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Depression and anxiety may be cause or effect of attacks in hereditary angioedema

Year 2021, Volume: 6 Issue: 3, 135 - 144, 30.12.2021

Güzin Özden , Mehmet Bankir

https://doi.org/10.22391/fppc.977781

Abstract

Introduction: The study aims to determine the depression and anxiety levels of patients with hereditary angioedema using the Beck depression inventory(BDI), Beck anxiety inventory (BAI) and to compare the results with the patients' demographic characteristics, the number of attacks, attack types, and healthy controls.
Methods: 60 hereditary angioedema patients and 60 healthy controls were included in the study. The demographic characteristics of the patients, the total number of attacks/months before treatment, the number of attacks according to the localization of the attacks, and the number of attacks/month after treatment were filled in retrospectively from their hospital records. BDI and BAI were used for anxiety and depression levels.
Results: Median BAI (11 vs 5; p=0.001) and BDI (11 vs 7; p=0.024) in HAE patients, the ratio of patients with moderate anxiety (21.7% vs 1.7%; p=0.001) and the ratio of patients with severe anxiety (8.3% vs. 0%; p=0.001) were compared to the control group, was high. There was no statistically significant difference between the number of attacks under treatment and the BAI and BDI scores. A positive correlation was found between the number of untreated attacks and the number of attacks under treatment and the BAI score (r=0.759; p=0.001) and BDI score (r=0.599; p=0.001).
Conclusions: Due to the high prevalence of depression and anxiety in HAE patients, health care providers should be attentive of this comorbidity and refer patients to mental health specialists, when needed.
Keywords: Hereditary Angioedema, Beck Depression Inventory, Beck Anxiety Inventory

