Psychological burden of food allergy

Table 1 Psychological aspects of adverse reactions to food

Author	Subjects	Examinations	Adverse reaction to food	Results
Pearson et al, 1983	8 males, 12 females; allergy clinic	Psychiatric clinical interview schedule Double blind placebo controlled food-challenge	Hypersensitivity was confirmed in 4 subjects	No psychological symptoms in subjects hypersensitivity was confirmed, high incidence of psychiatric disorder (neurotic depression, hysterical disorders) in subjects whose belief that they had a food allergy could not be confirmed
Rix et al,1984	23 patients; allergy clinic	Psychiatric clinical intervie schedule Double blind placebo controlled food-challenge	Hypersensitivity was confirmed in 4 subjects	No evidence of psychiatric disorder in subjects hypersensitivity was confirmed, high incidence of psychiatric disorder (identical with a group of psychiatric out patient referrals) in patients whose belief that they had a food allergy could not be confirmed
Bell et al,1993	490 young college students	Self-reported illness from several common foods and chemicals	Indefinite diagnosis	Correlation between perceived food intolerance and depression, anxiety, and somatization
Vatn et al,1995	17 patients with food intolerance 34 healthy referents	Prospective placebo-controlled study General Health Questionnaire Double blind placebo controlled food-challenge	Non IgE-mediated food intolerance	13 of 17 patients reported major distress or trauma during childhood, including loss of parents and violence or major psychiatric illness. Psychological problems are frequent
Peveler et al,1996	Community study in 273 adults	Blind food challenge test Clinical interview Several questionnaires Brief symptom inventory	Intolerance to test foods	Subjects that were judged not to be allergic on clinical grounds did not manifest significant mood disturbance or impaired social adjustment or other psychological symptoms
Knibb et al,1999	Random mailing recruited 955 participants, of whom 232 perceived them-selves to be food intolerant	General Health Questionnaire-28 (GHQ-28) Eysenck Personality Questionnaire	Selfperception of food intolerance	It is concluded that perceived food intolerance is associated with psychological distress in women, and neurotic symptoms in both men and women, but there is no greater prevalence of psychiatric disorder among women or men
Lind et al,2005	46 patients with food hypersensitivity 50 health car workers 70 volunteers	Subjective Health Complaints Inventory and Modern Health Worries Scale	Subjective food hypersensitivity No IgE-mediated allergy	Subjects with subjective food hypersensitivity reported more subjective health complaints and more worries An association between subjective food hypersensitivity and subjective health complaints was supposed

Table 2 Food allergy and quality of life

Author	Subjects	Examinations	Results
Primeau et al, 2000	153 peanut allergic children and 37 adults compared to 69 children and 42 adults with rheumatologic disease; furthermore their families	Impact on Family Questionnaire (IFQ)	Peanut allergic children have more disruption in their daily activities, more impairment in the familial-social dimension of the IFQ Adults with rheumatological disease reported more disruption in their family relations
Sicherer et al, 2001	253 children and adolescents with food allergy	Children's health questionnaire (CHQ-PF50) Allergy-related questionnaire	Worse scores for general health perception, parental distress and worries, and limitations in usual family activities compared to healthy controls. Family cohesion was greater in the food allergic group
Avery et al, 2003	20 children with peanut allergy and 20 children with insulin-dependent diabetes mellitus	Self-designed questionnaire Vespid Allergy Quality of life Questionnaire Cameras to record quality of life	Children with food allergy report more fear of an adverse event, more anxiety about eating, more restriction due to the illness
Marklund et al, 2004	1451 adolescents, thereof 19% "reactive" to food	Health Survey Short Form (SF-36)	Lower scores in seven of the eight scales (role functioning-physical, bodily pain, general health, vitality, social functioning, role functioning-emotional, mental health)
Lyons et al ,2004	162 young adults, of which 24 “reported" food allergy	Questionnaire, registering awareness and perceptions of food allergy, self-rated health State-Trait Anxiety Scale Perceived Health Competence Scale	Allergic subjects with high health competence reported great anxiety levels. They perceived that their allergy had less of an impact on their lives than others believed it would
Bollinger et al, 2006	87 families of food allergic children	Food allergy impact scale	All aspects of daily life are affected with most striking effects on family meal preparation and activities outside home