NEW YORK (Reuters Health) – People who suffer from asthma and allergic rhinitis have an increased risk for developing a psychiatric disorder, and assessing their emotional condition and monitoring their mental health might be worthwhile, say researchers from Taiwan.
Asthma, allergic rhinitis and atopic dermatitis – nicknamed the three “A’s” – are among some of the most common allergic diseases. “As a clinician, I observed that some patients with the three ‘A’s appeared to suffer emotionally. Therefore, I wanted to clarify whether these allergic diseases are associated with psychiatric disorders,” Dr. Nian-Sheng Tzeng from Tri-Service General Hospital said in a statement.
Using the Taiwan National Health Insurance (NHI) Program database, the researchers identified more than 186,000 adults, including 46,647 who suffered from allergic diseases, and 139,941 matched controls who did not.
Over 15 years, 10.8% people with allergic diseases developed a psychiatric disorder compared with 6.7% controls, translating into a significant 1.66-fold increase in risk for people with allergic disease (P<0.001) the researchers report in Frontiers in Psychiatry, online April 23.
Adults with allergic diseases had significantly elevated risks for developing an affective disorder (adjusted HR, 1.4), including depression (aHR 1.4) and bipolar disorder (aHR 1.1), and an anxiety disorder (aHR, 2.4), a psychotic disorder (aHR, 1.2) and dementia (aHR, 1.2).
The researchers divided participants with allergic diseases into six groups: asthma alone, allergic rhinitis alone, atopic dermatitis alone, asthma plus allergic rhinitis, asthma plus atopic dermatitis, allergic rhinitis plus atopic dermatitis and a combination of all these three allergic diseases.
Atopic dermatitis was associated with a lower overall risk of psychiatric disorders, but asthma and allergic rhinitis was associated an overall increased risk, they report.
Asthma was associated with a heightened risk of individual psychiatric disorders including anxiety and depression, dementia and bipolar disorder. Allergic rhinitis was associated with a lower risk of dementia but an increased risk of other psychiatric disorders. Having more allergic diseases was associated with an increased risk of psychiatric disorders, the authors note.
Dr. Tzeng and colleagues also found that use of oral prednisolone was associated with a lower risk of developing psychiatric disorders in asthma patients.
Also, the use of the beta-agonist aminophylline and leucotriene receptor antagonists was associated with a lower risk of psychiatric disorders, with or without prednisolone use.
The researchers note that some other studies have suggested a link between allergy-related inflammatory or immunological factors and psychiatric disorders. The psychological stress of a psychiatric disorder might also contribute to physical symptoms. Further study is needed to clarify the mechanisms underlying the association between allergic diseases and psychiatric disorders, they say.
Corresponding author Dr. Wu-Chien Chien of National Defense Medical Center in Taipei did not respond to a request for comment by press time.
The study had no commercial funding and the authors declare no conflicts of interest.
SOURCE: https://bit.ly/2HuU6Se
Front Psychiatry 2018.
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