Anxiety, depression, psychosomatic symptoms and autonomic nervous function in patients with chronic urticaria

Most reports on the psychological analysis of chronic urticaria have concentrated on psychodynamic theories of causation of the disease. For the present study, we used three kinds of psychological tests as well as electrocardiography to estimate anxiety, depressiveness, psychosomatic symptoms and autonomic nervous functions in 30 outpatients with chronic urticaria and 39 normal controls. For evaluation we used the manifest anxiety scale (MAS), self-rating depression scale (SDS), Cornell medical index (CMI) and convergence of variance of R-R interval (CVR-R). Psychologically positive responses to any one of the tests were seen in 70.0% of the chronic urticaria patients, but in only 25.6% of the controls. These differences all showed statistical significance (P < 0.01). The In(CVR-R) (Y) and age (X) suggested a linear regression, but although the regression slope was steeper for the urticaria group (Y = 2.924-0.027X) than for the controls (Y = 2.702-0.023X), the difference was not statistically significant. These data indicate that patients with chronic urticaria are more anxious, depressive and psychosomatic symptom-prone than normal controls. In conclusion, we suggest that chronic urticaria patients should be diagnosed and treated both dermatologically and psychologically.