Stress, itch and quality of life in chronic urticaria females

Abstract

IntroductionChronic urticaria (CU) belongs to a group of psychodermatological disorders, thus stress can play a significant role in this dermatosis onset and/or exacerbation. On the other hand, the disease itself accompanied by itch, may be a source of distress and could worsen patients’ quality of life (QoL).AimThe first goal of our study was to compare stress intensity between CU subjects and the control group. The second aim was to investigate the relationships between disease-related parameters (CU severity, itch) and psychological variables (stress and QoL) in CU patients.Material and methodsForty-six female patients with CU participated in our study. Thirty-three healthy females constituted a control group. The following methods were applied: Urticaria Activity Score (UAS), Itch Severity Evaluation Questionnaire, Visual analogue scale (VAS), Social Readjustment Rating Scale (SRRS) and the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL).ResultsChronic urticaria patients demonstrated a significantly higher stress level in comparison to the control group (z = 2.699; p < 0.001). Regarding the total pruritus score, all CU-Q2oL dimensions were affected, except for subscale swelling/mental status. The strongest link was revealed between global itch and QoL subscale embarrassment (r = 0.51, p < 0.001). There were also statistically significant correlations between stress (VAS scale and SRRS) and QoL (all at least p < 0.05).Conclusions: Taking into account the significant pruritus contribution to QoL impairment, it would be worth employing itch-coping trainings in the CU group. As a consequence, feeling of self-control and self-efficacy could be enhanced, thus resulting in the well-being improvement.

Constitutional markers of urticaria and their prognostic significance (analysis of scientific literature)

“…For example, patients with psoriasis, alopecia, or urticaria were more hostile and neurotic than people with other dermatological conditions. Some authors have reported that subjects with urticaria have significantly interpersonal, depressed, more hysterical, and suspicious personality traits compared with controls [20,23,25].…”

Patients with Chronic Urticaria Remain Largely Undertreated: Results from the DERMLINE Online Survey

“…Most participants indicated that psychological factors, such as stress at work or in their private lives, triggered their disease or worsened their symptoms. Indeed, patients with CU have demonstrated significantly higher stress levels compared to controls [ 21 ], and stress has been shown to exacerbate urticarial wheals [ 22 ]. Our findings underline the relevance of stress management and coping mechanisms in the treatment of patients with CU.…”

Partner bereavement and risk of chronic urticaria, alopecia areata and vitiligo: cohort studies in the UK and Denmark

“…This study investigated associations between partner bereavement and chronic urticaria, alopecia areata and vitiligo in population‐based cohorts in settings with universal healthcare (UK and Denmark), using harmonized methodology. Previous studies have been limited by small sample size, difficulty in measuring stress, and potential misclassification of adverse life events due to recall bias . We undertook our study in two similar cohorts to enable replication, and used partner bereavement as a proxy for acute severe stress, with specific onset date.…”

“…Previous studies have been limited by small sample size, difficulty in measuring stress, and potential misclassification of adverse life events due to recall bias. [6][7][8] We undertook our study in two similar cohorts to enable replication, and used partner bereavement as a proxy for acute severe stress, with specific onset date. Limitations include a lack of information on the level and duration of stress arising from bereavement, individual responses to bereavement, social support, potential misclassification of partnership status, possible delay between disease onset and diagnosis, overrepresentation of severe cases in the Danish hospital setting, and absence (Denmark) and missingness (UK) of body mass index and lifestyle covariates.…”