Allergic rhinitis and mental health: Allergy medications are not enough

Background: Allergic rhinitis (AR) is a chronic inflammatory condition with a significant mental health impact.Objectives: This study evaluates the prevalence of anxiety and depression symptoms among patients with AR to investigate the association between mental health risks and allergy control in response to AR medications.Methods A cross-sectional study was conducted between February 20 and June 25, 2024, involving 5,768 patients. Validated instruments used include Patient Health Questionnaire-9 (PHQ-9); depression, Generalized Anxiety Disorder-7 (GAD-7; anxiety), and Sinonasal Outcome Test-22 (SNOT-22) as AR control. Mediation analyses evaluated the impact of various AR (intranasal and oral) medications on the relationship between AR control and mental health, with significance set at p<0.05.Results The study population was 64.58%/35.42% female/male, respectively. Descriptive statistics (M±SD), PHQ-9 was 2.49 ± 4.99, GAD-7 2.54 ± 4.62, PHQ-GAD-16 was 5.03 ± 8.67, and SNOT-22 was 22.71 ± 16.75. Higher SNOT-22 (worse AR control) was significantly associated with higher PHQ-GAD-16 scores (more depressive and anxiety symptoms) across all medication types (direct effect). Intranasal antihistamines, decongestants, steroids, and oral leukotriene blockers did not significantly mediate the effect of SNOT-22 on PHQ-GAD-16 scores (indirect effect). Worse AR control led to more depressive and anxiety symptoms (total effect r = 0.53, P<0.0001).Conclusion Results demonstrate a significant association between poor AR control and increased levels of depressive and anxiety symptoms, regardless of various medications used. Integrating mental health screening and support is essential for enhancing management and improving patient outcomes. Healthcare providers must consider both physical and mental health in their treatment strategies.