Keywords

Hereditary Angioedema Beck Depression Inventory Beck Anxiety Inventory

References

  • 1. Bowen T, Cicardi M, Bork K, Zuraw B, Frank M, Ritchie B, et al. Hereditary angioedema: a current state-of-the-art review, VII: Canadian Hungarian 2007 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema. Ann Allergy Asthma Immunol 2008; 100(1 Suppl 2): 30-40. https://doi.org/10.1016/s1081-1206(10)60584-4
  • 2. Banerji A. The burden of illness in patients with hereditary angioedema. Ann Allergy Asthma Immunol 2013; 111(5): 329-36. https://doi.org/10.1016/j.anai.2013.08.019
  • 3. Zuraw BL. Clinical practice. Hereditary angioedema. N Engl J Med 2008; 359(10): 1027-36 https://doi.org/10.1056/NEJMcp0803977
  • 4. Nzeako UC, Frigas E, Tremaine WJ. Hereditary angioedema: a broad review for clinicians. Arch Intern Med 2001; 161(20): 2417-29. https://doi.org/10.1001/archinte.161.20.2417
  • 5. Longhurst H, Bygum A. The Humanistic, Societal, and Pharmaco-economic Burden of Angioedema. Clin Rev Allergy Immunol 2016; 51(2): 230-9. https://doi.org/10.1007/s12016-016-8575-2
  • 6. Zotter Z, Csuka D, Szabo E, Czaller I, Nebenfuhrer Z, Temesszentandrasi G, et al. The influence of trigger factors on hereditary angioedema due to C1-inhibitor deficiency. Orphanet J Rare Dis 2014; 9: 44. https://doi.org/10.1186/1750-1172-9-44
  • 7. Fouche AS, Saunders EF, Craig T. Depression and anxiety in patients with hereditary angioedema. Ann Allergy Asthma Immunol 2014; 112(4): 371-5. https://doi.org/10.1016/j.anai.2013.05.028
  • 8. Burns VE, Edwards KM, Ring C, Drayson M, Carroll D. Complement cascade activation after an acute psychological stress task. Psychosom Med 2008; 70(4):387-96 https://doi.org/10.1097/PSY.0b013e31816ded22
  • 9. Lumry WR, Castaldo AJ, Vernon MK, Blaustein MB, Wilson DA, Horn PT. The humanistic burden of hereditary angioedema: Impact on health-related quality of life, productivity, and depression. Allergy Asthma Proc 2010; 31(5):407-14. https://doi.org/10.2500/aap.2010.31.3394
  • 10. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev 1988; 8(1):77-100. https://doi.org/10.1016/0272-7358(88)90050-5
  • 11. Hisli N. [Validity, reliability and validity of Beck depression inventory for university students] (İn Turkish) Turk Psikol Derg 1989; 7: 3-14.
  • 12. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56(6): 893-7. https://doi.org/10.1037//0022-006x.56.6.893
  • 13. Ulusoy M, Sahin NH, Erkmen H. Turkish Version of the Beck Anxiety Inventory. J Cogn Psychother 1998; 12: 163-72.
  • 14. Savarese L, Mormile I, Bova M, Petraroli A, Maiello A, Spadaro G, et al. Psychology and hereditary angioedema: A systematic review. Allergy Asthma Proc 2021; 42(1): 1-7. https://doi.org/10.2500/aap.2021.42.200073
  • 15. Freda MF, Savarese L, Dolce P, Picione RL. Caregivers' Sensemaking of Children's Hereditary Angioedema: A Semiotic Narrative Analysis of the Sense of Grip on the Disease. Front Psychol 2019; 10: 2609. https://doi.org/10.3389/fpsyg.2019.02609
  • 16. Savarese L, Bova M, De Falco R, Guarino MD, De Luca Picione R, Petraroli A, et al. Emotional processes and stress in children affected by hereditary angioedema with C1-inhibitor deficiency: a multicenter, prospective study. Orphanet J Rare Dis 2018; 13(1): 115. https://doi.org/10.1186/s13023-018-0871-x
  • 17. Kuman Tuncel O, Gokmen NM, Demir E, Gulbahar O, Pirildar S. The impact of hereditary angioedema on quality of life and family planning decisions. Int J Psychiatry Med 2019; 54(6): 377-394. https://doi.org/10.1177/0091217419837068
  • 18. Freda MF, Savarese L, Bova M, Galante A, De Falco R, De Luca Picione R, et al. Stress and Psychological Factors in the Variable Clinical Phenotype of Hereditary Angioedema in Children: A Pilot Study. Pediatr Allergy Immunol Pulmonol 2016; 29(1): 6-12. https://doi.org/10.1089/ped.2015.0557
  • 19. Liu S, Wang X, Xu Y, Xu Q, Zhi Y. Risk factors for diagnostic delay in Chinese patients with hereditary angioedema. Allergy Asthma Proc 2019; 40(5): 343-9. https://doi.org/10.2500/aap.2019.40.4234
  • 20. Caballero T, Sala-Cunill A, Cancian M, Craig TJ, Neri S, Keith PK, et al. Current status of implementation of self-administration training in various regions of Europe, Canada and the USA in the management of hereditary angioedema. Int Arch Allergy Immunol 2013; 161 Suppl 1:10-6. https://doi.org/10.1159/000351233
  • 21. Bygum A, Aygoren-Pursun E, Caballero T, Beusterien K, Gholizadeh S, Musingarimi P, et al. The hereditary angioedema burden of illness study in Europe (HAE-BOIS-Europe): background and methodology. BMC Dermatol 2012; 12:4. https://doi.org/10.1186/1471-5945-12-4
  • 22. Banerji A, Davis KH, Brown TM, Hollis K, Hunter SM, Long J, et al. Patient-reported burden of hereditary angioedema: findings from a patient survey in the United States. Ann Allergy Asthma Immunol 2020; 124(6): 600-7. https://doi.org/10.1016/j.anai.2020.02.018
  • 23. Roche O, Blanch A, Caballero T, Sastre N, Callejo D, Lopez-Trascasa M, Hereditary angioedema due to C1 inhibitor deficiency: patient registry and approach to the prevalence in Spain. Ann Allergy Asthma Immunol 2005; 94(4):498-503. https://doi.org/10.1016/S1081-1206(10)61121-0
  • 24. Bygum A. Hereditary angio-oedema in Denmark: a nationwide survey. Br J Dermatol 2009; 161(5):1153-8. https://doi.org/10.1111/j.1365-2133.2009.09366.x
  • 25. Fragnan N, Tolentino ALN, Borba GB, Oliveira AC, Simoes JA, Palma SMU, et al. Hereditary angioedema with C1 inhibitor (C1-INH) deficit: the strength of recognition (51 cases). Braz J Med Biol Res 2018; 51(12):7813. https://doi.org/10.1590/1414-431X20187813
  • 26. Jolles S, Williams P, Carne E, Mian H, Huissoon A, Wong G, et al. A UK national audit of hereditary and acquired angioedema. Clin Exp Immunol 2014; 175(1): 59-67. https://doi.org/10.1111/cei.12159
  • 27. Perricone C, Agmon-Levin N, Shoenfeld N, de Carolis C, Guarino MD, Gigliucci G, et al. Evidence of impaired sense of smell in hereditary angioedema. Allergy 2011; 66(1): 149-54. https://doi.org/10.1111/j.1398-9995.2010.02453.x
  • 28. Caballero T, Zanichelli A, Aberer W, Maurer M, Longhurst HJ, Bouillet L, et al. Effectiveness of icatibant for treatment of hereditary angioedema attacks is not affected by body weight: findings from the Icatibant Outcome Survey, a cohort observational study. Clin Transl Allergy 2018; 8:11. https://doi.org/10.1186/s13601-018-0195-x
  • 29. Caballero T, Aygoren-Pursun E, Bygum A, Beusterien K, Hautamaki E, Sisic Z, et al. The humanistic burden of hereditary angioedema: results from the Burden of Illness Study in Europe. Allergy Asthma Proc 2014; 35(1):47-53. https://doi.org/10.2500/aap.2013.34.3685

