Anxiety and depression levels and their relationship with disease activity in patients with chronic spontaneous urticaria

Objective: Emotional factors are frequently emphasized in the etiology of urticaria, which is considered among psychocutaneous diseases. There are many studies in the literature investigating the relationship between chronic urticaria and psychological diseases. Although different psychometric methods were used in studies, the most common psychological diseases in patients with chronic urticaria were reported as depression, anxiety and somatoform disorders. Again, in many studies comparing chronic spontaneous urticaria (CSU) and healthy groups, anxiety and depression levels were found to be significantly higher in patients with CSU. In this study, it was aimed to compare the anxiety and depression levels between patients with CSU and the healthy population, and to investigate the relationship between the UAS7 score and the level of anxiety and depression in patients with CSU. Materials and Methods: The study included 45 CSU patients over the age of 18, who applied to Aydın Adnan Menderes University Hospital, Immunology and Allergy outpatient clinic, without any systemic disease, autoimmune disease, malignancy, infectious disease and any drug use history. In the control group, 45 healthy volunteers who did not have urticaria attack, did not have chronic disease and did not use any medication, were homogeneous with the CSU patient group in terms of age and gender were included. A seven-day urticaria activity score (UAS7) was used to determine urticaria disease activity. Beck anxiety scale (BAI) and Beck depression scale (BDI) were used to evaluate anxiety and depression states. "SPSS for Windows version 20.0" software was used in the statistical analysis of the research data. Results: Of the 45 patients included in the study, 34 (75.5%) were female and 11 (24.5%) were male. Their ages ranged from 18-61. The duration of the disease ranged from 2-504 months. Thirty-four (75.5%) of the 45 subjects taken as the control group were female and 11 (24.5%) were male. The age range was 20-55. When the patient and control groups were compared in terms of age and gender distribution, no difference was found (p=0.186, p=1.0). Anxiety and depression levels evaluated with BAI and BDI were found to be significantly higher in the patient group (p=0.056 ; p=0.014, respectively). When the patients' UAS-7 score was compared with the anxiety and depression scale, BDI and BAI scores were higher in patients with high UAS7 scores. Statistically, the increase in the UAS7 score and the increase in the BAI and BDI scores were positively and weakly correlated. Conclusion: Our findings suggest that psychological factors may play a role in the etiology of CSU and that psychotherapeutic approaches may be beneficial in its treatment. It is still unknown whether the observed psychiatric comorbidities develop due to chronic urticaria or predispose to chronic urticaria. Therefore, psychosomatic evaluation of patients may provide additional benefit. Keywords: Chronic spontaneous urticaria, anxiety, depression, UAS7.