Managing anxiety related to anaphylaxis in childhood: a systematic review

Objectives. This paper reviews the relationship between anxiety and anaphylaxis in children and youth, and principles for managing anxiety in the anaphylactic child and his or her parents. Methods. A review of the medical literature (Medline) was done using the keywords "anxiety," "anaphylaxis," and "allergy," limited to children and adolescents. Findings were organized into categories used in the treatment of childhood anxiety disorders, then applied to managing anxiety in the anaphylactic child. Results. Twenty-four relevant papers were identified. These varied widely in methodology. Findings emphasized included the need to distinguish anxiety-related and organic symptoms, ameliorate the anxiety-related impact of anaphylaxis on quality of life, and address parental anxiety about the child. Conclusion. Children with anaphylaxis can function well despite anxiety, but the physical, cognitive, and behavioral aspects of anxiety associated with anaphylactic risk must be addressed, and parents must be involved in care in constructive ways.