Herediter anjioödemde anksiyete ve depresyon, atakların nedeni veya sonucu olabilir

Year 2021, Volume: 6 Issue: 3, 135 - 144, 30.12.2021

Güzin Özden , Mehmet Bankir

https://doi.org/10.22391/fppc.977781

Abstract

Giriş: Çalışmanın amacı Herediter Anjioödem hastalarında depresyon ve anksiyete düzeylerini Beck depresyon ve anksiyete ölçeği ile belirlemek ve sonuçlarını hastaların demografik özellikleri, atak sayıları, atak yerleri ve sağlıklı kontroller ile karşılaştırmaktır.
Yöntem: Çalışmaya 60 Herediter Anjioödem ve 60 sağlıklı kontrol çalışmaya dahil edildi. Hastaların demografik özellikleri, toplam atak sayıları/ay, atakların yerine göre atak sayısı, tedavi sonrası atak sayısı/ay dosyalarından retrospektif olarak kaydedildi. Anksiyete ve depresyon düzeyi için Beck depresyon ölçeği (BAÖ, BDÖ) kullanıldı.
Bulgular: Herediter Anjioödem hastalarında medyan BAÖ(11'e 5; p=0,001) ve BDÖ (11'e 7; p=0,024) orta düzeyde anksiyetesi olan hastaların oranı (%21,7’ye karşı %1,7; p=0,001) ve şiddetli anksiyetesi olan hastaların oranı (% 8,3 vs. %0; p=0,001) kontrol grubuna göre anlamlı oranda yüksek olarak saptandı. Tedavi altındaki atak sayısı ile BAÖ ve BDÖ skorları arasında istatistiksel olarak anlamlı bir fark yoktu. Tedavi edilmeyen atak sayısı ile tedavi altındaki atak sayısı ile BAÖ skoru (r=0,759; p=0,001) ve BDÖ skoru (r=0,599; p=0,001) arasında pozitif korrelasyon bulundu.
Sonuç: Herediter Anjioödem hastalarında depresyon ve anksiyete prevalansının yüksek olması nedeniyle, sağlık hizmeti sunucuları bu komorbidite konusunda dikkatli olmalı ve gerektiğinde hastaları ruh sağlığı uzmanlarına yönlendirmelidir.
Anahtar Kelimeler: Herediter Anjioödem, Beck Depresyon Ölçeği, Beck Anksiyete Ölçeği

