2026-03-04 ノースカロライナ州立大学
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＜関連情報＞
- https://news.ncsu.edu/2026/03/the-itch-to-brain-circuit-neural-change-and-depression/
- https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2845750
アトピー性皮膚炎における併存性うつ病 ― かゆみと脳の回路形成理論
Comorbid Depression in Atopic Dermatitis—The Itch-to-Brain Circuitry Theory
Ian McConnell, PhD; John M. Davis, MD; Santosh Kumar Mishra, PhD
JAMA Psychiatry Published:March 4, 2026
DOI:10.1001/jamapsychiatry.2026.0029
Chronic atopic dermatitis (AD) has an alarming propensity to generate psychiatric comorbidities, with patients with chronic AD incurring an approximately 7 times higher risk of developing major depressive disorder (MDD).1 Today, the link between AD and neuropsychiatric disorders, particularly depression, is well established.2,3 However, the mechanisms speculated so far have primarily fixated on systemic inflammation, sleep disturbance, stress responses mediated by the hypothalamic-pituitary-adrenal axis, and the psychological distress of living with a chronic disease. For clinicians concerned with AD-generated comorbid depression (synonymous with “mood disorder due to another medical condition, with MDD-like features,” according to the DSM-5-TR), a vexing question persists: is the profound comorbid depression merely a consequence of these mechanisms or is there also a deeper, more fundamental neurological pathology driving the comorbidity? Although the most distinctive symptoms of AD—recurrent erythema and persistently itchy, eczematous skin lesions—are visible and debilitating, it is the invisible burden of chronic itch that is a key driver of the disease’s overall burden. This Viewpoint proposes a more precise, neural circuit–driven connection that argues that AD-associated chronic itch signaling from lesional skin not only causes inflammation, stress, and distress, it drives neuroplastic changes in the brain’s sensory, emotional, and cognitive control circuits, directly contributing to AD-generated comorbid depression.
