Mental health problems associated with idiopathic anaphylaxis.
Allergies
Anxiety
Depression
Idiopathic anaphylaxis
Psychiatry
Stress
Journal
Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology
ISSN: 1710-1484
Titre abrégé: Allergy Asthma Clin Immunol
Pays: England
ID NLM: 101244313
Informations de publication
Date de publication:
13 Sep 2023
13 Sep 2023
Historique:
received:
01
01
2023
accepted:
13
07
2023
medline:
14
9
2023
pubmed:
14
9
2023
entrez:
13
9
2023
Statut:
epublish
Résumé
Idiopathic Anaphylaxis (IA) is the most common anaphylactic syndrome in adults. Mental health problems associated with IA are not well recognised. We aimed to assess if patients diagnosed with IA were more likely to experience mental health problems compared to a normative Australian population. We additionally hypothesised that the number of anaphylactic episodes would correlate with symptoms of anxiety. A total of 34 patients with at least one episode of IA were recruited from an adult immunology clinic. Patients were recruited as part of a separate study evaluating alternative aetiologies in IA. Mental health problems were measured using the Depression, Anxiety and Stress Scale (DASS-21). An extension of the survey included questions specifically focused on the psychological impact of IA. Compared to population norms, those with IA had significantly higher levels of mental health problems. Statistically significant DASS-21 scores were identified for depression 4.24 vs. 2.57 (p < 0.001), anxiety 4.76 vs. 1.74 (p < 0.012), stress 7.35 vs. 3.95 (p < 0.001) and total score 16.35 vs. 8.00 (p < 0.001). There was no association between two or more episodes of anaphylaxis and increased anxiety levels (β = 0.52, CI -2.59-3.62, p = 0.74). This is the first paper to demonstrate that patients living with idiopathic anaphylaxis are more symptomatic for mental illness than those in the community. Screening for mental illness and referral for psychological support should be undertaken in people with IA.
Sections du résumé
BACKGROUND
BACKGROUND
Idiopathic Anaphylaxis (IA) is the most common anaphylactic syndrome in adults. Mental health problems associated with IA are not well recognised. We aimed to assess if patients diagnosed with IA were more likely to experience mental health problems compared to a normative Australian population. We additionally hypothesised that the number of anaphylactic episodes would correlate with symptoms of anxiety.
METHODS
METHODS
A total of 34 patients with at least one episode of IA were recruited from an adult immunology clinic. Patients were recruited as part of a separate study evaluating alternative aetiologies in IA. Mental health problems were measured using the Depression, Anxiety and Stress Scale (DASS-21). An extension of the survey included questions specifically focused on the psychological impact of IA.
RESULTS
RESULTS
Compared to population norms, those with IA had significantly higher levels of mental health problems. Statistically significant DASS-21 scores were identified for depression 4.24 vs. 2.57 (p < 0.001), anxiety 4.76 vs. 1.74 (p < 0.012), stress 7.35 vs. 3.95 (p < 0.001) and total score 16.35 vs. 8.00 (p < 0.001). There was no association between two or more episodes of anaphylaxis and increased anxiety levels (β = 0.52, CI -2.59-3.62, p = 0.74).
CONCLUSIONS
CONCLUSIONS
This is the first paper to demonstrate that patients living with idiopathic anaphylaxis are more symptomatic for mental illness than those in the community. Screening for mental illness and referral for psychological support should be undertaken in people with IA.
Identifiants
pubmed: 37705020
doi: 10.1186/s13223-023-00824-0
pii: 10.1186/s13223-023-00824-0
pmc: PMC10500772
doi:
Types de publication
Journal Article
Langues
eng
Pagination
84Informations de copyright
© 2023. Canadian Society of Allergy & Clinical Immunology.