Keywords

Herediter Anjioödem Beck Depresyon Ölçeği Beck Anksiyete Ölçeği

References

  • 1. Bowen T, Cicardi M, Bork K, Zuraw B, Frank M, Ritchie B, et al. Hereditary angioedema: a current state-of-the-art review, VII: Canadian Hungarian 2007 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema. Ann Allergy Asthma Immunol 2008; 100(1 Suppl 2): 30-40. https://doi.org/10.1016/s1081-1206(10)60584-4
  • 2. Banerji A. The burden of illness in patients with hereditary angioedema. Ann Allergy Asthma Immunol 2013; 111(5): 329-36. https://doi.org/10.1016/j.anai.2013.08.019
  • 3. Zuraw BL. Clinical practice. Hereditary angioedema. N Engl J Med 2008; 359(10): 1027-36 https://doi.org/10.1056/NEJMcp0803977
  • 4. Nzeako UC, Frigas E, Tremaine WJ. Hereditary angioedema: a broad review for clinicians. Arch Intern Med 2001; 161(20): 2417-29. https://doi.org/10.1001/archinte.161.20.2417
  • 5. Longhurst H, Bygum A. The Humanistic, Societal, and Pharmaco-economic Burden of Angioedema. Clin Rev Allergy Immunol 2016; 51(2): 230-9. https://doi.org/10.1007/s12016-016-8575-2
  • 6. Zotter Z, Csuka D, Szabo E, Czaller I, Nebenfuhrer Z, Temesszentandrasi G, et al. The influence of trigger factors on hereditary angioedema due to C1-inhibitor deficiency. Orphanet J Rare Dis 2014; 9: 44. https://doi.org/10.1186/1750-1172-9-44
  • 7. Fouche AS, Saunders EF, Craig T. Depression and anxiety in patients with hereditary angioedema. Ann Allergy Asthma Immunol 2014; 112(4): 371-5. https://doi.org/10.1016/j.anai.2013.05.028
  • 8. Burns VE, Edwards KM, Ring C, Drayson M, Carroll D. Complement cascade activation after an acute psychological stress task. Psychosom Med 2008; 70(4):387-96 https://doi.org/10.1097/PSY.0b013e31816ded22
  • 9. Lumry WR, Castaldo AJ, Vernon MK, Blaustein MB, Wilson DA, Horn PT. The humanistic burden of hereditary angioedema: Impact on health-related quality of life, productivity, and depression. Allergy Asthma Proc 2010; 31(5):407-14. https://doi.org/10.2500/aap.2010.31.3394
  • 10. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev 1988; 8(1):77-100. https://doi.org/10.1016/0272-7358(88)90050-5
  • 11. Hisli N. [Validity, reliability and validity of Beck depression inventory for university students] (İn Turkish) Turk Psikol Derg 1989; 7: 3-14.
  • 12. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56(6): 893-7. https://doi.org/10.1037//0022-006x.56.6.893
  • 13. Ulusoy M, Sahin NH, Erkmen H. Turkish Version of the Beck Anxiety Inventory. J Cogn Psychother 1998; 12: 163-72.
  • 14. Savarese L, Mormile I, Bova M, Petraroli A, Maiello A, Spadaro G, et al. Psychology and hereditary angioedema: A systematic review. Allergy Asthma Proc 2021; 42(1): 1-7. https://doi.org/10.2500/aap.2021.42.200073
  • 15. Freda MF, Savarese L, Dolce P, Picione RL. Caregivers' Sensemaking of Children's Hereditary Angioedema: A Semiotic Narrative Analysis of the Sense of Grip on the Disease. Front Psychol 2019; 10: 2609. https://doi.org/10.3389/fpsyg.2019.02609
  • 16. Savarese L, Bova M, De Falco R, Guarino MD, De Luca Picione R, Petraroli A, et al. Emotional processes and stress in children affected by hereditary angioedema with C1-inhibitor deficiency: a multicenter, prospective study. Orphanet J Rare Dis 2018; 13(1): 115. https://doi.org/10.1186/s13023-018-0871-x
  • 17. Kuman Tuncel O, Gokmen NM, Demir E, Gulbahar O, Pirildar S. The impact of hereditary angioedema on quality of life and family planning decisions. Int J Psychiatry Med 2019; 54(6): 377-394. https://doi.org/10.1177/0091217419837068
  • 18. Freda MF, Savarese L, Bova M, Galante A, De Falco R, De Luca Picione R, et al. Stress and Psychological Factors in the Variable Clinical Phenotype of Hereditary Angioedema in Children: A Pilot Study. Pediatr Allergy Immunol Pulmonol 2016; 29(1): 6-12. https://doi.org/10.1089/ped.2015.0557
  • 19. Liu S, Wang X, Xu Y, Xu Q, Zhi Y. Risk factors for diagnostic delay in Chinese patients with hereditary angioedema. Allergy Asthma Proc 2019; 40(5): 343-9. https://doi.org/10.2500/aap.2019.40.4234
  • 20. Caballero T, Sala-Cunill A, Cancian M, Craig TJ, Neri S, Keith PK, et al. Current status of implementation of self-administration training in various regions of Europe, Canada and the USA in the management of hereditary angioedema. Int Arch Allergy Immunol 2013; 161 Suppl 1:10-6. https://doi.org/10.1159/000351233
  • 21. Bygum A, Aygoren-Pursun E, Caballero T, Beusterien K, Gholizadeh S, Musingarimi P, et al. The hereditary angioedema burden of illness study in Europe (HAE-BOIS-Europe): background and methodology. BMC Dermatol 2012; 12:4. https://doi.org/10.1186/1471-5945-12-4
  • 22. Banerji A, Davis KH, Brown TM, Hollis K, Hunter SM, Long J, et al. Patient-reported burden of hereditary angioedema: findings from a patient survey in the United States. Ann Allergy Asthma Immunol 2020; 124(6): 600-7. https://doi.org/10.1016/j.anai.2020.02.018
  • 23. Roche O, Blanch A, Caballero T, Sastre N, Callejo D, Lopez-Trascasa M, Hereditary angioedema due to C1 inhibitor deficiency: patient registry and approach to the prevalence in Spain. Ann Allergy Asthma Immunol 2005; 94(4):498-503. https://doi.org/10.1016/S1081-1206(10)61121-0
  • 24. Bygum A. Hereditary angio-oedema in Denmark: a nationwide survey. Br J Dermatol 2009; 161(5):1153-8. https://doi.org/10.1111/j.1365-2133.2009.09366.x
  • 25. Fragnan N, Tolentino ALN, Borba GB, Oliveira AC, Simoes JA, Palma SMU, et al. Hereditary angioedema with C1 inhibitor (C1-INH) deficit: the strength of recognition (51 cases). Braz J Med Biol Res 2018; 51(12):7813. https://doi.org/10.1590/1414-431X20187813
  • 26. Jolles S, Williams P, Carne E, Mian H, Huissoon A, Wong G, et al. A UK national audit of hereditary and acquired angioedema. Clin Exp Immunol 2014; 175(1): 59-67. https://doi.org/10.1111/cei.12159
  • 27. Perricone C, Agmon-Levin N, Shoenfeld N, de Carolis C, Guarino MD, Gigliucci G, et al. Evidence of impaired sense of smell in hereditary angioedema. Allergy 2011; 66(1): 149-54. https://doi.org/10.1111/j.1398-9995.2010.02453.x
  • 28. Caballero T, Zanichelli A, Aberer W, Maurer M, Longhurst HJ, Bouillet L, et al. Effectiveness of icatibant for treatment of hereditary angioedema attacks is not affected by body weight: findings from the Icatibant Outcome Survey, a cohort observational study. Clin Transl Allergy 2018; 8:11. https://doi.org/10.1186/s13601-018-0195-x
  • 29. Caballero T, Aygoren-Pursun E, Bygum A, Beusterien K, Hautamaki E, Sisic Z, et al. The humanistic burden of hereditary angioedema: results from the Burden of Illness Study in Europe. Allergy Asthma Proc 2014; 35(1):47-53. https://doi.org/10.2500/aap.2013.34.3685
There are 29 citations in total.

