Anxiety and nonpsychotic mental disorders in acute urticaria
Background: Acute urticaria (AU) is characterized by the sudden onset of wheals, angioedema, or both, with symptoms resolving within 6 weeks. While the association between chronic urticaria and mental health disorders is well-documented, the relationship between AU and psychological conditions remai...
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Elsevier
2025-10-01
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| Series: | Brain, Behavior, & Immunity - Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666354625001462 |
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| author | Eli Magen Eugene Merzon Shai Ashkenazi Abraham Weizman Iris Manor Israel Magen Avi Yakov Akim Geishin Ilan Green Avivit Golan-Cohen Shlomo Vinker Ariel Israel |
| author_facet | Eli Magen Eugene Merzon Shai Ashkenazi Abraham Weizman Iris Manor Israel Magen Avi Yakov Akim Geishin Ilan Green Avivit Golan-Cohen Shlomo Vinker Ariel Israel |
| author_sort | Eli Magen |
| collection | DOAJ |
| description | Background: Acute urticaria (AU) is characterized by the sudden onset of wheals, angioedema, or both, with symptoms resolving within 6 weeks. While the association between chronic urticaria and mental health disorders is well-documented, the relationship between AU and psychological conditions remains understudied. Objective: To investigate the association between AU and anxiety and personality disorders, and to explore the potential psychoneuroimmunological mechanisms underlying these relationships. Methods: We conducted a population-based case-control study using the comprehensive electronic health records database of Leumit Health Services in Israel. The study included 72,805 AU patients and 291,220 matched controls. Subjects were matched for gender, age, ethnicity, year of first documented visit, and socioeconomic status. We analyzed the 20-year prevalence of anxiety disorders, personality disorders, and various nonpsychotic mental disorders in both groups. Results: AU patients demonstrated significantly higher prevalence of anxiety disorders (7.02 % vs. 5.22 %, p < 0.001, OR = 1.37 [95 % CI: 1.33–1.42]), personality disorders (0.23 % vs. 0.134 %, p < 0.001, OR = 1.73 [95 % CI: 1.44–2.08]), and adjustment disorders (0.91 % vs. 0.67 %, p < 0.001, OR = 1.37 [95 % CI: 1.25–1.50]) compared to controls. Particularly notable were the associations with personality disorders characterized by persistent mood disturbances (OR = 1.91 [95 % CI: 1.53–2.38]) and adjustment disorders with depressive features (OR = 1.49 [95 % CI: 1.27–1.74]). Conclusions: Our findings reveal significant associations between AU and various mental health disorders, particularly anxiety and personality disorders. These associations suggest a complex bidirectional relationship mediated through psychoneuroimmunological pathways involving the HPA axis, mast cell activation, and inflammatory cytokines. We recommend implementing specific screening tools (HADS, GAD-7) and a stepped-care approach for integrated dermatological and psychological management of AU patients. |
| format | Article |
| id | doaj-art-8d4fc48175c24f85b8d9264db2911e4a |
| institution | Kabale University |
| issn | 2666-3546 |
| language | English |
| publishDate | 2025-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain, Behavior, & Immunity - Health |
| spelling | doaj-art-8d4fc48175c24f85b8d9264db2911e4a2025-08-20T05:07:54ZengElsevierBrain, Behavior, & Immunity - Health2666-35462025-10-014810108810.1016/j.bbih.2025.101088Anxiety and nonpsychotic mental disorders in acute urticariaEli Magen0Eugene Merzon1Shai Ashkenazi2Abraham Weizman3Iris Manor4Israel Magen5Avi Yakov6Akim Geishin7Ilan Green8Avivit Golan-Cohen9Shlomo Vinker10Ariel Israel11Leumit Health Services, Tel Aviv-Yafo, 6473817, Israel; Department of Medicine A, Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheba, 8410501, Israel; Corresponding author. Department of Medicine A, Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheba, 8410501, Israel.Leumit Health Services, Tel Aviv-Yafo, 6473817, Israel; Adelson School of Medicine, Ariel University, Ariel, 4077625, IsraelAdelson School of Medicine, Ariel University, Ariel, 4077625, IsraelDepartment of Psychiatry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; ADHD