Anxiety and Depression Effects During Drug Provocation Test.

Autor:	Losappio LM; Allergy and Immunology Unit, Niguarda Ca' Granda Hospital, Milano, Italy. Electronic address: losappiolaura@yahoo.it., Cappai A; South London and Maudsley NHS Foundation Trust, London, UK., Arcolaci A; Department of Internal Medicine, Allergology and Clinical Immunology, University of Cagliari, Cagliari, Italy., Badiu I; Allergy Unit, Santa Croce e Carle Hospital, Cuneo, Italy., Bonadonna P; Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy., Boni E; Allergy Unit, Santo Spirito Hospital, Casale Monferrato, AL, Italy., Bussolino C; Allergy and Clinical Immunology Unit, Mauriziano Umberto I Hospital, Torino, Italy., Caminati M; Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy., Galati P; Allergy Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy., Heffler E; Department of Biomedical Sciences-Personalized Medicine, Asthma and Allergy Clinic-Humanitas University and Research Hospital, Milano, Italy., Intravaia R; Medicine Unit, Catania University, Catania, Italy., Mauro M; Allergy Unit, ASST Lariana, Sant'Anna Hospital, Como, Italy., Massaro I; Transfusion Medicine Unit, Careggi Hospital, Firenze, Italy., Romano A; Allergy Unit, Fondazione Policlinico Universitario A. Gemelli, Sacro Cuore University, Columbus, Roma, Italy., Rumi G; Allergy Unit, Fondazione Policlinico Universitario A. Gemelli, Sacro Cuore University, Columbus, Roma, Italy., Parolo A; Inter-departmental, Unit of Transfusion Medicine, Padova, Italy., Pizzimenti S; Immunology and Microbiology Unit, Agnelli Hospital, Torino, Italy., Nichelatti M; Service of Biostatistics, Niguarda Ca' Granda Hospital, Milano, Italy., Pastorello EA; Allergy and Immunology Unit, Niguarda Ca' Granda Hospital, Milano, Italy.
Jazyk:	angličtina
Zdroj:	The journal of allergy and clinical immunology. In practice [J Allergy Clin Immunol Pract] 2018 Sep - Oct; Vol. 6 (5), pp. 1637-1641. Date of Electronic Publication: 2018 Jan 12.
DOI:	10.1016/j.jaip.2017.12.005
Abstrakt:	Background: Drug provocation test (DPT) represents the gold standard for the diagnosis of drug allergy. A DPT can be performed in a single-blind placebo-controlled manner. In anxiety and depressive disorders, patients need to be evaluated to understand the nature of placebo reactions. Objective: The aim of this study was to evaluate the psychological profile of patients with reactions to placebo during a DPT. Methods: We consecutively enrolled patients with suspected drug allergy undergoing a DPT preceded by the administration of the placebo. All patients underwent the Hospital Anxiety and Depression Scale (HADS), a questionnaire aimed to identify anxiety and depression, before the challenge test. Results: A total of 196 patients were enrolled into this study: 8 (4%) patients resulted positive to the DPT, 60 (30.6%) demonstrated anxiety or depression based on the HADS, and 54 had at least 1 placebo reaction during drug provocation. There were statically significant correlations between the positivity of the HADS and the finding of a placebo reaction (Fisher's exact test: P < .001), and between the latter and a history of severe reactions to drug (Fisher's exact test: P < .001). Conclusions: There is a significant and strong correlation between the loss of psychic equilibrium and the development of a placebo reaction during a DPT. We suggest the use the HADS or other validated questionnaire in clinical practice before a DPT to evaluate the possible psychiatric components. (Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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