Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 1637-1641 |
| Number of pages | 5 |
| Journal | Journal of Allergy and Clinical Immunology: In Practice |
| Volume | 6 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Sep 1 2018 |
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Keywords
- Anxiety
- Depression
- Drug allergy
- Drug provocation test
- Placebo
ASJC Scopus subject areas
- Immunology and Allergy
Cite this
Anxiety and Depression Effects During Drug Provocation Test. / Losappio, Laura Michelina; Cappai, Alessandra; Arcolaci, Alessandra; Badiu, Iuliana; Bonadonna, Patrizia; Boni, Elisa; Bussolino, Claudia; Caminati, Marco; Galati, Pietro; Heffler, Enrico; Intravaia, Rossella; Mauro, Marina; Massaro, Ilaria; Romano, Antonino; Rumi, Gabriele; Parolo, Anna; Pizzimenti, Stefano; Nichelatti, Michele; Pastorello, Elide Anna.
In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 6, No. 5, 01.09.2018, p. 1637-1641.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Anxiety and Depression Effects During Drug Provocation Test
AU - Losappio, Laura Michelina
AU - Cappai, Alessandra
AU - Arcolaci, Alessandra
AU - Badiu, Iuliana
AU - Bonadonna, Patrizia
AU - Boni, Elisa
AU - Bussolino, Claudia
AU - Caminati, Marco
AU - Galati, Pietro
AU - Heffler, Enrico
AU - Intravaia, Rossella
AU - Mauro, Marina
AU - Massaro, Ilaria
AU - Romano, Antonino
AU - Rumi, Gabriele
AU - Parolo, Anna
AU - Pizzimenti, Stefano
AU - Nichelatti, Michele
AU - Pastorello, Elide Anna
PY - 2018/9/1
Y1 - 2018/9/1
N2 - 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.
AB - 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.
KW - Anxiety
KW - Depression
KW - Drug allergy
KW - Drug provocation test
KW - Placebo
UR - http://www.scopus.com/inward/record.url?scp=85040452887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040452887&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2017.12.005
DO - 10.1016/j.jaip.2017.12.005
M3 - Article
AN - SCOPUS:85040452887
VL - 6
SP - 1637
EP - 1641
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
SN - 2213-2198
IS - 5
ER -