PURPOSE OF THE STUDY.
To study whether skin prick test (SPT) response to common allergens in patients with allergic rhinitis is affected by anxiety and stress.
Healthy individuals between 18 and 40 years of age with seasonal allergic rhinitis by clinical history and SPT.
Participants were admitted to a hospital research unit twice, at least 2 weeks apart, for testing. An acute stress condition was induced using the Trier Social Stress Test. In a crossover design, SPT wheals to 9 common aeroallergens were assessed at multiple time points: before and after the test, as well as the next morning. For further comparison, SPT wheals were evaluated before and after a separate session without a stressor, as a control. A 20-item Anxiety Test Scale was used to assess anxiety.
A higher incidence of positive SPT reactions was found to allergens that had previously tested negative in more anxious patients with atopy. Positive SPT under nonstressful conditions was unrelated to anxiety. On the basis of clinical symptoms, the SPT wheal response for allergens previously testing negative were enhanced after a stressor, therefore correcting previous false-negative SPT results. No effects on SPT responses for the positive histamine control or negative saline controls.
The results of this study indicate that a laboratory stressor in more anxious patients with allergic rhinitis affects SPT response. Such a response was not noted in the more anxious patient when the laboratory stressor was not introduced. Therefore, assessment of anxiety and current stress may provide useful information during evaluation for atopy.
Stress and anxiety have effects on many aspects of our health. The study aims at looking at the effect of stress and anxiety on SPT results. Although the sample size of the study was small, the results appear important to our diagnosis of atopic disease in patients. A larger-scale study is warranted to see whether such a principle may be applied across demographic groups. This study further emphasizes the importance of a good clinical history and assessing more external and internal factors that may affect patient care.
- Copyright © 2015 by the American Academy of Pediatrics