R Confino-Cohen1, S Melamed, A Goldberg. 1. Allergy and Clinical Immunology Unit, Meir Hospital, Kfar Sava, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND: Patients who receive immunotherapy for systemic reaction to insect stings are told that once they reach maintenance dose they are almost 100% protected against future systemic reactions. However, we have observed that some patients continued to perceive themselves as highly debilitated by the allergy, and this perception had a significant impact on their quality of life. OBJECTIVE: To validate this clinical observation and to explore possible reasons for such an undesired psychological reaction. METHODS: The study group consisted of 97 patients who regularly attended an allergy outpatient clinic for venom immunotherapy, and who had been under medical surveillance for up to 8 years. They completed a questionnaire measuring debilitating beliefs, preoccupation with the systemic reaction event, emotional distress, perceived restriction by allergy, and perceived quality of life. We also recorded the duration of immunotherapy, physician-graded severity of the systemic reaction and the frequency at which immunotherapy was administered. The reference group consisted of patients who had not reached maintenance dose and were still at risk of recurrent systemic reactions. RESULTS: As many as one-third of the patients held self-imposed debilitating beliefs, were preoccupied with the systemic reaction event, perceived a moderate to severe impairment in their quality of life, and manifested symptoms of emotional distress. These psychological responses did not correlate with the immunotherapy dosage that had been reached. Patients who reached a full maintenance dose were doing no better psychologically than those in the reference group. Moreover, the length of time on immunotherapy did not result in attenuation of the psychological responses. CONCLUSION: This study demonstrates for the first time, the long-lasting psychological impact of a threatening systemic reaction. It suggests a need for intervention aimed at dispelling patients' unfounded and persisting debilitating beliefs.
BACKGROUND:Patients who receive immunotherapy for systemic reaction to insect stings are told that once they reach maintenance dose they are almost 100% protected against future systemic reactions. However, we have observed that some patients continued to perceive themselves as highly debilitated by the allergy, and this perception had a significant impact on their quality of life. OBJECTIVE: To validate this clinical observation and to explore possible reasons for such an undesired psychological reaction. METHODS: The study group consisted of 97 patients who regularly attended an allergyoutpatient clinic for venom immunotherapy, and who had been under medical surveillance for up to 8 years. They completed a questionnaire measuring debilitating beliefs, preoccupation with the systemic reaction event, emotional distress, perceived restriction by allergy, and perceived quality of life. We also recorded the duration of immunotherapy, physician-graded severity of the systemic reaction and the frequency at which immunotherapy was administered. The reference group consisted of patients who had not reached maintenance dose and were still at risk of recurrent systemic reactions. RESULTS: As many as one-third of the patients held self-imposed debilitating beliefs, were preoccupied with the systemic reaction event, perceived a moderate to severe impairment in their quality of life, and manifested symptoms of emotional distress. These psychological responses did not correlate with the immunotherapy dosage that had been reached. Patients who reached a full maintenance dose were doing no better psychologically than those in the reference group. Moreover, the length of time on immunotherapy did not result in attenuation of the psychological responses. CONCLUSION: This study demonstrates for the first time, the long-lasting psychological impact of a threatening systemic reaction. It suggests a need for intervention aimed at dispelling patients' unfounded and persisting debilitating beliefs.
Authors: Tamara Eitel; Kim Nikola Zeiner; Katharina Assmus; Hanns Ackermann; Nadja Zoeller; Markus Meissner; Roland Kaufmann; Stefan Kippenberger; Eva Maria Valesky Journal: World Allergy Organ J Date: 2021-04-21 Impact factor: 4.084
Authors: Ewa Cichocka-Jarosz; Piotr Brzyski; Ewa Swiebocka; Joanna Lange; Beata Tobiasz-Adamczyk; Grzegorz Lis; Urszula Jedynak-Wąsowicz; Marek Kulus; Maciej Kaczmarski; Teresa Małaczyńska; Barbara Klajna-Kraluk; Anna Bręborowicz; Zdzisława Kycler; Jacek J Pietrzyk Journal: Arch Med Sci Date: 2012-12-19 Impact factor: 3.318
Authors: Pilar Rodríguez-Rubio; Laura Lacomba-Trejo; Selene Valero-Moreno; Inmaculada Montoya-Castilla; Marián Pérez-Marín Journal: Int J Environ Res Public Health Date: 2022-03-08 Impact factor: 3.390