Perceived stress and severity of chronic rhinosinusitis in allergic and nonallergic patients

Abstract

Chronic stress exposure carries greater risk of onset of atopic respiratory disorders such as rhinitis and asthma. The interaction between depression, anxiety, and severity of chronic rhinosinusitis (CRS) has been suggested. We aimed to access the relationship between psychological stress, severity of CRS, and atopy. Sixty-three consecutive patients referred with CRS were asked to score the severity of rhinosinusitis symptoms on a visual analog scale and to fill in questionnaires on the disease-specific quality of life and perceived stress-22-item Sino-Nasal Outcome Test (SNOT-22) and measure of perceived stress (MPS) scale, respectively. Inclusion criteria for the study were a reliable allergy evaluation and a recent computerized tomography (CT) scan of the sinuses. Patients with nasal polyps (NPs), asthma, and previous surgery were excluded. The study group consisted of 14 allergic and 18 nonallergic patients with CRS without NPs (CRSsNPs). Correlation between MPS and SNOT-22 scores in the study group was highly significant (Pearson r = 0.61; p = 0.001). Patients with higher stress scores had significantly stronger postnasal discharge, thick discharge, cough, disturbed sleep, fatigue, and sadness. Postnasal drip was significantly stronger in patients with allergy. The correlation between SNOT-22 and CT scores was insignificant. The correlation between MPS and SNOT-22 scores suggests an interaction between severity of CRS and chronic stress, but not with the extent of the disease on CT in CRSsNPs. Chronic psychological stress might be one of the factors that modifies the disease severity and may lead to uncontrolled disease in CRS patients.

Incidence and burden of comorbid pain and depression in patients with chronic rhinosinusitis awaiting endoscopic sinus surgery in Canada

“…Sino-nasal symptoms have been documented to be associated with significant anxiety and depression [10, 11]; especially in patients without polyps [11], and more than half of patients with CRS reportedly suffer from pain [12, 13]. Dysfunction of sleep and pain have been seen to be inter-related in the presence of depression [13].…”

Correlation of Serumβ-Endorphin and the Quality of Life in Allergic Rhinitis

“…It is noteworthy that the opioid peptide β -endorphin is not only a mediator of immune responses but also a predictor of mental health problems [30–32]. Mental health problems such as stress, depressive episodes, and anxiety disorders have been reported to be much more prevalent among patients with AR than among individuals without prevalent AR [33–35]. Although β -endorphin has received considerable attention for both its immunological function in allergic disease and its potential to predict the mental state of patients, few studies have investigated the relationship between β -endorphin and QOL, which are associated with these two conditions.…”

CRH promotes S. pneumoniae growth in vitro and increases lung carriage in mice

“…Previous studies have been associated with the activation of stress factors with disease pathogenesis along respiratory tissues ( Lim et al, 2014 ; Runeson-Broberg and Norback, 2014 ; Tomljenovic et al, 2014 ; Yang et al, 2014a ). Utilizing an experimental model of aversive stress and S. pneumoniae infection, we demonstrated CRH’s ability to regulate disease severity by controlling cellular immune and inflammatory responses ( Kim et al, 2011 ).…”