Mental health and behavior of food-allergic adolescents compared to a healthy matched sample

Polloni, Laura; Ferruzza, Emilia; Ronconi, Lucia; Lazzarotto, Francesca; Bonaguro, Roberta; Toniolo, Alice; Celegato, Nicolò; Muraro, Antonella

doi:10.1016/j.anai.2015.05.023

Cited by 22 publications

(29 citation statements)

References 10 publications

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“…Our effect estimates for asthma were comparable with other studies using cohorts of comparable age . In regard to the other atopic diseases, although less studied than asthma, our study contributes to the growing body of epidemiological evidence finding that eczema, food allergy and rhinitis are each associated with depression or anxiety in children.…”

Section: Discussionsupporting

confidence: 84%

The familial aggregation of atopic diseases and depression or anxiety in children

Brew

Lundholm

Gong

et al. 2018

Clin Experimental Allergy

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SummaryBackgroundChildren with asthma and atopic diseases have an increased risk of depression or anxiety. Each of these diseases has strong genetic and environmental components; therefore, it seems likely that there is a shared liability rather than causative risk.ObjectiveTo investigate the existence and nature of familial aggregation for the comorbidity of atopic diseases and depression or anxiety.MethodsParticipants came from the Childhood and Adolescent Twin Study in Sweden (CATSS), n = 14 197. Current and ever asthma, eczema, hay fever and food allergy were reported by parents. Internalizing disorders were identified using validated questionnaires. Familial co‐aggregation analysis compared monozygotic (MZ) twins and same‐sex dizygotic (DZ) twins for atopic disease in 1 twin with internalizing disorder in the other to test for genetic liability. Several familial liability candidates were also tested including parental education, recent maternal psychological stress, childhood family trauma and parental country of birth.ResultsFamilial co‐aggregation analysis found that if 1 twin had at least 1 current atopic disease the partner twin was at risk of having an internalizing disorder regardless of their own atopic status (adjusted OR 1.22 (95% CI 1.08, 1.37). Similar results were found for each atopic disease ever and current. MZ associations were not higher than DZ associations, suggesting that the liability is not genetic in nature. Including other familial candidates to the models made little difference to effect estimates.Conclusions and Clinical RelevanceAtopic diseases and depression or anxiety tend to occur together in families; therefore, when treating for 1 disease, the physician should consider comorbidity in both the individual and the individual's siblings. We did not find evidence to support a genetic explanation for comorbidity, and further exploration is needed to disentangle the environmental and epigenetic reasons for familial aggregation.

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Section: Discussionsupporting

confidence: 84%

The familial aggregation of atopic diseases and depression or anxiety in children

Brew

Lundholm

Gong

et al. 2018

Clin Experimental Allergy

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“…The SDL improves to a lesser degree, probably because most patients have not reached a maintenance dose and their ability to consume the allergenic food is still limited. Emotional and behavioral problems, particularly depression, anxiety, and ADHD, and internalizing (anxiety, depression, isolation, and problems with peers) were previously shown to be more common among adolescents with food allergy . In our study, the EI did not significantly change during OIT, probably expressing the balance between the emotional burden of the treatment on one hand, and the increasing confidence and diversity of foods consumed, on the other.…”

Section: Discussionsupporting

confidence: 43%

Changes in patient quality of life during oral immunotherapy for food allergy

Epstein‐Rigbi

Goldberg

Levy

et al. 2017

Allergy

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“…Adolescents with FA have reported also lower self‐esteem which, in turn, may negatively influence their mood during this developmental period. In a cross‐sectional study among Italian FA adolescents, patients reported significantly higher internalizing problems and impact of mental health problems on everyday life but lower externalizing problems compared with healthy peers. Previous anaphylaxis and EAI prescription were associated with internalizing and externalizing score, confirming that life‐threatening reactions are associated with greater psychological complaints …”

Section: Results From the Selected Literaturementioning

confidence: 95%

“…Although most individuals with FA reported moderate anxiety, a small but substantial proportion experiences relevant anxiety that interfere with optimal functioning. In many studies, this dysfunctional anxiety has been related to previous anaphylaxis . As a life‐threatening event, anaphylaxis may lead to post‐traumatic stress reactions in patients and caregivers who assisted, so that it seems crucial to assess and support individuals in the weeks and months following a severe reaction, and to implement effective preventive measures.…”

Section: Discussionmentioning

confidence: 99%

“…In many studies, this dysfunctional anxiety has been related to previous anaphylaxis. 17,63,66,69,77 As a life-threatening event, anaphylaxis may lead to post-traumatic stress reactions in patients and caregivers who assisted, so that it seems crucial to assess and support individuals in the weeks and months following a severe reaction, and to implement effective preventive measures. Another important finding confirmed by several researches is that children and adolescents with FA reported higher separation anxiety.…”

Section: Con Clus I On S and Future Direc Tionsmentioning

confidence: 99%

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Anxiety and food allergy: A review of the last two decades

Polloni

Muraro

2020

Clin Experimental Allergy

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Food allergy (FA) is recognized as a growing public health burden affecting 5%‐10% of children worldwide. Several unique features specific to FA elicit high levels of emotional distress and anxiety in patients and caregivers, the first among all the possibility of a life‐threatening reaction. Anxiety disorders are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patient health. This review aimed to offer a comprehensive overview of literature data on FA and anxiety of the last two decades. A review of the medical and psychological literature from the year 2000 (MEDLINE, PubMed and PsycINFO) was done using the keywords “anxiety” and “food allergy.” Clinical implications for disease management, various manifestations in different target groups, proper interventions and possible explanations on the nature of the association between FA and anxiety have been discussed, as well as limitations and further research directions. The relationship between FA and anxiety is attributed to FA‐specific fears and anxiety, rather than a general propensity towards anxiety. Some anxiety—short‐lived and related to key events–is to be expected and may even be helpful if it sustains allergen avoidance and preparedness to emergency. However, some data reported that increased anxiety did not improve adherence. Rather, high levels of anxiety have been demonstrated counterproductive and related to maladaptive coping. Further research is needed to elucidate the association between FA and anxiety, especially to understand biopsychosocial directions of the underlying mechanisms and to build proper, effective, standardized protocols of intervention. Clinicians must be aware of the association between FA and anxiety, understand their role in recognizing maladaptive anxiety and encouraging to seek psychological support when needed.

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Mental health and behavior of food-allergic adolescents compared to a healthy matched sample

Cited by 22 publications

References 10 publications

The familial aggregation of atopic diseases and depression or anxiety in children

The familial aggregation of atopic diseases and depression or anxiety in children

Changes in patient quality of life during oral immunotherapy for food allergy

Anxiety and food allergy: A review of the last two decades

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