Références
Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report–second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006;117(2):391–7.
doi: 10.1016/j.jaci.2005.12.1303
pubmed: 16461139
Kaplan MS, Anaphylaxis. Perm J. 2007;11(3):53–6.
doi: 10.7812/TPP/07-019
pubmed: 21461113
pmcid: 3057722
Turner PJ, Gowland MH, Sharma V, Ierodiakonou D, Harper N, Garcez T, et al. Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992–2012. J Allergy Clin Immunol. 2015;135(4):956–63e1.
doi: 10.1016/j.jaci.2014.10.021
pubmed: 25468198
pmcid: 4382330
Mullins RJ, Dear KBG, Tang MLK. Changes in australian food anaphylaxis admission rates following introduction of updated allergy prevention guidelines. J Allergy Clin Immunol. 2022;150(1):140–5e1.
doi: 10.1016/j.jaci.2021.12.795
pubmed: 35077775
Speakman S, Kool B, Sinclair J, Fitzharris P. Paediatric food-induced anaphylaxis hospital presentations in New Zealand. J Paediatr Child Health. 2018;54(3):254–9.
doi: 10.1111/jpc.13705
pubmed: 28885749
Motosue MS, Bellolio MF, Van Houten HK, Shah ND, Campbell RL. National trends in emergency department visits and hospitalizations for food-induced anaphylaxis in US children. Pediatr Allergy Immunol. 2018;29(5):538–44.
doi: 10.1111/pai.12908
pubmed: 29663520
Turner PJ, Jerschow E, Umasunthar T, Lin R, Campbell DE, Boyle RJ. Fatal Anaphylaxis: Mortality Rate and Risk factors. J Allergy Clin Immunol Pract. 2017;5(5):1169–78.
doi: 10.1016/j.jaip.2017.06.031
pubmed: 28888247
pmcid: 5589409
de Silva NR, Dasanayake W, Karunatilake C, Wickramasingha GD, De Silva BD, Malavige GN. Aetiology of anaphylaxis in patients referred to an immunology clinic in Colombo, Sri Lanka. Allergy Asthma Clin Immunol. 2018;14:81.
doi: 10.1186/s13223-018-0295-0
pubmed: 30455720
pmcid: 6225671
Bacal E, Patterson R, Zeiss CR. Evaluation of severe (anaphylactic) reactions. Clin Allergy. 1978;8(3):295–304.
doi: 10.1111/j.1365-2222.1978.tb03227.x
pubmed: 668103
Fenny N, Grammer LC. Idiopathic anaphylaxis. Immunol Allergy Clin North Am. 2015;35(2):349–62.
doi: 10.1016/j.iac.2015.01.004
pubmed: 25841556
Simons FE, Ardusso LR, Bilò MB, El-Gamal YM, Ledford DK, Ring J, et al. World allergy organization guidelines for the assessment and management of anaphylaxis. World Allergy Organ J. 2011;4(2):13–37.
doi: 10.1097/WOX.0b013e318211496c
pubmed: 23268454
pmcid: 3500036
Carter MC, Ruiz-Esteves KN, Workman L, Lieberman P, Platts-Mills TAE, Metcalfe DD. Identification of alpha-gal sensitivity in patients with a diagnosis of idiopathic anaphylaxis. Allergy. 2018;73(5):1131–4.
doi: 10.1111/all.13366
pubmed: 29161766
Greenberger PA, Lieberman P. Idiopathic anaphylaxis. J Allergy Clin Immunol Pract. 2014;2(3):243–50. quiz 51.
doi: 10.1016/j.jaip.2014.02.012
pubmed: 24811012
Heaps A, Carter S, Selwood C, Moody M, Unsworth J, Deacock S, et al. The utility of the ISAC allergen array in the investigation of idiopathic anaphylaxis. Clin Exp Immunol. 2014;177(2):483–90.
doi: 10.1111/cei.12334
pubmed: 24654858
pmcid: 4226599
Crawford J, Cayley C, Lovibond PF, Wilson PH, Hartley C. Percentile norms and accompanying interval estimates from an australian general adult population sample for self-report mood scales (BAI, BDI, CRSD, CES-D, DASS, DASS-21, STAI-X, STAI-Y, SRDS, and SRAS). Australian Psychol. 2011;46(1):3–14.
