Anxiety symptoms in allergic patients: identification and risk factors.
OBJECTIVE
Multiple relationships between anxiety, allergic symptoms, and treatment difficulties have been observed. The aim of the present study was to estimate the prevalence of anxiety disorders in outpatients with various allergic diseases, to identify diagnostic cues or possible risk factors, and to test the usefulness of self-administered questionnaire screening at the allergy clinic.


METHODS
Six hundred forty-six (646) consecutive patients with rhinoconjunctivitis (59.3%), asthma (26.8%), or "other" allergy (13.9%), aged 16 to 65 years, completed self-administered questionnaires in six outpatient allergy clinics; 60 of the respondents also participated in structured psychiatric interviews. Anxiety was measured with the Spielberger State-Trait Anxiety.


RESULTS
According to the interviews, STAI-T > 52 predicted with 86% accuracy a current psychiatric diagnosis, without differentiating between anxiety and depression. Using this threshold, the rate of anxiety and/or depressive disorders is estimated as 19% (95% CI: 15.9-22.1) in our unselected allergic outpatient sample; 46% of these patients never received any psychopharmacological treatment, indicating that anxiety related disorders are underdiagnosed and undertreated. Risk indicators were female gender; asthma; perennial symptoms; sleep problems; nonspecific allergy triggers like strong emotions; stressful situations; and considerable limitation in everyday activities attributed to the allergic symptoms.


CONCLUSIONS
Our findings confirm a high rate of anxiety and/or depressive disorders in patients visiting the allergy clinic. Self-administered questionnaires such as STAI-T provide reliable help for the identification of these frequent psychiatric problems.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003233:Conjunctivitis, Allergic / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D007406:Interview, Psychological; D008297:Male; D015995:Prevalence; D012130:Respiratory Hypersensitivity / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D012621:Seasons; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires