Substantial psychosocial impairments in patients with chronic urticaria are associated with delayed referral to urticaria centers, non-academic treatments, and dietary changes.

Abstract

Background: Chronic idiopathic urticaria (CIU) is common in allergological practice. Although therapeutic options have improved in the past decade, patients still suffer from a significant burden of disease and are often treated insufficiently.

Objective: We aimed at analyzing the psychiatric comorbidities, social impairments, and treatment gap in a real-world setting.

Materials and methods: Adult patients with CIU were investigated for demographical data, medical history, and psychosocial burden. Validated questionnaires were used to assess urticaria activity, control of disease, quality-of-life impairment, and psychiatric comorbidities.

Results: 82 patients (78% female; 47.5 ± 14.8 years) were included. 65.9% had insufficient disease control, 11% reported on prior self-medication with drugs, 19.5% were seeking help from non-academic medicine, and 54.9% tried a change of diet. The use of non-academic treatment was significantly associated with higher disease activity. Self-initiated dietary changes were significantly associated with less control of disease. Delayed referrals to a urticaria-specialized center were significantly linked to self-reported psychiatric diseases, self-medication with drugs and self-initiated dietary changes.

Conclusion: Our data show an unsatisfactory control of CIU in many patients and substantial psychosocial impairments which are also associated with a delayed referral to urticaria centers, self-initiated non-academic treatments, and dietary changes.