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. (C) 2017 American Academy of Allergy, Asthma & Immunology.

Anxiety and Depression Effects During Drug Provocation Test

Arcolaci, Alessandra;Bonadonna, Patrizia;Caminati, Marco;Mauro, Marina;
2018

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. (C) 2017 American Academy of Allergy, Asthma & Immunology.
Anxiety; Depression; Drug allergy; Drug provocation test; Placebo; Adolescent; Adult; Aged; Anxiety; Bronchial Provocation Tests; Depression; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Placebos; Single-Blind Method; Skin Tests; Surveys and Questionnaires; Young Adult; Placebo Effect
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1015339
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