Association Between Frequency of Pruritic Symptoms and Perceived Psychological Stress

Abstract

Main Outcome Measures: Frequency of pruritic symptomsassessedbyself-reportedhealthdiariesoverthe1-month period and subsequent psychological stress measured using the Japanese version of the Perceived Stress Scale. Results: The 2224 participants had a mean age of 44.6 years, 1212 (54.5%) were women, and 70 (3.1%) presented with pruritic symptoms. Multivariable analysis showed that patients with pruritic symptoms had significantly higher psychological stress than those without pruritic symptoms (␤ coefficient, 2.33; 95% confidence interval [CI], 0.53-4.14; P =.01). Furthermore, a linear trend was observed between increased psychological stress and increased severity of pruritic symptoms, with ␤ coefficients for the first, second, and third tertiles for symptoms of 0.81 (95% CI, −1.97 to 3.59), 1.77 (95% CI, −0.82 to 4.37), and 4.86 (95% CI, 1.29 to 8.43), respectively (P value for trend, .004). Conclusion: Our results suggest that frequency of pruritic symptoms is associated with psychological stress in the general population.

Allergy and high trait anxiety are related to increases in heart rate variability: results of naturalistic long-term design study

“…Due to similar psychophysiological changes (24) and reported comorbidity of anxiety and allergy (16,17,18,23) as well as the role of stress in allergic process (15), psychological interventions aimed on better coping and reduction of anxiety could be beneficial to allergic patients (45). Similarly, interventions based on normalization of HRV such as HRV biofeedback might also be employed, which has already been demonstrated in a study with asthma (46).…”

“…Increased trait anxiety was correlated with elevated levels of IgE and increase in Th2 immune response, which play a critical role in development of allergy (16). Other studies (17,18) found that personality traits such as anxiety, depression, a high emotional excitability, as well as higher comorbidity of anxiety disorders were linked to major allergic disorders (atopic dermatitis, allergic rhinitis, allergic asthma). Based on associations between allergy and anxiety, as well as on expected discomfort due to the presence of allergic symptoms, reduced HRV in allergy would be expected.…”

“…These findings were interpreted in context of allostatic model, as inability to react with adaptive stress reaction. While allergy is often associated with increases in anxiety, depression and problems in emotional regulation (17,18), effects of blunted cortisol (41) as well as salivary alpha amylase, which is commonly associated with sympathetic activity (42) and aldosterone (24) were reported for both allergy as well as high trait anxiety. Based on the mentioned effects we could speculate whether choosing only very high trait anxious subjects (STAI-T score < 49) and contrarily very low anxious subjects as controls (STAI-T < 39) could play a role in the observed effects.…”

Increased Heart Rate Variability in Allergic and Highly Trait Anxious Individuals

“…Most studies associate high anxiety with reduced HRV and increased HR, which can also be seen in anxiety disorders studies [23]. On the other hand, close similarities between allergy and anxiety were documented [8,19,20]. Similar findings in allergy and anxiety were also found in HPA axis reaction to stress, where both allergy and high trait anxiety subjects exhibited lowered cortisol responses [5,26].…”

“…Possible underlying mechanism can be illustrated by correlations of anxiety and Th2 immune response, as well as synthesis of IgE antibody [19]. People with allergy also exhibit higher subjective perception of stress and have higher comorbidity of anxiety disorders [20].…”