Summary: According to researchers, suffering from asthma or hay fever may put you at an increased risk of developing a psychiatric disorder. The study reports over a 15 year period, 10.8% of people with allergies developed psychiatric disorders, compare to 6.7% of people without allergic diseases.
Patients with asthma and hay fever have an increased risk of developing psychiatric disorders, finds a new study published in open-access journal Frontiers in Psychiatry. Almost 11% of patients with common allergic diseases developed a psychiatric disorder within a 15-year period, compared to only 6.7% of those without — a 1.66-fold increased risk. While previous studies have linked allergies with certain psychiatric or emotional disorders, this is the first to find a connection between common allergies and the overall risk of developing psychiatric disorders. The findings could have implications for how doctors care for and monitor patients with allergic diseases.
Asthma, allergic rhinitis (hay fever) and atopic dermatitis (eczema), are among some of the most common allergic diseases and are nicknamed the three “A”s. Dr. Nian-Sheng Tzeng , from Tri-Service General Hospital in Taiwan and lead author of the study, noticed something unexpected about these patients.
“As a clinician, I observed that some patients with the three ‘A’s appeared to suffer emotionally,” says Tzeng. “Therefore, I wanted to clarify whether these allergic diseases are associated with psychiatric disorders.”
When Tzeng and colleagues searched the literature, they found that previous studies had reported links between allergic diseases and specific psychiatric disorders or emotional problems. For example, a study in Denmark found that children with allergic diseases had more emotional and behavioral problems.
However, not all previous research supported this positive link, with one study in Taiwan suggesting that allergic rhinitis is less common among patients with schizophrenia, for example. Clearly, more extensive research was needed for a more complete picture.
Despite the previous research, no-one had studied the link between the three “A”s and the overall risk of developing psychiatric disorders. To study this in a large sample of people, the researchers used an extensive database of health insurance claims in Taiwan, covering a 15-year period.
The researchers identified 46,647 people in the database with allergic diseases and 139,941 without. Unlike previous studies, the researchers included patients of all ages. They found that over the 15-year period, 10.8% of people with allergic diseases developed a psychiatric disorder, compared with 6.7% of those with no allergic disease. This translated to a 1.66-fold increased risk of developing psychiatric disorders for people with an allergic disease.
A closer look at the data revealed that people with atopic dermatitis had a lower risk of developing a psychiatric disorder, while those with asthma and allergic rhinitis had a higher risk. Interestingly, the team discovered that using certain asthma medications was associated with a lower risk of psychiatric disorders in asthma patients.
So, why might patients with certain allergic diseases have a higher risk of psychiatric disorders? Recent research suggests that inflammation is linked to psychiatric disorders, such as depression and anxiety disorders. As allergies also involve inflammation, it is possible that it may contribute to psychiatric disorders in the same patients. The psychological stress of a psychiatric disorder might also contribute to physical symptoms.
The current study did not examine the potential cause of this phenomenon and researchers need to complete further studies to identify the precise mechanisms involved. However, knowing that there is a link between allergic diseases and psychiatric disorders could help doctors to care for their patients.
“We would like to let clinicians who care for patients with allergic diseases know that their risk for psychiatric diseases may be higher,” says Tzeng. “Assessing their emotional condition and monitoring their mental health could help to avoid later psychiatric problems.”
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Original Research: Abstract for “Increased Risk of Psychiatric Disorders in Allergic Diseases: A Nationwide, Population-Based, Cohort Study” by Nian-Sheng Tzeng, Hsin-An Chang, Chi-Hsiang Chung, Yu-Chen Kao, Chuan-Chia Chang, Hui-Wen Yeh, Wei-Shan Chiang, Yu-Ching Chou, Shan-Yueh Chang and Wu-Chien Chien in Frontiers in Psychiatry. Published April 2018.
Increased Risk of Psychiatric Disorders in Allergic Diseases: A Nationwide, Population-Based, Cohort Study
Allergic diseases, such as bronchial asthma, allergic rhinitis, atopic dermatitis, and psychiatric disorders are major health issues. There have been reports that allergic diseases were associated with depression or anxiety disorders. This study aimed to investigate the association between these allergic diseases and the risk of developing overall psychiatric disorders in patients from Taiwan.
This cohort study used the database of the Taiwan National Health Insurance (NHI) Program. A total of 186,588 enrolled patients, with 46,647 study subjects who had suffered from allergic diseases, and 139,941 controls matched for sex and age, from the Longitudinal Health Insurance Dataset of 2000-2015, were selected from a sub-dataset of the National Health Insurance Research Database (NHIRD). Fine & Gray’s competing risk model analysis was used to explore the hazard ratio (HR), and 95% confidence interval (CI), for the risk of allergic diseases being associated with the risk of developing psychiatric disorders during the 15 years of follow-up.
Of the study subjects, 5,038 (10.8%) developed psychiatric disorders when compared to 9,376 (6.7%) in the control group, with significant difference (p < 0.001). Fine and Gray's competing risk model analysis revealed that the adjusted HR was 1.659 (95% CI= 1.602 - 1.717, p < 0.001). In this study, we found that the groups of atopic dermatitis alone, and the allergic rhinitis + atopic dermatitis were associated with a lower risk of psychiatric disorders, but all the other four groups, as bronchial asthma alone, allergic rhinitis alone, bronchial asthma + allergic rhinitis, bronchial asthma + atopic dermatitis, and the combination of all these three allergic diseases were associated with a higher risk of psychiatric disorders.
Allergic diseases are therefore associated with a 1.66-fold increased hazard of psychiatric disorders in Taiwan.