ADULTS living with anaphylaxis who have difficulty identifying and expressing emotions may experience poorer quality of life and greater psychological distress, according to a new study highlighting the importance of integrating psychological assessment into allergy care.
Researchers investigated the relationship between alexithymia, quality of life (QoL), anxiety, depression, and perceived disease severity in adults with confirmed anaphylaxis who had been prescribed self-injectable epinephrine. While the physical management of anaphylaxis is well established, less is known about the emotional burden associated with the condition.
The study included 29 adults with a confirmed diagnosis of anaphylaxis. Participants completed a series of validated questionnaires assessing anaphylaxis-specific and general quality of life, perceived stress, anxiety, depression, and alexithymia. These included the Anaphylaxis Quality of Life Scale for Adults, the World Health Organization Quality of Life Brief questionnaire, the Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Toronto Alexithymia Scale.
Alexithymia Affects Quality of Life
More than one-third of participants (37.9%) were classified as alexithymic or borderline alexithymic. Higher alexithymia scores were associated with greater perceived severity of anaphylaxis, with patients in the alexithymic group significantly more likely to report severe disease than those without alexithymia.
The researchers also identified significant associations between alexithymia and several measures of psychological wellbeing. Higher alexithymia scores correlated with increased symptoms of depression and anxiety, alongside poorer scores in psychological and environmental domains of general quality of life. Participants with higher alexithymia scores also reported worse anaphylaxis-specific quality of life, including greater limitations on daily living and social functioning.
Supporting Holistic Anaphylaxis Care
The findings suggest that psychological factors may have an important influence on how patients experience and cope with anaphylaxis beyond the physical risk of allergic reactions. Although the study cannot establish causality and was limited by its small sample size, it highlights the potential value of routinely assessing emotional wellbeing in people with severe allergic disease.
The authors propose that incorporating psychological screening into anaphylaxis management could help identify patients who may benefit from additional support. Alongside education on allergen avoidance and appropriate use of epinephrine auto-injectors, interventions targeting emotional wellbeing may improve long-term quality of life and overall patient care.
Reference
Patella V et al. Psychological burden in anaphylaxis: a study on alexithymia and quality of life. Front Allergy. 2026;7:1791020.
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