Psychological burden in hereditary angioedema: An evaluation of depression, anxiety, and perceived stress

Aim: Hereditary angioedema (HAE) is a rare disorder characterized by swelling that significantly impacts patients' quality of life.This study aims to assess the prevalence of psychological distress, including depression, anxiety, and stress.Material and Methods: A cross-sectional study was conducted with validated psychological assessment tools, including the Beck Depression Inventory (BDI), Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale-10 (PSS-10), and Generalized Anxiety Disorder-7 (GAD-7).Angioedema severity and disease control were evaluated using questionnaires: the Angioedema Activity Score (AAS) and the Angioedema Control Test (AECT).Results: A total of 18 patients completed all questionnaires.The median age was 33 years (IQR: 27.7-37.2),with a female predominantly female population (77.7%).Disease control was poor in 76.4% of patients (AECT median: 8, IQR: 5.5-10).The median AAS score was 49.5 (IQR: 17-76).Psychological assessments revealed a high burden of distress, with 50% of patients exceeding the BDI treatment threshold (median: 16, IQR: 10.7-22.7)and scoring within the moderate-to-severe depression range on the PHQ-9 (median: 9.5, IQR: 7.5-16).Moderate stress (PSS-10 median: 20, IQR: 15.7-25) was reported by 88.8% of participants, while 38.9% exhibited moderate-to-severe anxiety (GAD-7 median: 8, IQR: 4-10.5).No significant correlations were observed between disease control (AECT, AAS) and psychological distress measures (BDI, PHQ-9, PSS-10, GAD-7).Discussion: Our findings emphasize the substantial psychological burden of HAE, with a significant proportion of patients experiencing depression, anxiety, and stress.Beyond clinical severity, attack-related uncertainty and chronic disease burden likely contribute to this distress.Future research with larger, longitudinal cohorts is essential to better delineate the complex interplay between HAE and mental health.