Impact of help-seeking behaviors on allergic rhinitis and mental health: A longitudinal study

Allergic rhinitis (AR), anxiety, and depression are prevalent comorbidities that negatively impact patients' quality of life. This study explored how help-seeking behaviors act as intermediaries between medication use, AR symptoms as measured by the Sino-Nasal Outcome Test (SNOT-22), and mental health outcomes, specifically anxiety and depressive symptoms, assessed through the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7).

This longitudinal study analyzed data from 1035 adults 18 years and older. Participants were recruited from 105 non-allergist primary care clinics across the United States using the QHSLab Digital Medicine platform between February 20, 2024, and January 18, 2025. Of the original sample, 891 participants completed the follow-up, yielding an attrition rate of approximately 14 %. Health-seeking behavior was defined as seeking professional assistance for emotional well-being, allergies, or neither. Baseline medication use for intranasal steroids, antihistamines, decongestants, and oral leukotriene blockers was recorded. Pearson correlations, Analysis of Variance (ANOVA), chi-squared test (χ² test), and regression analyses explored relationships between these factors and health score changes (α = 0.05).

Patients who actively sought help for emotional well-being and allergic rhinitis exhibited the most significant improvements in symptom severity and mental health outcomes. Pearson correlation analyses revealed a significant negative association between dual-condition help-seeking and reductions in both SNOT-22 (r = -0.22, p < 0.01) and PHQ-GAD scores (r = -0.34, p < 0.01). Regression analysis confirmed that help-seeking behaviors (HSB) were significant predictors of symptom improvement, with individuals seeking assistance for both conditions showing notable reductions in SNOT-22 (β = -0.19, p < 0.05) and PHQ-GAD scores (β = -0.28, p < 0.01). Longitudinal analyses further demonstrated that consistent HSB engagement over six months led to a 23 % greater reduction in SNOT-22 scores (β = -0.21, p = 0.03) and a 31 % greater reduction in PHQ-GAD scores (β = -0.27, p < 0.01) compared to pharmacologic interventions alone. Sensitivity analyses reaffirmed these findings, and mindfulness meditation (β = 3.54, p < 0.001) and allergen immunotherapy (β = 5.60, p = 0.0185) were identified as additional predictors of mental health improvement. These results highlight integrated care's critical role in addressing physical and mental health conditions to optimize patient outcomes.

This study underscores the importance of help-seeking behaviors in improving allergic rhinitis and mental health outcomes, highlighting the benefits of integrated care approaches. Patients who sought help for both conditions experienced the most significant symptom relief, reinforcing the need for multidisciplinary, patient-centered treatment. Expanding mental health screening within AR management, enhancing access to behavioral interventions, and leveraging digital health tools can optimize patient engagement and long-term outcomes. These findings advocate for a holistic shift in AR care, emphasizing integrating physical and mental health support to improve overall well-being.