Unit, Geha Mental Health Center, Petah-Tikva, IsraelDepartment of Psychiatry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Laboratory of Molecular and Biological Psychiatry, Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Medicine A, Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheba, 8410501, IsraelDepartment of Medicine A, Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheba, 8410501, IsraelLeumit Health Services, Tel Aviv-Yafo, 6473817, IsraelLeumit Health Services, Tel Aviv-Yafo, 6473817, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medical & Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, IsraelLeumit Health Services, Tel Aviv-Yafo, 6473817, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medical & Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, IsraelLeumit Health Services, Tel Aviv-Yafo, 6473817, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medical & Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, IsraelLeumit Health Services, Tel Aviv-Yafo, 6473817, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medical & Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, IsraelBackground: Acute urticaria (AU) is characterized by the sudden onset of wheals, angioedema, or both, with symptoms resolving within 6 weeks. While the association between chronic urticaria and mental health disorders is well-documented, the relationship between AU and psychological conditions remains understudied. Objective: To investigate the association between AU and anxiety and personality disorders, and to explore the potential psychoneuroimmunological mechanisms underlying these relationships. Methods: We conducted a population-based case-control study using the comprehensive electronic health records database of Leumit Health Services in Israel. The study included 72,805 AU patients and 291,220 matched controls. Subjects were matched for gender, age, ethnicity, year of first documented visit, and socioeconomic status. We analyzed the 20-year prevalence of anxiety disorders, personality disorders, and various nonpsychotic mental disorders in both groups. Results: AU patients demonstrated significantly higher prevalence of anxiety disorders (7.02 % vs. 5.22 %, p < 0.001, OR = 1.37 [95 % CI: 1.33–1.42]), personality disorders (0.23 % vs. 0.134 %, p < 0.001, OR = 1.73 [95 % CI: 1.44–2.08]), and adjustment disorders (0.91 % vs. 0.67 %, p < 0.001, OR = 1.37 [95 % CI: 1.25–1.50]) compared to controls. Particularly notable were the associations with personality disorders characterized by persistent mood disturbances (OR = 1.91 [95 % CI: 1.53–2.38]) and adjustment disorders with depressive features (OR = 1.49 [95 % CI: 1.27–1.74]). Conclusions: Our findings reveal significant associations between AU and various mental health disorders, particularly anxiety and personality disorders. These associations suggest a complex bidirectional relationship mediated through psychoneuroimmunological pathways involving the HPA axis, mast cell activation, and inflammatory cytokines. We recommend implementing specific screening tools (HADS, GAD-7) and a stepped-care approach for integrated dermatological and psychological management of AU patients.http://www.sciencedirect.com/science/article/pii/S2666354625001462AcuteUrticariaMentalPersonalityAnxietyDisorders |
| spellingShingle | Eli Magen Eugene Merzon Shai Ashkenazi Abraham Weizman Iris Manor Israel Magen Avi Yakov Akim Geishin Ilan Green Avivit Golan-Cohen Shlomo Vinker Ariel Israel Anxiety and nonpsychotic mental disorders in acute urticaria Brain, Behavior, & Immunity - Health Acute Urticaria Mental Personality Anxiety Disorders |
| title | Anxiety and nonpsychotic mental disorders in acute urticaria |
| title_full | Anxiety and nonpsychotic mental disorders in acute urticaria |
| title_fullStr | Anxiety and nonpsychotic mental disorders in acute urticaria |
| title_full_unstemmed | Anxiety and nonpsychotic mental disorders in acute urticaria |
| title_short | Anxiety and nonpsychotic mental disorders in acute urticaria |
| title_sort | anxiety and nonpsychotic mental disorders in acute urticaria |
| topic | Acute Urticaria Mental Personality Anxiety Disorders |
| url | http://www.sciencedirect.com/science/article/pii/S2666354625001462 |
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