Alerjik Hastalıkların Anksiyete, Depresyon ve Yaşam Kalitesi Açısından Karşılaştırılması

Yıl 2024, Cilt: 46 Sayı: 3, 436 - 446, 27.05.2024

Betül Özdel Öztürk Mehmet Kayhan

https://doi.org/10.20515/otd.1459297

Öz

Alerjik hastalıklarda anksiyete ve depresyonun sık olduğu ve yaşam kalitesinin bozulduğu farklı çalışmalarda gösterilmiştir. Bu çalışmanın amacı, herhangi bir psikiyatrik tanısı olmayan astım, alerjik rinit (AR), ürtiker/anjioödem (Ü/A) ve ilaç alerjisi olan hastalarda anksiyete ve depresyon semptomlarını ve yaşam kalitesini değerlendirmek ve bu dört hastalık grubunu bu açılardan karşılaştırmaktı. Kesitsel nitelikte olan bu çalışmada hastaların sosyodemografik ve klinik özelliklerine ait veriler hasta kayıtlarından elde edildi. Anksiyete ve depresyon belirtilerini ve yaşam kalitesini ölçmek için Hastane Anksiyete Depresyon Ölçeği (HADS) ve Kısa Form 36 (SF-36) kullanıldı. Toplam 159 hasta çalışmaya dahil edildi. Hastalar astım (n=43, %27,1), AR (n=45, %28,3), Ü/A (n=44, %27,7) ve ilaç alerjisi (n=27, %17) olmak üzere dört gruba ayrıldı. Gruplar arasında, HADS anksiyete skoru ve SF-36 fiziksel fonksiyon alt skoru açısından anlamlı farklılık vardı (sırasıyla; p<0.001 ve p=0.001); HADS anksiyete skoru Ü/A grubunda anlamlı daha yüksekti ve SF-36 fiziksel fonksiyon alt skoru astımlı hastalarda daha düşüktü. Basamak 4 ve 5 tedavi alan astımlıların (n=22, %51,2) SF-36’nın fiziksel rol güçlüğü, emosyonel rol güçlüğü, sosyal işlevsellik alt skorları basamak 2 ve 3 tedavi alanlarınkine (n=21, %48,8) göre daha düşüktü (sırasıyla; p=0.001, p=0.031 ve p=0.005). Ürtiker/anjioödem grubunda, ürtiker aktivite skoru 7 ile HADS anksiyete skoru arasında pozitif bir korelasyon vardı (r:0.579, p<0.001) ve hafif (n=16, %36,4), orta (n=12, %27,3) ve ağır (n=16, %36,4) gruplar arasında HADS anksiyet skoru açısından farklılık vardı (p=0.002). Çalışmamız Ü/A hastalarının diğer alerjik hastalalıklara göre daha fazla anksiyete belirtilerine sahip olduğunu gösterdi. Hastalık aktivitesi ve ağırlığı ürtikerli hastalarda artmış ankiyete düzeyi ile astımlı hastalarda ise düşük yaşam kalitesi ile ilişkiliydi.

Anahtar Kelimeler

anksiyete, depresyon, yaşam kalitesi, alerjik hastalıklar, ürtiker, astım

Comparison of Allergic Diseases in terms of Anxiety, Depression and Quality of Life

Öz

Studies have shown the frequency of anxiety and depression and decreased quality of life (QoL) in patients with allergic diseases. The aim of this study was to evaluate anxiety and depression symptoms and QoL in patients with asthma, allergic rhinitis (AR), urticaria/angioedema (U/A) and drug allergy without any psychiatric diagnosis and to compare these four diseases in these respects. In this cross-sectional study demographic and clinical characteristics were collected from patients’records. Hospital Anxiety and Depression Scale (HADS) and Short Form 36 (SF-36) were used to assess anxiety and depression symptoms and QoL. A total of 159 patients were included in the study and grouped as asthma (n=43, 27.1%), AR (n=45, 28.3%), U/A (n=44, 27.7%) and drug allergy (n=27, 17%). There was a significant difference in HADS anxiety score and SF-36 physical functioning subscore (p<0.001 and p=0.001, respectively). HADS anxiety score was higher in the U/A group and SF-36 physical functioning was lower in asthma group. Among asthmatics, SF-36 subscores of physical role functioning, emotional role functioning, social role functioning were lower in the patients at step 4 and 5 (n=22, 51.2%) than in those at step 2 and 3 (n=21, 48.8%) (p=0.001, p=0.031 and p=0.005, recpectively). In the U/A group, there was a positive moderate correlation between the urticaria activity score 7 and the HADS anxiety score (r:0.579, p<0.001). Our study showed that U/A patients had more anxiety symptoms comparing to other allergic diseases. Disease activity and severity had a significant relationship with anxiety level in U/A patients and with QoL in asthmatics.

