Parental anxiety before and after food challenges in children with suspected peanut and hazelnut allergy

Abstract

As ingestion of peanut and hazelnut by allergic children is potentially life threatening, parents of these children need to be vigilant about their child's dietary intake. This may cause high levels of anxiety. To assess parental anxiety about food-allergic reaction in their child (state anxiety) and their personal disposition to anxiety (trait anxiety). Parental anxiety was investigated again after food challenges. Fifty-seven children (3-16 yr, mean age 7.2) with suspected peanut or hazelnut allergy (mean specific IgE 20.9) were evaluated by double-blind, placebo-controlled food challenge (DBPCFC). Thirty-two children (56%) developed an allergic reaction. All parents completed the Spielberger State-Trait Anxiety Inventory (STAI) prior to DBPCFC and 2 wk, 3 months and 1 yr thereafter. The mean anxiety scores on these moments were compared with each other and with general Dutch norms. The STAI was also investigated in a group that refused DBPCFC. Prior to DBPCFC, parents had high levels of state anxiety in contrast to a lower trait anxiety compared to the norm group. After DBPCFC, the state anxiety was significantly lower, regardless of a positive or negative outcome (p<or=0.05). The state anxiety was still significant lower after 1 yr (p<or=0.03). The trait anxiety remained unchanged in mothers and slightly decreased in fathers. The state anxiety in the group that refused DBPCFC was comparable to the challenge group, but the trait anxiety was significantly higher (p=0.038). Parents of children with suspected peanut or hazelnut allergy show high levels of anxiety about a food-allergic reaction. After DBPCFC, the anxiety was significantly lower, even in the group with a positive outcome.

Patients’ Satisfaction with Diagnostic Drug Provocation Tests and Perception of Its Usefulness

“…This was also shown recently for food challenges in children in a study where a decrease in parental anxiety was documented even in the group with a positive test result [15]. …”

Food allergy–related quality of life after double-blind, placebo-controlled food challenges in adults, adolescents, and children

“…Overall, our findings are in agreement with those of previous literature, which showed that parent-proxy reports on the child's HRQL improved significantly after a food challenge in children aged 0 to 12 years and that larger improvements in HRQL were shown after a negative outcome than after a positive outcome. 3 Additionally, other studies on parents' perceptions of their child's food challenge [23][24][25][26] showed reduced parental concerns 25,26 and parental anxiety 24 after food challenges, irrespective of the outcome of the challenge. It was hypothesized that these improvements in HRQL/well-being were caused by the fact that a definitive diagnosis provides a sense of certainty.…”

The diagnostic value of specific IgE to Ara h 2 to predict peanut allergy in children is comparable to a validated and updated diagnostic prediction model

“…A cutoff point of a probability of > _0. 6 showed the best diagnostic accuracy with regard to the PPV and the NPV (93% and 83%, respectively; Table III).…”

“…[1][2][3] It has an important influence on daily life for both children and their parents, especially because of the strict elimination diet that is generally prescribed. [4][5][6] The gold standard to diagnose a peanut allergy is a doubleblind, placebo-controlled food challenge (DBPCFC). 7 This is a costly and, especially for young children, burdensome test demanding specialized medical facilities.…”