"Impact of unintended pregnancy on maternal mental health: A causal analysis using follow up data of the Panel Study on Korean Children (PSKC)","volume":"15","author":"Bahk","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"466","DOI":"10.4168\/aair.2018.10.5.466","article-title":"Prevalence, Risk Factors and Cutoff Values for Bronchial Hyperresponsiveness to Provocholine in 7-Year-Old Children","volume":"10","author":"Jung","year":"2018","journal-title":"Allergy Asthma Immunol. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4168\/aair.2020.12.1.72","article-title":"Risk Factors and Comorbidities Associated With the Allergic Rhinitis Phenotype in Children According to the ARIA Classification","volume":"12","author":"Jung","year":"2020","journal-title":"Allergy Asthma Immunol. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee (1998). Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet, 351, 1225\u20131232.","DOI":"10.1016\/S0140-6736(97)07302-9"},{"key":"ref_22","unstructured":"Achenbach, T. (1991). Manual for the CBCL\/4-18 and 1991 Profile, Department of Psychiatry, University of Vermont."},{"key":"ref_23","unstructured":"Oh, K., Lee, H., Hong, K., and Ha, E. (1997). Korean Version of Child Behavior Checklist (K-CBCL), Chung Ang Aptitude Publishing Co."},{"key":"ref_24","unstructured":"European Task Force on Atopic Dermatitis (1993). Severity scoring of atopic dermatitis: The SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology, 186, 23\u201331."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2058738420962902","DOI":"10.1177\/2058738420962902","article-title":"Childhood atopic dermatitis as a precursor for developing attention deficit\/hyperactivity disorder","volume":"34","author":"Xu","year":"2020","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1089\/ped.2016.0705","article-title":"Attention-Deficit\/Hyperactivity Disorder in Atopic Dermatitis: An Appraisal of the Current Literature","volume":"29","author":"Nygaard","year":"2016","journal-title":"Pediatr. Allergy Immunol. Pulmonol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/jdv.18564","article-title":"Atopic dermatitis and risk of major neuropsychiatric disorders in children: A population-based cohort study","volume":"37","author":"Wan","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"110","DOI":"10.4172\/2155-9899.1000110","article-title":"Th2 Cytokines and Atopic Dermatitis","volume":"2","author":"Brandt","year":"2011","journal-title":"J. Clin. Cell. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2500\/jfa.2020.2.200025","article-title":"Psychosocial issues and quality of life associated with food allergy","volume":"2","author":"Kachru","year":"2020","journal-title":"J. Food Allergy"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s11882-023-01121-x","article-title":"Psychosocial Impact of Food Allergy on Children and Adults and Practical Interventions","volume":"24","author":"Bingemann","year":"2024","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3456","DOI":"10.3748\/wjg.v13.i25.3456","article-title":"Psychological burden of food allergy","volume":"13","author":"Teufel","year":"2007","journal-title":"World J. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3086","DOI":"10.1017\/S0033291720005140","article-title":"Sex differences in neural correlates of common psychopathological symptoms in early adolescence","volume":"52","author":"Biondo","year":"2022","journal-title":"Psychol. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"41547","DOI":"10.1038\/s41598-025-25420-7","article-title":"Testing gender differences in psychological adjustment among early adolescents though a multigroup analysis of latent profiles","volume":"15","author":"Villar","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1177\/1087054720923736","article-title":"Meta-Analysis of Sex Differences in ADHD Symptoms and Associated Cognitive Deficits","volume":"25","author":"Demers","year":"2021","journal-title":"J. Atten. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1002\/ppul.23120","article-title":"The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects","volume":"50","author":"Goldstein","year":"2015","journal-title":"Pediatr. Pulmonol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"8102","DOI":"10.1038\/s41598-022-12207-3","article-title":"Associations of sleep problems with asthma and allergic rhinitis among Chinese preschoolers","volume":"12","author":"Ma","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_37","first-page":"1483919","article-title":"Sex hormones and allergies: Exploring the gender differences in immune responses","volume":"5","year":"2024","journal-title":"Front. Allergy"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Cristallo, M., Furci, F., Casciaro, M., Gangemi, S., and Nettis, E. (2025). Sex Differences in Oxidative Stress Concerning Allergic Diseases. Biomolecules, 15.","DOI":"10.3390\/biom15101461"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.anai.2009.10.002","article-title":"From atopic dermatitis to asthma: The atopic march","volume":"105","author":"Spergel","year":"2010","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.jaci.2024.10.036","article-title":"Developmental trajectories of atopic dermatitis with multiomics approaches in the infant gut: COCOA birth cohort","volume":"155","author":"Lee","year":"2025","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1111\/apa.15709","article-title":"Asthma and allergies correlate with mental health problems in preschool children","volume":"110","author":"Fabian","year":"2021","journal-title":"Acta Paediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1111\/pde.14588","article-title":"Predictors and age-dependent pattern of psychologic problems in childhood atopic dermatitis","volume":"38","author":"Hou","year":"2021","journal-title":"Pediatr. Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.anai.2022.05.008","article-title":"Allergic disease, sleep problems, and psychological distress in children recruited from the general community","volume":"129","author":"Sherrey","year":"2022","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e190025","DOI":"10.1001\/jamapediatrics.2019.0025","article-title":"Association of Atopic Dermatitis With Sleep Quality in Children","volume":"173","author":"Ramirez","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e0228533","DOI":"10.1371\/journal.pone.0228533","article-title":"The association between allergic rhinitis and sleep: A systematic review and meta-analysis of observational studies","volume":"15","author":"Liu","year":"2020","journal-title":"PLoS ONE"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jped.2021.11.010","article-title":"Allergic rhinitis and sleep disorders in children\u2014Coexistence and reciprocal interactions","volume":"98","author":"Gozal","year":"2022","journal-title":"J. Pediatr."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Venkatesan, P. (Lancet Respir. Med., 2025). 2025 GINA report for asthma, Lancet Respir. Med., ahead of print.","DOI":"10.1016\/S2213-2600(25)00242-5"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.anai.2014.02.002","article-title":"Allergic rhinitis quality of life in urban children with asthma","volume":"112","author":"Everhart","year":"2014","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11910-016-0631-z","article-title":"Allergic Rhinitis and Chronic Daily Headaches: Is There a Link?","volume":"16","author":"Gryglas","year":"2016","journal-title":"Curr. Neurol. Neurosci. Rep."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1017\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:23:38Z","timestamp":1785558218000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13081017"],"URL":"https:\/\/doi.org\/10.3390\/children13081017","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]}}}