Association Between Disease Severity and Symptoms of Anxiety and Depression Among Patients with Chronic Urticaria Attending a Dermatology Outpatient Department: A Cross-Sectional Study
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Abstract
Background: Chronic urticaria is a recurring skin condition marked by itchy wheals, angioedema, or both, lasting for more than six weeks. Its unpredictable, relapsing course keeps patients in a state of near-constant distress, and a growing body of work links it to anxiety and depression. Yet how closely the emotional burden tracks with the clinical activity of the disease is still not well described in Indian outpatient settings.
Objectives: To estimate the proportion of patients with chronic urticaria who screen positive for anxiety and depression, and to examine whether these symptoms rise with increasing disease severity.
Methodology: This was a hospital-based cross-sectional study of 150 adults with chronic urticaria attending the dermatology outpatient department of GS Medical College & Hospital, Pilkhuwa, between January and June 2022. Disease severity was graded with the weekly Urticaria Activity Score (UAS7). Anxiety and depression were screened using the Hospital Anxiety and Depression Scale (HADS), with a subscale score of 8 or more taken as a positive screen. Associations were tested with the chi-square test and Spearman correlation using SPSS version 25.
Results: Of the 150 patients, 92 (61.3%) were women and the mean age was 34.8 (SD 11.2) years. A positive screen for anxiety was found in 68 patients (45.3%) and for depression in 58 patients (38.7%). The proportion screening positive climbed steadily with severity: anxiety was present in 22.7% of the mild group, 43.8% of the moderate group and 71.4% of the severe group (p < 0.001). Depression followed the same pattern (18.2%, 37.5% and 61.9%; p < 0.001). UAS7 correlated positively with both HADS-A (r = 0.46) and HADS-D (r = 0.41), both p < 0.001.
Conclusion: Anxiety and depression were common in this outpatient population and became more frequent as urticaria worsened. Screening for mental health at the dermatology clinic, especially for patients with severe disease, would help catch distress that might otherwise go unnoticed.
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References
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