Connecticut Asthma and Allergy Center, West Hartford, Connecticut.
Yale School of Medicine, New Haven, Connecticut.
Ann Allergy Asthma Immunol. 2023 May;130(5):657-663. doi: 10.1016/j.anai.2023.01.028. Epub 2023 Feb 2.
Although efficacy, safety, and quality of life measures associated with peanut oral immunotherapy (OIT) have been studied, the relationship between peanut OIT and clinical anxiety has not yet been evaluated. The latter is important to help providers and families have an improved shared medical decision discussion around the benefits of initiating OIT.
To investigate the relationship between undergoing OIT and anxiety in patients with peanut allergy.
In this prospective cross-sectional cohort study, using validated and age-appropriate anxiety scales administered with electronic survey questionnaires, we used generalized linear regressions to compare anxiety between patients undergoing OIT and similar patients with peanut allergy but not on OIT (controls).
In the younger cohort (<7 years, n = 80), there was generally a low prevalence of diagnosable anxiety across patients on OIT and controls. In the older cohort (>7 years, n = 125), there was a higher prevalence of anxiety but no clinically meaningful difference between anxiety scores of patients on OIT and controls. In the older cohort, patients with asthma were more likely to have higher mean anxiety scores (P = .04), as were female patients compared with male patients (P = .004). A subanalysis of separation anxiety scores in the older cohort revealed that younger age (7-12 years vs >12 years, P < .001), non-White race (P = .04), and eczema (P = .02) were found to be meaningful predictors of higher scores. A subanalysis of social anxiety on the older cohort pointed toward non-White race as a meaningful predictor of higher scores (P < .02).
The clinical implications of these findings suggest that allergists should particularly consider screening children with food allergy for anxiety and anxiety subtypes among patients who are non-White, female, or have asthma.
虽然已经研究了与花生口服免疫治疗（OIT）相关的疗效、安全性和生活质量措施，但花生 OIT 与临床焦虑之间的关系尚未得到评估。后者对于帮助提供者和家庭改善围绕启动 OIT 的益处的共同医疗决策讨论很重要。
调查接受 OIT 的患者与花生过敏患者之间的焦虑关系。
在这项前瞻性横断面队列研究中，我们使用经过验证和适合年龄的焦虑量表，并通过电子调查问卷调查，使用广义线性回归比较正在接受 OIT 的患者和未接受 OIT 的类似花生过敏患者（对照组）之间的焦虑情况。
在年龄较小的队列（<7 岁，n=80）中，接受 OIT 的患者和对照组的患者中普遍存在诊断性焦虑的低患病率。在年龄较大的队列（>7 岁，n=125）中，焦虑的患病率较高，但接受 OIT 的患者和对照组的焦虑评分之间没有临床意义上的差异。在较大的队列中，患有哮喘的患者更有可能出现较高的平均焦虑评分（P=.04），与男性患者相比，女性患者的焦虑评分也更高（P=.004）。对较大队列中分离焦虑评分的亚分析表明，年龄较小（7-12 岁比>12 岁，P<.001）、非白种人（P=.04）和湿疹（P=.02）是更高分数的重要预测指标。对较大队列中社交焦虑的亚分析表明，非白种人是更高分数的重要预测指标（P<.02）。
这些发现的临床意义表明，过敏症专家应特别考虑对患有食物过敏的儿童进行焦虑症和焦虑症亚型的筛查，尤其是在非白种人、女性或患有哮喘的患者中。
