A Prospective Observation of Psychological Distress in Patients With Anaphylaxis
10.4168/aair.2020.12.3.496
- Author:
Youngsoo LEE
1
;
Hyoung Yoon CHANG
;
Sang Ha KIM
;
Min Suk YANG
;
Young Il KOH
;
Hye Ryun KANG
;
Jeong Hee CHOI
;
Cheol Woo KIM
;
Hye Kyung PARK
;
Joo Hee KIM
;
Young Hee NAM
;
Tae Bum KIM
;
Gyu Young HUR
;
Jae Woo JUNG
;
Kyung Hee PARK
;
Mi Ae KIM
;
Jiwoong KIM
;
Jiwon YOON
;
Young Min YE
Author Information
1. Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea. ye9007@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Anaphylaxis;
stress disorders, post-traumatic;
psychological distress;
anxiety;
depression
- MeSH:
Adult;
Anaphylaxis;
Anxiety;
C-Reactive Protein;
Depression;
Hospitals, University;
Humans;
Hypersensitivity;
Interleukin-6;
Korea;
Multivariate Analysis;
Necrosis;
Prevalence;
Prospective Studies;
Stress Disorders, Post-Traumatic;
Tryptases
- From:Allergy, Asthma & Immunology Research
2020;12(3):496-506
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Anaphylaxis is an immediate allergic reaction characterized by potentially life-threatening, severe, systemic manifestations. While studies have evaluated links between serious illness and posttraumatic stress disorder (PTSD), few have investigated PTSD after anaphylaxis in adults. We sought to investigate the psychosocial burden of recent anaphylaxis in Korean adults.METHODS: A total of 203 (mean age of 44 years, 120 females) patients with anaphylaxis were recruited from 15 university hospitals in Korea. Questionnaires, including the Impact of Event Scale-Revised-Korean version (IES-R-K), the Korean version of the Beck Anxiety Inventory (K-BAI), and the Korean version of the Beck Depression Inventory (K-BDI), were administered. Demographic characteristics, causes and clinical features of anaphylaxis, and serum inflammatory markers, including tryptase, platelet-activating factor, interleukin-6, tumor necrosis factor-α, and C-reactive protein, were evaluated.RESULTS: PTSD (IES-R-K ≥ 25) was noted in 84 (41.4%) patients with anaphylaxis. Of them, 56.0% had severe PTSD (IES-R-K ≥ 40). Additionally, 23.2% and 28.1% of the patients had anxiety (K-BAI ≥ 22) and depression (K-BDI ≥ 17), respectively. IES-R-K was significantly correlated with both K-BAI (r = 0.609, P < 0.0001) and K-BDI (r = 0.550, P < 0.0001). Among the inflammatory mediators, tryptase levels were lower in patients exhibiting PTSD; meanwhile, platelet-activating factor levels were lower in patients exhibiting anxiety and depression while recovering from anaphylaxis. In multivariate analysis, K-BAI and K-BDI were identified as major predictive variables of PTSD in patients with anaphylaxis.CONCLUSIONS: In patients with anaphylaxis, we found a remarkably high prevalence of PTSD and associated psychological distresses, including anxiety and depression. Physicians ought to be aware of the potential for psychological distress in anaphylactic patients and to consider psychological evaluation.