Details

Primary Language English
Subjects Dermatology
Journal Section Original Research
Authors

Güzin Özden 0000-0003-4856-2267

Mehmet Bankir 0000-0003-3284-2838

Publication Date December 30, 2021
Submission Date August 2, 2021
Acceptance Date November 14, 2021
Published in Issue Year 2021 Volume: 6 Issue: 3

Cite

APA Özden, G., & Bankir, M. (2021). Depression and anxiety may be cause or effect of attacks in hereditary angioedema. Family Practice and Palliative Care, 6(3), 135-144. https://doi.org/10.22391/fppc.977781
AMA Özden G, Bankir M. Depression and anxiety may be cause or effect of attacks in hereditary angioedema. Fam Pract Palliat Care. December 2021;6(3):135-144. doi:10.22391/fppc.977781
Chicago Özden, Güzin, and Mehmet Bankir. “Depression and Anxiety May Be Cause or Effect of Attacks in Hereditary Angioedema”. Family Practice and Palliative Care 6, no. 3 (December 2021): 135-44. https://doi.org/10.22391/fppc.977781.
EndNote Özden G, Bankir M (December 1, 2021) Depression and anxiety may be cause or effect of attacks in hereditary angioedema. Family Practice and Palliative Care 6 3 135–144.
IEEE G. Özden and M. Bankir, “Depression and anxiety may be cause or effect of attacks in hereditary angioedema”, Fam Pract Palliat Care, vol. 6, no. 3, pp. 135–144, 2021, doi: 10.22391/fppc.977781.
ISNAD Özden, Güzin - Bankir, Mehmet. “Depression and Anxiety May Be Cause or Effect of Attacks in Hereditary Angioedema”. Family Practice and Palliative Care 6/3 (December2021), 135-144. https://doi.org/10.22391/fppc.977781.
JAMA Özden G, Bankir M. Depression and anxiety may be cause or effect of attacks in hereditary angioedema. Fam Pract Palliat Care. 2021;6:135–144.
MLA Özden, Güzin and Mehmet Bankir. “Depression and Anxiety May Be Cause or Effect of Attacks in Hereditary Angioedema”. Family Practice and Palliative Care, vol. 6, no. 3, 2021, pp. 135-44, doi:10.22391/fppc.977781.
Vancouver Özden G, Bankir M. Depression and anxiety may be cause or effect of attacks in hereditary angioedema. Fam Pract Palliat Care. 2021;6(3):135-44.

Family Practice and Palliative Care       ISSN 2458-8865       E-ISSN 2459-1505