Psychological Wellbeing of Patients with Chronic Spontaneous Urticaria and Its Relation to Their Overall Health-Related Quality of Life

Maha F Saja,1 Raneem Hamad Alhoqail,2 Renad A Alduwayan,2 Lamia S Alsubaie,2 Layan A Alhelal,2 Fay M Alluhaydan,2 Hend M Alotaibi3 1Department of Physiology, King Saud University, Riyadh, Saudi Arabia; 2College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Department of Dermatology, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Maha F Saja, Department of Physiology, King Saud University, Riyadh, 11461, Saudi Arabia, Email [email protected]: Chronic spontaneous urticaria (CSU) is a chronic skin disease characterized by the appearance of wheals with or without angioedema for more than 6 weeks. Its troublesome symptomatology, recurrent nature, and long-term treatment can be physically, psychologically, and economically challenging to patients adversely affecting their psychological wellbeing and health-related quality of life (HRQoL). This study aimed at (i) measuring the level of anxiety and depression in patients with CSU, (ii) evaluating their HRQoL, and (iii) assessing the relationship between psychological wellbeing and HRQoL in those patients.Patients and Methods: In this cross-sectional study, patients with CSU (n=114) were recruited by convenience sampling from the dermatology clinic at King Saud University Medical City (KSUMC) between October 2022 and April 2024. Four datasets were collected from each patient: (i) Sociodemographic, disease-, and medication-related characteristics, (ii) anxiety level using the General Anxiety Disorder 7-Item (GAD-7) Scale, (iii) depression level via the 9-item Patient Health Questionnaire (PHQ-9), and (iv) HRQoL using the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL).Results: The mean age was 42 (SD: 12.5) with 90.4% being females. The majority had mild-to-moderate disease activity. Around 8% reported concomitant inducible urticaria while 53.5% reported angioedema. The prevalence of patients with CSU at risk of either Generalized Anxiety Disorder (GAD) or Major Depressive Disorder (MDD) was around 28% for each. Mean CU-Q2oL score was 35.3 (SD: 23.4). Several factors were shown to be significantly associated with higher anxiety and depression levels as well as lower HRQoL including, disease activity, presence of angioedema, drug allergy, and the use of sedative antihistamines. Multivariable regression analysis identified high anxiety and depression levels as significant independent predictors of lower HRQoL in patients with CSU.Conclusion: Clinically significant anxiety and depression are prevalent among patients with CSU and are linked to lower HRQoL in those patients.Keywords: chronic urticaria, quality of life, anxiety, depression, patient health questionnaire