Anahtar Kelimeler

anxiety, depression, quality of life, allergic diseases, urticaria, asthma

Etik Beyan

The study was approved by Bolu Abant Izzet Baysal University Noninterventional Clinical Research Ethical Committee (Decision no: 2024/48, Date: 5.3.2024 ).

Kaynakça

• 1. Genuneit J, Standl M. Epidemiology of Allergy: Natural Course and Risk Factors of Allergic Diseases. Handb Exp Pharmacol. 2022;268:21-7.
• 2. Kosse RC, Koster ES, Kaptein AA, de Vries TW, Bouvy ML. Asthma control and quality of life in adolescents: The role of illness perceptions, medication beliefs, and adherence. J Asthma. 2020;57(10):1145-54.
• 3. Juniper EF. Quality of life in adults and children with asthma and rhinitis. Allergy. 1997;52(10):971-7.
• 4. Baiardini I, Braido F, Brandi S, Canonica GW. Allergic diseases and their impact on quality of life. Ann Allergy Asthma Immunol. 2006;97(4):419-28; quiz 29-30, 76.
• 5. Stadler PC, Marsela E, Kämmerer T, Frommherz LH, Clanner-Engelshofen B, French LE, et al. Impact of allergic reactions and urticaria on mental health and quality of life. Allergol Immunopathol (Madr). 2022;50(2):124-30.
• 6. Lu Z, Chen L, Xu S, Bao Q, Ma Y, Guo L, et al. Allergic disorders and risk of depression: A systematic review and meta-analysis of 51 large-scale studies. Ann Allergy Asthma Immunol. 2018;120(3):310-7.e2.
• 7. Feldman JM, Siddique MI, Morales E, Kaminski B, Lu SE, Lehrer PM. Psychiatric disorders and asthma outcomes among high-risk inner-city patients. Psychosom Med. 2005;67(6):989-96.
• 8. Licari A, Castagnoli R, Ciprandi R, Brambilla I, Guasti E, Marseglia GL, et al. Anxiety and depression in adolescents with asthma: a study in clinical practice. Acta Biomed. 2022;93(1):e2022021.
• 9. Shin JH, Roh D, Lee DH, Kim SW, Kim SW, Cho JH, et al. Allergic rhinitis and rhinosinusitis synergistically compromise the mental health and health-related quality of life of Korean adults: A nationwide population-based survey. PLoS One. 2018;13(1):e0191115.
• 10. Ozkan M, Oflaz SB, Kocaman N, Ozseker F, Gelincik A, Büyüköztürk S, et al. Psychiatric morbidity and quality of life in patients with chronic idiopathic urticaria. Ann Allergy Asthma Immunol. 2007;99(1):29-33.
• 11. Hergüner S, Kiliç G, Karakoç S, Tamay Z, Tüzün U, Güler N. Levels of depression, anxiety and behavioural problems and frequency of psychiatric disorders in children with chronic idiopathic urticaria. The British journal of dermatology. 2011;164(6):1342-7.
• 12. Staubach P, Dechene M, Metz M, Magerl M, Siebenhaar F, Weller K, et al. High prevalence of mental disorders and emotional distress in patients with chronic spontaneous urticaria. Acta Derm Venereol. 2011;91(5):557-61.
• 13. Alerjik Rinit Tanı ve Tedavi Rehberi 2022 2022 [Available from: https://www.aid.org.tr/wp-content/uploads/2022/11/Alerjik-Rinit-Tani-ve-Tedavi-Rehberi-2022-web-vers4.pdf.
• 14. Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017;140(4):950-8.
• 15. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2023. Updated July 2023 [Available from: https://ginasthma.org.
• 16. Stull D, McBride D, Tian H, Gimenez Arnau A, Maurer M, Marsland A, et al. Analysis of disease activity categories in chronic spontaneous/idiopathic urticaria. The British journal of dermatology. 2017;177(4):1093-101.
