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Anxiety and Depression Effects During Drug Provocation Test.
Laura Michelina Losappio1, Alessandra Cappai2, Alessandra Arcolaci3
1Allergy and Immunology Unit, Niguarda Ca' Granda Hospital, Milano, Italy.
The Journal of Allergy and Clinical Immunology. in Practice
|January 18, 2018
Summary
Patients undergoing drug provocation tests (DPTs) with anxiety or depression are more likely to experience placebo reactions. The Hospital Anxiety and Depression Scale (HADS) can help identify these individuals before testing.
Area of Science:
- Allergy and Immunology
- Psychiatry
Background:
- Drug provocation tests (DPTs) are the gold standard for diagnosing drug allergies.
- Single-blind placebo-controlled DPTs require evaluation of placebo reactions, especially in patients with anxiety and depressive disorders.
Purpose of the Study:
- To assess the psychological profile of patients experiencing placebo reactions during DPTs.
- To investigate the correlation between psychological status and placebo reactions in drug allergy diagnosis.
Main Methods:
- 196 patients with suspected drug allergies undergoing DPT were enrolled.
- The Hospital Anxiety and Depression Scale (HADS) was administered before the DPT.
- Placebo reactions during the DPT were recorded.
Main Results:
- 60 patients (30.6%) showed anxiety or depression via HADS.
- 54 patients experienced at least one placebo reaction during the DPT.
- Significant correlations were found between positive HADS scores and placebo reactions (P < .001), and between placebo reactions and a history of severe drug reactions (P < .001).
Conclusions:
- A strong correlation exists between psychological distress and placebo reactions in DPTs.
- Utilizing the HADS or similar questionnaires before DPTs is recommended to identify potential psychiatric factors influencing test outcomes.
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