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. 2020 May;12(3):496-506.
doi: 10.4168/aair.2020.12.3.496.

A Prospective Observation of Psychological Distress in Patients With Anaphylaxis

Youngsoo Lee  1 , Hyoung Yoon Chang  2 , Sang Ha Kim  3 , Min Suk Yang  4 , Young Il Koh  5 , Hye Ryun Kang  6 , Jeong Hee Choi  7 , Cheol Woo Kim  8 , Hye Kyung Park  9 , Joo Hee Kim  10 , Young Hee Nam  11 , Tae Bum Kim  12 , Gyu Young Hur  13 , Jae Woo Jung  14 , Kyung Hee Park  15 , Mi Ae Kim  16 , Jiwoong Kim  17 , Jiwon Yoon  17 , Young Min Ye  18
Affiliations

A Prospective Observation of Psychological Distress in Patients With Anaphylaxis

Youngsoo Lee et al. Allergy Asthma Immunol Res. 2020 May.

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.

Keywords: Anaphylaxis; anxiety; depression; psychological distress; stress disorders, post-traumatic.

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Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

Figures

Fig. 1
Fig. 1. Measurements of IES-R-K, K-BAI, and K-BDI and the proportion of patients who scored over the cut-off point of each questionnaire.
PTSD, posttraumatic stress disorder; IES-R-K, the Impact of Event Scale-Revised-Korean version; K-BAI, Korean version of the Beck Anxiety Inventory; K-BDI, Korean version of the Beck Depression Inventory.
Fig. 2
Fig. 2. Correlations for IES-R-K with K-BAI (A) and K-BDI (B) in patients with anaphylaxis.
IES-R-K, the Impact of Event Scale-Revised-Korean version; K-BAI, Korean version of the Beck Anxiety Inventory; K-BDI, Korean version of the Beck Depression Inventory.
See this image and copyright information in PMC

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