• 17. Brown SG. Clinical features and severity grading of anaphylaxis. J Allergy Clin Immunol. 2004;114(2):371-6.
• 18. Aydemir O, Güvenir T, Küey L, Kültür S. Hastane Anksiyete ve Depresyon Ölçeği Türkçe Formunun Geçerlilik ve Güvenilirlik Çalışması. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. Turk psikiyatri dergisi = Turkish journal of psychiatry. 1997;8:280-7.
• 19. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
• 20. Koçyiğit H, Aydemir O, Fişek G, Ölmez N, Memiş A. Kısa Form-36 (SF-36)'nın Türkçe Versiyonunun Güvenilirliği ve Geçerliliği. Reliability and Validity of the Turkish Version of Short Form-36 (SF-36). İlaç ve Tedavi Dergisi. 1999;12:102-6.
• 21. Kimyai-Asadi A, Usman A. The role of psychological stress in skin disease. J Cutan Med Surg. 2001;5(2):140-5.
• 22. Barbosa F, Freitas J, Barbosa A. Chronic idiopathic urticaria and anxiety symptoms. J Health Psychol. 2011;16(7):1038-47.
• 23. Chung MC, Symons C, Gilliam J, Kaminski ER. The relationship between posttraumatic stress disorder, psychiatric comorbidity, and personality traits among patients with chronic idiopathic urticaria. Compr Psychiatry. 2010;51(1):55-63.
• 24. Rani S, Singh S, Kumar D, Dabas S, Ritu K. Assessment of depression, anxiety, and stress in chronic urticaria and its correlation with disease severity. Ann Allergy Asthma Immunol. 2022;128(3):330-1.
• 25. Tat TS. Higher Levels of Depression and Anxiety in Patients with Chronic Urticaria. Med Sci Monit. 2019;25:115-20.
• 26. Choi GS, Nam YH, Park CS, Kim MY, Jo EJ, Park HK, et al. Anxiety, depression, and stress in Korean patients with chronic urticaria. Korean J Intern Med. 2020;35(6):1507-16.
• 27. Demiral Y, Ergor G, Unal B, Semin S, Akvardar Y, Kivircik B, et al. Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population. BMC Public Health. 2006;6:247.
• 28. Laveneziana P, Lotti P, Coli C, Binazzi B, Chiti L, Stendardi L, et al. Mechanisms of dyspnoea and its language in patients with asthma. Eur Respir J. 2006;27(4):742-7.
• 29. Sanz-Santiago V, Diez-Vega I, Santana-Sosa E, Lopez Nuevo C, Iturriaga Ramirez T, Vendrusculo FM, et al. Effect of a combined exercise program on physical fitness, lung function, and quality of life in patients with controlled asthma and exercise symptoms: A randomized controlled trial. Pediatr Pulmonol. 2020;55(7):1608-16.
• 30. Chiner E, Hernández C, Blanco-Aparicio M, Funenga-Fitas E, Jiménez-Ruiz C. Patient perspectives of the influence of severe and non-severe asthma on their quality of life: A national survey of asthma patients in Spain. Clin Respir J. 2022;16(2):130-41.
• 31. Furtado PR, Maciel Á CC, Barbosa RRT, Silva A, Freitas DA, Mendonça K. Association between quality of life, severity of asthma, sleep disorders and exercise capacity in children with asthma: a cross-sectional study. Braz J Phys Ther. 2019;23(1):12-8.
• 32. Muñoz-Cano R, Ribó P, Araujo G, Giralt E, Sanchez-Lopez J, Valero A. Severity of allergic rhinitis impacts sleep and anxiety: results from a large Spanish cohort. Clin Transl Allergy. 2018;8:23.
• 33. Bousquet J, Neukirch F, Bousquet PJ, Gehano P, Klossek JM, Le Gal M, et al. Severity and impairment of allergic rhinitis in patients consulting in primary care. J Allergy Clin Immunol. 2006;117(1):158-62.