[Psychological factors in chronic urticaria]

Chronic urticaria is above all a cutaneous disease, affecting the skin, a visible organ, which plays a privileged role in relational life. Like any chronic disease, it raises two principal problems: preservation of the quality of life and therapeutic compliance. In chronic urticaria, psychological factors intervene on several levels: the doctor-patient relationship, the urticarian crisis itself, the onset and/or the aggravation of the disease, and the psychosocial consequences of urticaria. The role of psychological factors in the onset and/or the aggravation of the disease is variously estimated, generally based on retrospective studies and without consensus between the authors. On the other hand, the psychosocial impact of the disease is regularly mentioned: 30 to 40 p. 100 of the patients presenting with an associated depressive state. Quality of life is especially impaired in case of an associated physical urticaria. These data plead in favour of taking into account the psychological factors involved in the disease in order to propose, combined with the classical treatments of chronic urticaria and before the use of heavier treatments, a psychological treatment, i.e. a prescription of psychotropic drugs (especially antidepressants), alone or associated to a psychotherapy (a relaxation technique for example), without forgetting health education sessions.