References Allergy, Mood, Depression, Anxiety Disorder

References Allergy, Mood, Depression, Anxiety Disorder

Previous studies have suggested an association between allergy and mood, DEPRESSION,  and anxiety disorders. patients even with mild depressive symptoms have significantly more severe allergic complaints and assess general health state as much worse than those without depressive symptoms in any types of allergic diseases. Diagnosis and treatment of depressive symptoms in allergic patients is of great concern from both a clinical and an economical point of view.

There may be a number of allergy-related mediating variables, such as alterations in immunity/cytokines, the effects of nasal obstruction on sleep, disturbed cognitive functioning, and genetic overlap. Regardless, current evidence indicates that individuals with allergies appear to be at a higher risk, of an unknown degree, for developing various types of anxiety and/or mood syndromes.

Allergic disease is a prevalent condition, with approximately 50% of the American population sensitized to at least one allergen (NHANES II and III). Worldwide, a peak in suicide in the spring is consistently observed in epidemiologic research studies. In the fall, a second, smaller peak in suicides has also been observed, although it has been less well replicated. Such seasonal peaks in suicide correspond temporally with the peaks in aeroallergens that are measured in the environment. The spring peak is contemporaneous with high airborne tree pollen counts, and the fall peak with high weed counts, particularly ragweed in the United States. We have preliminarily reported an association between peaks in airborne tree pollen and springtime peaks in nonviolent suicide in women.

While depression is the disorder most frequently associated with suicide, anxiety has also been found to independently contribute to increased suicide risk. Comorbid anxiety further increases the risk of suicide, especially when comorbid with bipolar disorder or depression. In fact, comorbid depression and anxiety also peaks in the spring and again in the fall, with the seasonality of comorbidity greater than that of depression alone. Comorbid anxiety and depression symptoms are also commonly reported in allergic patients.

References Allergy, Mood, Depression, Anxiety Disorder

Severity of allergic complaints: the importance of depressed mood.

Kovács M, Stauder A, Szedmák S.

J Psychosom Res. 2003 Jun;54(6):549-57.


OBJECTIVE: To evaluate the prevalence of depressive symptoms in patients with different kinds of allergic diseases and the connection of depressive symptoms with the severity, type and seasonality of allergic complaints.

METHODS: Data was obtained via a cross-sectional multicenter questionnaire survey of 528 patients aged 16-60 years attending six regional in- and outpatient allergy clinics in Hungary in June to July 1998. Consecutive patients completed a structured, self-administered questionnaire containing questions about their current and past allergic complaints. Depressive symptoms were measured by the Shortened Beck Depression Inventory (BDI).

RESULTS: 32.2% of patients scored above the normal level (> or =10) and 12.5% had clinically significant depressive symptomatology (> or =19) by the BDI. These rates were significantly higher than those found in the control group from a national representative population sample (22.4% and 8.3%). Patients with asthma and with perennial symptoms had significantly higher depression scores than patients with other types of allergic diseases. There was a significant association between the severity of depressive symptoms and the severity of allergic complaints independently from age, sex, type and seasonality of the allergic disease, and other current physical illnesses and symptoms tested by the General Linear Model (GLM).

CONCLUSIONS: Our results draw attention that patients even with mild depressive symptoms have significantly more severe allergic complaints and assess general health state as much worse than those without depressive symptoms in any types of allergic diseases. Diagnosis and treatment of depressive symptoms in allergic patients is of great concern from both a clinical and an economical point of view.

Source: Institute of Behavioral Sciences, Semmelweis University Budapest, H-1089 Budapest, Nagyvárad tér 4, Hungary.

Impact of allergy treatment on the association between allergies and mood and anxiety in a population sample.

Goodwin RD, Galea S, Perzanowski M, Jacobi F.

Clin Exp Allergy. 2012 Dec;42(12):1765-71.


BACKGROUND: Previous studies have suggested an association between allergy and mood and anxiety disorders. Yet, extant work suffers from methodological limitations.

OBJECTIVE: To investigate the association between physician-diagnosed allergy and DSM-IV mood and anxiety disorders in the general population, and to examine the role of allergy treatment in this relationship.

