Association between chronic pruritus, depression, and insomnia: A cross-sectional study

Elsevier, JAAD International, Volume 3, June 2021, Pages 54-60


Skin diseases that cause chronic pruritus can have negative effects on a patient's quality of life.


We evaluated the associations between chronic pruritus and psychological conditions including insomnia and depression.


This study included responses from 91 participants with chronic pruritus (response rate: 74.6%). A survey including questionnaires regarding data on demographic characteristics, intensity of pruritus using the visual analog scale (VAS) and the 4-item itch questionnaire, and the degrees of insomnia and depression measured by the Insomnia Severity Index and Beck Depression Inventory, respectively.


Patients with symptoms of insomnia or depression had significantly more intense pruritus than patients without psychological symptoms (insomnia, VAS median [interquartile range]: 7.0 [5.0-8.25] vs. 5.0 [3.0-7.5]; depression, VAS median [interquartile range]: 7.5 [5.0-8.25] vs. 5.0 [3.0-7.0]). Multivariable analyses revealed that patients with moderate to severe pruritus were more likely to have depression than those with mild pruritus (odds ratio: 10.95; 95% confidence interval: 2.24-53.06). There were no differences in the severity of insomnia and depression among skin diseases.


This study had a cross-sectional design and limited generalizability.


Chronic pruritus is significantly associated with insomnia and depression, regardless of the etiology.