Chronic illnesses such as asthma and allergies have psychological impacts

ARLINGTON HEIGHTS, Ill. (May 7, 2025) – People who have struggled with asthma or allergies for years understand the psychological toll of these conditions. The May issue of Annals of Allergy, Asthma and Immunology (Annals), the scientific journal of the American College of Allergy, Asthma and Immunology, explores the mental health burden these conditions can exact.

“The diseases we treat in allergy/immunology are primarily chronic illnesses and they often have a psychological impact on those who suffer from them,” says allergist Mitchell Grayson, MD, editor in chief of Annals. “Sometimes, as doctors, we focus on the diagnosis and treatment of the disease but don’t realize the suffering that the patient is undergoing. Fear and anxiety can be major components of allergic diseases and can greatly interfere with successful treatment of the underlying disease. In this issue we explore the mental health impacts of atopic dermatitis, food allergy, and asthma. We not only describe the mental health impacts on patients, but also (and more importantly) explore ways in which clinicians can mitigate these effects leading to better care for their patients.”

Below are summaries from the abstracts of three of the mental health articles featured in the May issue of Annals:

Title: Depression and Anxiety in Patients with Atopic Dermatitis: Recognizing and Addressing Mental Health Burden

“The psychosocial burden of atopic dermatitis (AD) is extensive, stemming from intense itch, sleep disturbance, unpredictable flares, social stigma, treatment burden, lifestyle restrictions and missed activities…Although depression and anxiety are known comorbidities of AD, the mental health burden of AD often goes unaddressed, which may further a sense of isolation for patients and families. Given the strong association between symptom severity and increased mental health burden, optimizing AD treatment and reducing itch are critical. Health care professionals can support patients with AD and their caregivers by encouraging open conversations about mental health, addressing common areas of condition-related stress, screening for depression and anxiety, and facilitating referrals to mental health professionals for further assessment and evidence-based care…Further research is needed to  evaluate psychological interventions for pediatric patients with AD and for patients with clinical diagnoses of depression and anxiety to better guide shared decision-making around support for these patients.”

Title: Managing Childhood Asthma with an Eye Toward Environmental, Social and Behavioral Features

“Discussions around asthma management tend to focus on the therapeutic aspects… However, there are many other components of asthma management that are now receiving increased attention as we seek to make right on health disparities and strive towards health equity…On the other hand, we know very little about what we can do to control the other inflammatory features that contribute to asthma. Factors, such as environmental exposures, social determinants of health and risk-taking behaviors may be at the root of asthma persistence, progression and co-morbidities. We continue to learn about methods to identify these issues and draw them into a shared decision-making approach to dialogue with patients and their caregivers. In this review, we provide information and available tools to address these non-pharmacologic aspects of asthma management.”

Title: Want to Help Your Patients with Food Allergy Anxiety? Do Proximity Challenges!

“In their landmark paper published nearly a decade ago, Dinakar and colleagues recommended that food allergists incorporate proximity food challenges into clinical practice to improve patient knowledge and anxiety. Such challenges are akin to the exposure tasks routinely employed in cognitive-behavioral therapy (CBT), the first-line psychosocial intervention for anxiety disorders. Exposure is a therapy technique where a person…directly, strategically, and repeatedly confronts their feared object, situation, or activity in real life... Following a summary of the history and evidence-base for exposure in both the psychiatric and food allergy literature, we review several considerations related to conducting in-office proximity challenges. Topics include assessment of anxiety and medically unnecessary avoidance, choosing appropriate, individualized proximity challenges based on patient presentation, and practical considerations in carrying out in-office proximity challenges to maximize benefit to anxious patients.”

Dr. Grayson noted on the topic of theme issues, “Theme issues allow Annals the opportunity to highlight a specific issue, disease, or concept in a way where the reader gets a more concentrated exposure. This makes for a better reader experience and allows the reader to better focus on the specific topic of the issue. Having themes also allows readers to pull specific issues that contain the information they are interested in when they need that information. In addition, Annals has online article collections (at www.annallergy.org)  where readers can find groupings of articles (from multiple theme issues).”

About ACAAI

The ACAAI is the premier professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. The College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit AllergyandAsthmaRelief.org. Join us on Facebook, Pinterest, Instagram, Twitter/X and Threads.