History of anaphylaxis, allergy labeling associated with psychological disorders

Key takeaways:

• People with food allergies were at risk for developing anxiety, depression, PTSD, and eating and sleeping disorders.
• Greater risk was found among children aged younger than 3 years with food-induced anaphylaxis.

Anaphylaxis and food allergies appeared associated with psychiatric disorders, according to a study included in the program of the American Academy of Allergy, Asthma & Immunology Annual Meeting.

“This subject gained my attention a few years ago. I presented our study emphasizing the relation between anaphylaxis and PTSD at the 2019 AAAAI meeting,” Yuval Tal, MD, PhD, director of the allergy and clinical immunology unit at Hadassah-Hebrew University Medical Center, told Healio, noting that he was unable to present this research at the current meeting. “Last year we published two very large-scale studies, encompassing half of Israel’s population, regarding label of food allergy and psychiatric illnesses later in life and anaphylaxis in infancy and future psychological diseases.”

The current abstract summarizes the work of those three studies, which were conducted at Hadassah University Medical Center and health maintenance organization, Clalit, to identify the association between anaphylaxis and psychiatric disease.

The first study included 85 adults who had experienced anaphylaxis or local reactions following Hymenoptera stings. Those who experienced anaphylaxis had higher mean scores on the PCL-5, the DSM-5 PTSD checklist, compared with those who experienced local reactions (15.2 ± 18.5 vs. 1.6 ± 5.9; P < .001).

The second and third studies looked at the prevalence of and risk for psychological disorders among people with vs. without food allergies, one in a nationwide cohort and the other specifically in children.

In the national study of more than 600,000 individuals in Israel, researchers found a higher prevalence of psychological disorders among those with food allergies, including anxiety (HR = 1.498), depression (HR = 1.428), PTSD (HR = 1.462), eating disorders (HR = 2.069) and sleep disorders (HR = 1.468; P <.001 for all).

Specifically among children, a population-based matched-cohort study of 545 children who had experienced food-induced anaphylaxis (87.3% aged < 3 years) and 4,514 controls (87.6% < 3 years) showed an association between food-induced anaphylaxis and developing any psychological disorder (P < .001), sleeping disorder (P < .001) or eating disorder (P = .05) later in life.

Through these three studies, Tal and colleagues concluded that anaphylaxis and food allergies increase the risk for developing a psychiatric disorder, suggesting the importance of early mental health care referrals.

“It seems that allergy or mere allergy labeling is directly linked to psychiatric illnesses,” Tal said. “Furthermore, chronic stress might worsen allergic disorders, possibly through IL-4.”

References:

• Nemet S, et al. Allergy. 2023;doi:10.1111/all.15775.
• Nemet S, et al. Pediatr Allergy Immunol. 2023;doi:10.1111/pai.14061.
• Tal Y, et al. J Allergy Clin Immunol Pract. 2019;doi:10.1016/j.jaip.2019.07.035.