严重过敏反应中与健康相关的生活质量：聚焦于严重过敏性哮喘和膜翅目毒液过敏反应——一项横断面研究
Health-related quality of life in severe hypersensitivity reactions: focus on severe allergic asthma and hymenoptera venom anaphylaxis-a cross-sectional study.
作者信息
Ricciardi Luisa, Silvestro Orlando, Martino Gabriella, Catalano Antonino, Vicario Carmelo Mario, Lund-Jacobsen Trine, Schwarz Peter, Sapienza Daniela, Gangemi Sebastiano, Pioggia Giovanni, Giorgianni Concetto Mario
机构信息
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
出版信息
Front Psychol. 2024 Aug 23;15:1394954. doi: 10.3389/fpsyg.2024.1394954. eCollection 2024.
BACKGROUND
Growing evidence reveals the important role of clinical psychological factors in chronic-immune diseases. The aim of this study was to investigate Health-Related Quality of Life (HR-QoL), depression, anxiety, and alexithymia in patients with severe hypersensitivity reactions such as Severe Allergic Asthma (SAA) and Hymenoptera Venom Anaphylaxis (HVA).
METHODS
The Short-Form Health Survey-36 (SF-36), the Beck Depression Inventory Questionnaire (BDI-II), the Hamilton Anxiety Rating Scale (HAM-A) and the Toronto Alexithymia Scale (TAS-20) were used to assess HR-QoL and clinical psychological features of patients with SAA and HVA.
RESULTS
Overall, 78 patients were recruited. Patients with SAA ( = 35) reported lower scores for physical functioning [65 (58-75) vs. 90 (85-95); = <0.001], role limitations due to physical health [25 (0-50) vs. 62 (50-75); = 0.004], bodily pain [47.5 (41.1-61.3) vs. 55.5 (55-96); = 0.001], general health [40 (30-60) vs. 70 (50-80); = 0.0003] and social functioning [50 (37.5-62.5) vs. 62.5 (54.9-75); = 0.007] while higher scores for depressive symptoms [14 (11-15.4) vs. (9.5 (6-15.4); = 0.05)] compared to HVA patients ( = 43). All the dimensions of SF-36 were negatively correlated with anxiety ( from -0.26 to -0.66; < 0.01) and depressive symptoms ( from -0.44 to -0.73; < 0.001). Alexithymia was negatively correlated with vitality ( = -0.28; = 0.02) and mental health ( = -027; = 0.03). Additionally, patients with alexithymia (38% of participants) showed higher levels of depressive symptoms [9.5 (10-19) vs. 14 (6-13.9); = 0.005] and anxiety levels [31 (27.9-35) vs. 24 (16-33.9); = 0.02]; they also showed less vitality [40 (39.9-50) vs. 55 (50-60) = 0.01], social functioning [50 (37.5-62.5) vs. 62.5 (50 vs. 75); = 0.01] and mental health [48 (44-60) vs. 68 (56-76); = 0.004].
CONCLUSION
Clinical psychological features due to severe hypersensitive reactions may contribute to the patient's perceived HR-QoL. Focused clinical psychological interventions should be promoted to improve the clinical management of such conditions.
背景
越来越多的证据表明临床心理因素在慢性免疫疾病中发挥着重要作用。本研究旨在调查患有严重过敏反应（如严重过敏性哮喘（SAA）和膜翅目毒液过敏反应（HVA））的患者的健康相关生活质量（HR-QoL）、抑郁、焦虑和述情障碍。
方法
采用简明健康调查量表-36（SF-36）、贝克抑郁问卷第二版（BDI-II）、汉密尔顿焦虑评定量表（HAM-A）和多伦多述情障碍量表（TAS-20）来评估SAA和HVA患者的HR-QoL及临床心理特征。
结果
总共招募了78名患者。与HVA患者（n = 43）相比，SAA患者（n = 35）在生理功能[65（58 - 75）对90（85 - 95）；P = <0.001]、因身体健康导致的角色限制[25（0 - 50）对62（50 - 75）；P = 0.004]、身体疼痛[47.5（41.1 - 61.3）对55.5（55 - 96）；P = 0.001]、总体健康状况[40（30 - 60）对70（50 - 80）；P = 0.0003]和社会功能[50（37.5 - 62.5）对62.5（54.9 - 75）；P = 0.007]方面得分较低，而抑郁症状得分较高[14（11 - 15.4）对9.5（6 - 15.4）；P = 0.05]。SF-36的所有维度均与焦虑（r从 -0.26至 -0.66；P <0.01）和抑郁症状（r从 -0.44至 -0.73；P <0.001）呈负相关。述情障碍与活力（r = -0.28；P = 0.02）和心理健康（r = -0.27；P = 0.03）呈负相关。此外，有述情障碍的患者（占参与者的38%）表现出更高水平的抑郁症状[9.5（10 - 19）对14（6 - 13.9）；P = 0.005]和焦虑水平[31（27.9 - 35）对24（16 - 33.9）；P = 0.02]；他们的活力[40（39.9 - 50）对55（50 - 60）；P = 0.01]、社会功能[50（37.5 - 62.5）对62.5（50对75）；P = 0.01]和心理健康[48（44 - 60）对68（56 - 76）；P = 0.004]也较低。
结论
严重过敏反应导致的临床心理特征可能影响患者的HR-QoL感知。应推广有针对性的临床心理干预措施，以改善此类疾病的临床管理。
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