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. 2025 Jul;15(7):e70075.
doi: 10.1002/clt2.70075.

Exploring the impact of chronic urticaria profile as a key predictor of alexithymia: A cross-sectional study

Ivan Cherrez Ojeda  1   2   3 , Simon Francis Thomsen  4 , Ana M Gimenez-Arnau  5 , Jennifer Astrup Sørensen  4 , Hermenio Lima  6   7 , Kiran Godse  8 , Carole Guillet  9   10 , Luis Escalante  11   12 , Astrid Maldonado  11   13 , Gonzalo Federico Chorzepa  14 , Blanca Morfin-Maciel  15 , Jose Ignacio Larco Sousa  16 , Erika de Arruda-Chaves  17 , Abhishek De  18 , Daria Fomina  19 , Anant Patil  20 , Roberta Jardim Criado  21 , Luis Felipe Ensina  22 , Solange O R Valle  23 , Rosana Câmara Agondi  24 , Herberto Chong Neto  25 , Nelson Rosario  25 , German Dario Ramon  26 , Marco Faytong-Haro  3   27   28 , Isabel Ogueta  29   30   31 , Ivan Tinoco Moran  32 , Jennifer Donnelly  33 , Emek Kocatürk  1   34   35 , Anna Zalewska-Janowska  36 , Karla Robles-Velasco  2   3
Affiliations

Exploring the impact of chronic urticaria profile as a key predictor of alexithymia: A cross-sectional study

Ivan Cherrez Ojeda et al. Clin Transl Allergy. 2025 Jul.

Abstract

Introduction: The relationship between chronic urticaria (CU) and alexithymia, a cognitive-affective impairment characterized by difficulty in identifying and expressing emotions, is complex and underexplored. This study aimed to identify predictors of alexithymia in CU patients by focusing on the impact of coexisting mental illnesses and antihistamine use.

Methods: An online survey was distributed to specialized allergy and dermatology centers from 2021 to 2022. The survey included the TAS-20, UAS-7, UCT, CU-Q2oL, and demographic information. Participants were 18-80 years old, diagnosed with CU, and had no prior diagnosis of alexithymia. The final analysis included a total of 332 respondents from various countries. Regression models were used to investigate the relationship between clinical and demographic factors of patients with CU as key predictors of alexithymia.

Results: Among CU patients, the main predictors of having alexithymia were: presenting mental (OR = 2.406, p < 0.05) and cardiovascular comorbidities (OR = 2.085, p < 0.05), active urticaria (as opposed to being urticaria-free), OR = 1.989, p < 0.05, severe impact on quality of life (OR = 1.973, p < 0.01), and the use of oral first-generation antihistamines (OR = 2.340, p < 0.05). The duration of chronic urticaria diagnosis and other types of treatments (sg-AH use, omalizumab use, and corticosteroid use) do not appear to be significantly associated with alexithymia.

Conclusions: Alexithymia is closely linked to clinical and demographic variables among patients with CU. These findings suggest that comprehensive management of CU should include psychological assessment and support, especially for patients with alexithymia and those using fg-AH. Reducing the reliance on fg-AH and addressing mental health issues may improve outcomes for these patients.

Keywords: Toronto alexithymia scale; alexithymia; chronic urticaria; demographics; predictors.

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Conflict of interest statement

EK declares being a speaker and advisor for Novartis, Menarini, LaRoche Posey, Sanofi, Bayer, Abdi İbrahim, Pfizer. SFT declares being speaker or advisor for AbbVie, Almirall, Boehringer, Eli Lilly, Galderma, Incyte, Janssen Pharmaceuticals, LEO Pharma, Novartis, Pfizer, Sanofi, UCB Pharma, and Union Therapeutics, and received research support from AbbVie, Janssen Pharmaceuticals, LEO Pharma, Novartis, Sanofi, and UCB Pharma outside the submitted work. The rest of the coauthors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Margins from ordinal logistic regression predicting the TAS20 category as a function of UAS7 interpretation categories.
See this image and copyright information in PMC

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