Skin test results and self-reported symptom severity in allergic rhinitis: the role of psychological factors
Article first published online: 6 DEC 2006
Clinical & Experimental Allergy
Volume 36, Issue 12, pages 1532–1537, December 2006
How to Cite
Graif, Y., Goldberg, A., Tamir, R., Vigiser, D. and Melamed, S. (2006), Skin test results and self-reported symptom severity in allergic rhinitis: the role of psychological factors. Clinical & Experimental Allergy, 36: 1532–1537. doi: 10.1111/j.1365-2222.2006.02589.x
- Issue published online: 6 DEC 2006
- Article first published online: 6 DEC 2006
- Submitted 24 January 2006; revised 24 July 2006; accepted 21 August 2006
- allergic rhinitis;
- psychological factors;
- skin prick test;
- symptoms severity
Background In allergic conditions, the degree of skin test reactivity does not always correlate with the severity of clinical symptoms. Additional factors may contribute to the reported symptom severity.
Objectives To investigate the association between the magnitude of the skin prick test (SPT) response and the reported symptom severity in patients with allergic rhinitis and the possible modifying role of psychological factors.
Methods One hundred four patients with allergic rhinitis and 23 with non-allergic rhinitis, classified according to their SPT response to 19 aeroallergens, were asked to rate the severity of five symptoms and to indicate whether their symptoms intensified on exposure to five common aeroallergens. They also completed a psychological questionnaire.
Results Reported symptom severity of allergic rhinitis did not correlate with weal size for any of the aeroallergens tested or with the number of positive responses on SPT. It was not related to patient age, sex, or education. The reported symptoms severity correlated positively (0.29, P<0.01) with reported symptom intensification on exposure to allergens. Moreover, both outcomes were positively associated with the psychological factors of hypochondriasis (0.20, P<0.05 and 0.18, P<0.05, respectively), and somatic awareness (0.24, P<0.05 and 0.33, P<0.01, respectively), but not with neuroticism.
Conclusions The severity of symptoms experienced by patients with allergic rhinitis is apparently not related to the magnitude of SPT response, but rather to psychological factors of hypochondriasis and somatic awareness. Physicians should be aware of the contribution of psychological factors to patient perceptions of the intensity of symptoms and of the intensification of symptoms on their exposure to allergens.