P12 An audit of the psychological morbidity of children and young people on systemic medications for atopic eczema or psoriasis.

Abstract

Children and young people (CYP) living with skin conditions, experience significant psychological burden, which has been well-documented. Guidance has been produced to help support clinicians address this (McPherson T, Ravenscroft J, Ali R et al. British Society for Paediatric and Adolescent Dermatology assessment and support of mental health in children and young people with skin conditions: a multidisciplinary expert consensus statement and recommendations. Br J Dermatol 2023;189:459-66). The guidance stresses the importance of routinely asking about impact on psychosocial health and documenting this in communications. We audited clinic letters at our tertiary Dermatology Centre from 2013-2025 in CYP who have been prescribed systemic medications for eczema or psoriasis to assess if this is addressed and documented in clinic correspondence. 540 clinic letters from 47 CYP (age range 5 months-22 years) with eczema (n = 37) or psoriasis (n = 10), were examined. 80.2% of clinic letters had mental health impact and/ or quality of life (QoL) impact documented in some form. This was most commonly recorded using Patient Reported Outcome Measures (PROMs) and a comment (58.0%), followed by a comment only (27.5%) and PROM only (14.8%). Examples of mental health impact comments included decreased self-confidence, isolation, decreased mood during flares and sleep disturbance frequently due to pruritus. 18/47 patients were documented to be under CAMHS and 14 were referred to Psychological Medicine Service for skin condition related psychological support. Improvement in disease specific scores (EASI, POEM, PASI) did relate to improvement in QOL scores (CDLQI and TQoL) and reported psychological benefits such as improved sleep and mood. This data confirms that severe inflammatory skin conditions have a high mental health burden. Reassuringly this is generally being discussed in clinic and recorded in communications as part of ongoing assessment.