Sex Differences in Adults with Insect Venom Allergy regarding Psychological Distress, Attitudes toward the Emergency Medication, and Factual Knowledge about the Disease

Abstract

Background: Hymenoptera venom allergy (HVA) has a prevalence of 3% in adults. Although patients have no ongoing symptoms, they often suffer from an impairment of their psychological well-being and quality of life. Objective: The aim of this study was to analyze sex-specific differences regarding the psychological burden caused by this allergy and handling of the emergency medication. Method: Study participants filled out a questionnaire including sociodemographic and disease-specific characteristics, the Hospital Anxiety and Depression Score (HADS), and theoretical knowledge about the emergency medication set (EMS). Additionally, an objective structured clinical examination was used to assess practical knowledge and handling of the EMS. Results: Fifty-six patients were included (55.4% females). Female patients showed higher subjective anxiety levels due to HVA compared to men (mean 7.2 vs. 4.6, p = 0.0003). Furthermore, the HADS revealed that women had a significant higher anxiety level, especially after Mueller grade I–II anaphylactic reactions (mean 6.3 vs. 2.8, p = 0.0134). This was associated with a higher theoretical but not practical knowledge about their disease. On the other hand, males were less inclined to carry the emergency medication “always” or “almost always” (56 vs. 87.1%, p = 0.0015) but showed higher self-assurance in using it (mean 7.3 vs. 6.1, p = 0.0446). Conclusions: This clinical study provides evidence for sex differences in coping with HVA. The results suggest that females should be monitored more closely for allergy-associated anxiety symptoms, while men need more encouragement to carry the emergency medication.

What We Know About Sting-Related Deaths? Human Fatalities Caused by Hornet, Wasp and Bee Stings in Europe (1994-2016)

“…Moreover, males are more likely to suffer from mastocytosis, a risk factor for venom allergy [28]. Researchers highlight that woman should be monitored more closely for allergy-associated anxiety symptoms, while men need more encouragement to carry the emergency medication [29].…”

Health‐related quality of life in food and venom induced anaphylaxis and role of influencing factors

“…In a German study using sociodemographic and disease‐specific characteristics as well as the HADS, also female patients with mild SRs showed higher disease‐related anxiety levels than men 73 . As higher anxiety levels in female patients were reported in many studies, not only related to anaphylaxis, it is suggested that differences between sex with regard to mood disorders might be related to hormonal differences and diversities in the immune system 73,74 …”

“…62,71,72 In a German study using sociodemographic and disease-specific characteristics as well as the HADS, also female patients with mild SRs showed higher disease-related anxiety levels than men. 73 As higher anxiety levels in female patients were reported in many studies, not only related to anaphylaxis, it is suggested that differences between sex with regard to mood disorders might be related to hormonal differences and diversities in the immune system. 73,74 With the use of CHVAQoLS in Polish children, a higher anxiety in girls within the group of dermal reactors was shown, but higher levels of anxiety in boys than girls with grade II reactions were observed, 4 while other studies did not find any significant differences between girls and boys.…”

“…73 As higher anxiety levels in female patients were reported in many studies, not only related to anaphylaxis, it is suggested that differences between sex with regard to mood disorders might be related to hormonal differences and diversities in the immune system. 73,74 With the use of CHVAQoLS in Polish children, a higher anxiety in girls within the group of dermal reactors was shown, but higher levels of anxiety in boys than girls with grade II reactions were observed, 4 while other studies did not find any significant differences between girls and boys. 69 A significant association between the severity of the anaphylactic reaction (Mueller's grade IV compared to grade III) and anxiety was reported, 5 but not confirmed by others.…”

Associations between gender and health‐related quality of life in people with IgE‐mediated food allergy and their caregivers: A systematic review

“…An investigation of venom allergy found women had poorer anxiety-related HRQL, especially after experiencing anaphylactic reactions, than men. 6 Similarly, poorer asthma-related HRQL was observed in women, despite having similar disease statuses and management practices as men. 7 Studies in food allergy have reported conflicting findings on whether gender has a similar influence on HRQL and have largely only captured the perspectives of children with peanut allergy.…”