A prospective observation of psychological distress in patients with anaphylaxis

Youngsoo Lee; 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

doi:10.4168/aair.2020.12.3.496

A prospective observation of psychological distress in patients with anaphylaxis

Youngsoo Lee, 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

Internal Medicine

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

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.

Original language	English
Pages (from-to)	496-506
Number of pages	11
Journal	Allergy, Asthma and Immunology Research
Volume	12
Issue number	3
DOIs	https://doi.org/10.4168/aair.2020.12.3.496
Publication status	Published - 2020 May

Bibliographical note

Funding Information:
This research was supported by the Korean Academy of Asthma, Allergy and Clinical Immunology and partly by a National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2018R1A2B6006199).

Publisher Copyright:
© 2020 The Korean Academy of Asthma.

All Science Journal Classification (ASJC) codes

Immunology and Allergy
Immunology
Pulmonary and Respiratory Medicine

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10.4168/aair.2020.12.3.496

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Lee, Y., Chang, H. Y., Kim, S. H., Yang, M. S., Koh, Y. I., Kang, H. R., Choi, J. H., Kim, C. W., Park, H. K., Kim, J. H., Nam, Y. H., Kim, T. B., Hur, G. Y., Jung, J. W., Park, K. H., Kim, M. A., Kim, J., Yoon, J., & Ye, Y. M. (2020). A prospective observation of psychological distress in patients with anaphylaxis. Allergy, Asthma and Immunology Research, 12(3), 496-506. https://doi.org/10.4168/aair.2020.12.3.496

@article{e56e12277080448b931d7aa022255ea8,

title = "A prospective observation of psychological distress in patients with anaphylaxis",

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.",

author = "Youngsoo Lee and Chang, {Hyoung Yoon} and Kim, {Sang Ha} and Yang, {Min Suk} and Koh, {Young Il} and Kang, {Hye Ryun} and Choi, {Jeong Hee} and Kim, {Cheol Woo} and Park, {Hye Kyung} and Kim, {Joo Hee} and Nam, {Young Hee} and Kim, {Tae Bum} and Hur, {Gyu Young} and Jung, {Jae Woo} and Park, {Kyung Hee} and Kim, {Mi Ae} and Jiwoong Kim and Jiwon Yoon and Ye, {Young Min}",

note = "Funding Information: This research was supported by the Korean Academy of Asthma, Allergy and Clinical Immunology and partly by a National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2018R1A2B6006199). Publisher Copyright: {\textcopyright} 2020 The Korean Academy of Asthma.",

year = "2020",

month = may,

doi = "10.4168/aair.2020.12.3.496",

language = "English",

volume = "12",

pages = "496--506",

journal = "Allergy, Asthma and Immunology Research",

issn = "2092-7355",

publisher = "Korean Academy of Asthma, Allergy and Clinical Immunology",

number = "3",

}

Lee, Y, Chang, HY, Kim, SH, Yang, MS, Koh, YI, Kang, HR, Choi, JH, Kim, CW, Park, HK, Kim, JH, Nam, YH, Kim, TB, Hur, GY, Jung, JW, Park, KH, Kim, MA, Kim, J, Yoon, J & Ye, YM 2020, 'A prospective observation of psychological distress in patients with anaphylaxis', Allergy, Asthma and Immunology Research, vol. 12, no. 3, pp. 496-506. https://doi.org/10.4168/aair.2020.12.3.496

TY - JOUR

T1 - A prospective observation of psychological distress in patients with anaphylaxis

AU - Lee, Youngsoo

AU - Chang, Hyoung Yoon

AU - Kim, Sang Ha

AU - Yang, Min Suk

AU - Koh, Young Il

AU - Kang, Hye Ryun

AU - Choi, Jeong Hee

AU - Kim, Cheol Woo

AU - Park, Hye Kyung

AU - Kim, Joo Hee

AU - Nam, Young Hee

AU - Kim, Tae Bum

AU - Hur, Gyu Young

AU - Jung, Jae Woo

AU - Park, Kyung Hee

AU - Kim, Mi Ae

AU - Kim, Jiwoong

AU - Yoon, Jiwon

AU - Ye, Young Min

N1 - Funding Information: This research was supported by the Korean Academy of Asthma, Allergy and Clinical Immunology and partly by a National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2018R1A2B6006199). Publisher Copyright: © 2020 The Korean Academy of Asthma.

PY - 2020/5

Y1 - 2020/5

N2 - 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.

AB - 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.

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A prospective observation of psychological distress in patients with anaphylaxis

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

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