与特发性过敏反应相关的精神健康问题

Logan S Gardner, Zihao Tan, David Brown, David Gillis, James G Scott, Roger Prentice
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摘要

背景:特发性过敏反应(IA)是成人中最常见的过敏综合征。与内审有关的心理健康问题没有得到很好的认识。我们的目的是评估与正常的澳大利亚人群相比,被诊断为IA的患者是否更有可能经历心理健康问题。我们还假设过敏发作的次数与焦虑症状相关。方法:从一家成人免疫学诊所招募34例至少有一次IA发作的患者。患者被招募作为评估IA其他病因的单独研究的一部分。使用抑郁、焦虑和压力量表(DASS-21)测量心理健康问题。调查的延伸部分包括了专门针对IA心理影响的问题。结果:与正常人群相比,IA患者的心理健康问题水平显著高于正常人群。DASS-21在抑郁症方面的得分为4.24比2.57 (p)。结论:这是第一篇证明特发性过敏反应患者比社区患者更有精神疾病症状的论文。应对IA患者进行精神疾病筛查和心理支持转诊。
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Mental health problems associated with idiopathic anaphylaxis.

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: 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: 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: 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.

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