METHODS: Data were drawn from the German National Health Interview and Examination Survey, a population-based, representative sample of 4,181 adults aged 18-65 in Germany. Allergy was diagnosed by physicians during medical examination and mental disorders were diagnosed using the CIDI.

RESULTS: Allergy was associated with an increased prevalence of any anxiety disorder [OR = 1.3 (1.1, 1.6)], panic attacks [OR = 1.6 (1.1, 2.1)], panic disorder [OR = 1.6 (1.01, 2.3)], GAD [OR = 1.8 (1.1, 3.0)], any mood disorder [OR = 1.4 (1.1, 1.7)], depression [OR = 1.4 (1.1, 1.7)] and bipolar disorder [OR = 2.0, (1.0, 3.8)]. After adjusting for desensitization treatment status, these relationships were no longer significant. Those treated for allergy were significantly less likely to have any mood or anxiety disorder [OR = 0.65 (0.4, 0.96)], compared to those untreated. All relationships were adjusted for age, gender and socioeconomic status (SES). CONCLUSIONS & CLINICAL RELEVANCE: These findings provide the first evidence of a link between physician-diagnosed allergy and DSM-IV mood and anxiety disorders in a representative sample. Treatment for allergy may mitigate much of this relationship.

Source: Department of Psychology, Queens College, City University of New York (CUNY), Flushing, NY, USA.

Changes in allergy symptoms and depression scores are positively correlated in patients with recurrent mood disorders exposed to seasonal peaks in aeroallergens.

Scientific WorldJournal. 2007 Dec 17;7:1968-77.

Postolache TT, Lapidus M, Sander ER, Langenberg P, Hamilton RG, Soriano JJ, McDonald JS, Furst N, Bai J, Scrandis DA, Cabassa JA, Stiller JW, Balis T, Guzman A, Togias A, Tonelli LH.


Although growing evidence supports an association between allergy, allergens and depression, it remains unknown if this relationship is between “states” (possible triggers) or “traits” (possible vulnerabilities). We hypothesized that patients with recurrent mood disorders who are sensitized to tree pollen (as determined by allergen specific IgE antibodies), in comparison to those who are not sensitized, would report larger negative changes in mood during exposure to tree pollen in spring. We also hypothesized that differences between high and low tree pollen periods in self reported allergy symptoms would correlate positively with differences in self reported depression scores. We present 1-year preliminary data on the first 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female, twelve patients were tree-pollen IgE positive). Ratings of mood and allergic disease status were performed once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. Linear regression models were developed to examine associations of changes in depression scores (dependent variable) with tree pollen sensitization, changes in the allergy symptom severity score, adjusted for gender and order of testing. We did not confirm the hypothesized relationship between a specific tree pollen sensitization and changes in mood during tree pollen exposure. We did confirm the hypothesized positive relationship between the changes in allergy symptoms and changes in subjects’ depression scores (adjusted p<0.05). This result is consistent with previous epidemiological evidence connecting allergy with depression, as well as our recent reports of increased expression of cytokines in the prefrontal cortex in victims of suicide and in experimental animals sensitized and exposed to tree pollen. A relationship between changes in allergy symptom scores and changes in depression scores supports a state-level rather than only trait-level relationship, and thus lends optimism to future causality-testing interventional studies, which might then lead to novel preventative environmental interventions in mood disorders.

Source: Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.

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ARTIKEL TEREKOMENDASI: Kumpulan Artikel Permasalahan Alergi Anak dan Imunologi, Dr Widodo Judarwanto, pediatrician


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Current Allergy Immunology by Widodo Judarwanto

Gejala Alergi pada bayi dan anak justru paling sering dipicu oleh adanya infeksi khususnya infeksi virus. Tetapi sebaliknya saat itu sering dianggap karena alergi susu atau alergi makanan. Gejala infeksi virus pada bayi khususnya sulit dikenali karena mirip gejala alergi. Reaksi terhadap alergi susu atau alergi makanan biasanya relatif ringan, namun begitu dipicu infeksi manifestasinya lebih berat. Pemicu alergi tidak akan berarti bila penyebab alergi dihindari. Widodo Judarwanto 2012
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