title: A cohort study of the relationship between anger and chronic spontaneous urticaria.
abstract: BACKGROUND
  Anger plays a major role in psychodermatological diseases. Researchers have reported that anger and other psychological factors play a role in the etiology of chronic urticaria. This study aimed to examine symptoms of anger, anger-related behavioral patterns, thoughts associated with anger, situations that cause anger and experiences of interpersonal anger in patients with chronic spontaneous urticaria (CSU). The authors hypothesized that patients with CSU react to more situations with anger and experience more anger symptoms as compared to alopecia areata (AA) patients and healthy controls.
  
  
  METHODS
  The cohort study population consisted of literate adult patients aged <65 years that were diagnosed with CSU at the outpatient dermatology clinics of Başkent and Gazi University, Ankara, Turkey, between September 2011 and October 2012. The first control group included individuals without any physical or mental disorders and the second one included literate adult patients diagnosed with AA. The patients and controls were matched according to age, gender, and level of education. A sociodemographic data form, and the Hospital Anxiety and Depression Scale and Multi-Dimensional Anger Inventory were administered to the participants. Data were analyzed using SPSS v.17.0 for Windows. The primary outcome was to determine whether there was a relationship between anger and CSU.
  
  
  RESULTS
  The CSU group consisted of 30 participants; AA group consisted of 30 participants; and the healthy group consisted of 39 participants. Anxiety and depression scores in the CSU group were significantly higher than those in the healthy control group. Symptoms of anger, situations that cause anger, and thoughts associated with anger were significantly more common in the CSU group compared to AA group and healthy group.
  
  
  CONCLUSIONS
  More of the CSU patients were observed to respond with excessive anger to most situations, to have high levels of anxiety anger and passive aggressive interpersonal relationships.
authors.affiliation: Ankara Penal Institution Campus State Hospital, Psychiatry, Ankara Ceza Infaz Kurumları Kampüs Devlet Hastanesi Adalet Mh. Adalet Cd. Yenikent Sincan Ankara Sincan, Ankara, PK:06900, Turkey, ercanaltinoz@hotmail.com.
authors.forename: Ali Ercan
authors.initials: AE
authors.lastname: Altınöz
authors.forename: Nilgün
authors.initials: N
authors.lastname: Taşkıntuna
authors.forename: Sengül Tosun
authors.initials: ST
authors.lastname: Altınöz
authors.forename: Selvi
authors.initials: S
authors.lastname: Ceran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000786:Anger / Q000502:physiology*; D001007:Anxiety / Q000523:psychology*; D002908:Chronic Disease; D015331:Cohort Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D014421:Turkey; D014581:Urticaria / Q000523:psychology*; D055815:Young Adult