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心理社会因素相关食物过敏的心理治疗:当前治疗方法和未满足的需求。

Psychotherapeutic Treatment for Psychosocial Concerns Related to Food Allergy: Current Treatment Approaches and Unmet Needs.

机构信息

Division of Psychology & Behavioral Health, Children's National Hospital, Washington, DC; Department of Pediatrics, George Washington University School of Medicine, Washington, DC.

School of Applied Psychology, University College Cork, National University of Ireland, Cork City, Ireland; Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

出版信息

J Allergy Clin Immunol Pract. 2021 Jan;9(1):101-108. doi: 10.1016/j.jaip.2020.10.037.

Abstract

Psychosocial concerns, such as anxiety and decreased quality of life, are common among patients with food allergy and their caregivers. There is evidence that childhood anxiety disorders are at the outset of a "cascade of psychopathology," highlighting the importance of early recognition and treatment. Provision of psychological services is needed, beginning with a thorough assessment of food allergy-related quality of life, subjective perceptions of food allergy severity, and environmental factors. Implementation of patient-centered cognitive-behavioral, medical coping, and motivational interviewing strategies may promote healthy food allergy management and adjustment. We present 2 cases, a mother of a young child with food allergy and a young boy preparing for oral immunotherapy treatment, who received psychological services for food allergy-related anxiety. For each, treatment resulted in decreased anxiety and improved food allergy management/oral immunotherapy treatment engagement. We also discuss unmet food allergy-related psychosocial needs, including the lack of food allergy-specific anxiety measures, psychosocial domains that warrant investigation (trauma, feeding concerns), development of supportive interventions for patients engaging in allergen immunotherapy, and the lack of adequate mental health providers with food allergy expertise.

摘要

心理社会问题,如焦虑和生活质量下降,在食物过敏患者及其照顾者中很常见。有证据表明,儿童焦虑障碍是“精神病理学级联”的开始,这凸显了早期识别和治疗的重要性。需要提供心理服务,首先要彻底评估与食物过敏相关的生活质量、对食物过敏严重程度的主观感知以及环境因素。实施以患者为中心的认知行为、医疗应对和动机访谈策略可能会促进健康的食物过敏管理和调整。我们介绍了 2 个病例,一个是有食物过敏幼儿的母亲,另一个是准备接受口服免疫治疗的小男孩,他们都接受了与食物过敏相关焦虑相关的心理服务。对于每个病例,治疗都导致焦虑减轻和食物过敏管理/口服免疫治疗参与度提高。我们还讨论了未满足的食物过敏相关心理社会需求,包括缺乏特定于食物过敏的焦虑措施、需要调查的心理社会领域(创伤、喂养问题)、为接受过敏原免疫治疗的患者开发支持性干预措施,以及缺乏具有食物过敏专业知识的足够心理健康提供者。

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