title: Perceived stress predicts allergy flares.
abstract: BACKGROUND
  A relation between stress and symptoms of rhinitis has not been established.
  
  
  OBJECTIVE
  To determine if participants' reporting of allergy flares correlated with perceived emotional stress, depression, mood, and a biomarker of stress (cortisol).
  
  
  METHODS
  This study was a secondary analysis of 179 university employees who participated in a study evaluating the influence of several lifestyle interventions on health symptoms and inflammation. Perceived stress and depressive symptom questionnaires were obtained before each 2-week study period. Online diary entries documenting same-day allergy flares, stressful events, perceived stress, mood, and salivary cortisol levels were collected daily during 2 14-day blocks.
  
  
  RESULTS
  Thirty-nine percent of subjects (n = 69) self-reported allergy symptoms. This allergy flare group had higher perceived stress scores than the group without allergy symptoms. Perceived stress, but not depressive symptoms, positively correlated with allergy flares evaluated during 2 independent 14-day periods. There also was a positive relation between negative mood scores and allergy flares over the course of the study. Cortisol had no association with allergy symptom flares.
  
  
  CONCLUSIONS
  These findings suggest that individuals with persistent emotional stress have more frequent allergy flares. Furthermore, those with more flares have greater negative mood.
authors.affiliation: Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; Section of Allergy/Immunology, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Amber M
authors.initials: AM
authors.lastname: Patterson
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, Ohio.
authors.forename: Vedat O
authors.initials: VO
authors.lastname: Yildiz
authors.affiliation: Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio; School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.
authors.forename: Maryanna D
authors.initials: MD
authors.lastname: Klatt
authors.affiliation: Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio; Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio. Electronic address: William.Malarkey@osumc.edu.
authors.forename: William B
authors.initials: WB
authors.lastname: Malarkey
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D003863:Depression / Q000453:epidemiology*; D018450:Disease Progression; D004644:Emotions; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology* / Q000523:psychology*; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology* / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D006854:Hydrocortisone