doi: 10.1111/j.1742-9544.2010.00003.x
Wang K, Shi HS, Geng FL, Zou LQ, Tan SP, Wang Y, et al. Cross-cultural validation of the Depression anxiety stress Scale-21 in China. Psychol Assess. 2016;28(5):e88–e100.
doi: 10.1037/pas0000207
pubmed: 26619091
Chung MC, Walsh A, Dennis I. Trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder, and psychiatric comorbidity among people with anaphylactic shock experience. Compr Psychiatry. 2011;52(4):394–404.
doi: 10.1016/j.comppsych.2010.09.005
pubmed: 21081226
Akeson N, Worth A, Sheikh A. The psychosocial impact of anaphylaxis on young people and their parents. Clin Exp Allergy. 2007;37(8):1213–20.
doi: 10.1111/j.1365-2222.2007.02758.x
pubmed: 17651152
Ferro MA, Van Lieshout RJ, Ohayon J, Scott JG. Emotional and behavioral problems in adolescents and young adults with food allergy. Allergy. 2016;71(4):532–40.
doi: 10.1111/all.12829
pubmed: 26715290
Rouf K, White L, Evans K. A qualitative investigation into the maternal experience of having a young child with severe food allergy. Clin Child Psychol Psychiatry. 2012;17(1):49–64.
doi: 10.1177/1359104511415636
pubmed: 21852318
Cummings AJ, Knibb RC, King RM, Lucas JS. The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy. 2010;65(8):933–45.
doi: 10.1111/j.1398-9995.2010.02342.x
pubmed: 20180792
Flokstra-de Blok BM, DunnGalvin A, Vlieg-Boerstra BJ, Oude Elberink JN, Duiverman EJ, Hourihane JO, et al. Development and validation of a self-administered Food Allergy Quality of Life Questionnaire for children. Clin Exp Allergy. 2009;39(1):127–37.
doi: 10.1111/j.1365-2222.2008.03120.x
pubmed: 19016799
Baiardini I, Gaeta F, Molinengo G, Braido F, Canonica GW, Romano A. Quality-of-life issues in survivors to anaphylactic reactions to drugs. Allergy. 2015;70(7):877–9.
doi: 10.1111/all.12610
pubmed: 25789409
Jennings S, Russell N, Jennings B, Slee V, Sterling L, Castells M, et al. The Mastocytosis Society survey on mast cell disorders: patient experiences and perceptions. J Allergy Clin Immunol Pract. 2014;2(1):70–6.
doi: 10.1016/j.jaip.2013.09.004
pubmed: 24565772
Walklet E, Taylor C, Bradley E, Mahoney B, Scurlock-Evans L, O’Hickey S. Because it kind of falls in between, doesn’t it? Like an acute thing and a chronic’: the psychological experience of anaphylaxis in adulthood. J Health Psychol. 2018;23(12):1579–89.
doi: 10.1177/1359105316664130
pubmed: 27553607
Chida Y, Hamer M, Steptoe A. A bidirectional relationship between psychosocial factors and atopic disorders: a systematic review and meta-analysis. Psychosom Med. 2008;70(1):102–16.
doi: 10.1097/PSY.0b013e31815c1b71
pubmed: 18158379
Dehdar K, Mahdidoust S, Salimi M, Gholami-Mahtaj L, Nazari M, Mohammadi S, et al. Allergen-induced anxiety-like behavior is associated with disruption of medial prefrontal cortex - amygdala circuit. Sci Rep. 2019;9(1):19586.
doi: 10.1038/s41598-019-55539-3
pubmed: 31863052
pmcid: 6925103
Choy AC, Patterson R, Patterson DR, Grammer LC, Greenberger PA, McGrath KG, et al. Undifferentiated somatoform idiopathic anaphylaxis: nonorganic symptoms mimicking idiopathic anaphylaxis. J Allergy Clin Immunol. 1995;96(6 Pt 1):893–900.
doi: 10.1016/S0091-6749(95)70225-3
pubmed: 8543746
Malhi GS, Bell E, Bassett D, Boyce P, Bryant R, Hazell P, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry. 2021;55(1):7–117.
doi: 10.1177/0004867420979353
pubmed: 33353391