Anxiety and depression in patients with self-reported food hypersensitivity

Lillestøl, Kristine; Berstad, Arnold; Lind, Ragna; Florvaag, Erik; Arslan Lied, Gülen; Tangen, Tone

doi:10.1016/j.genhosppsych.2009.08.006

« Previous Next »General Hospital Psychiatry
Volume 32, Issue 1 , Pages 42-48, January 2010

Anxiety and depression in patients with self-reported food hypersensitivity☆

Kristine Lillestøl, M.D.
- Institute of Medicine, University of Bergen, N-5021 Bergen, Norway
- Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
- Corresponding author. Institute of Medicine, Haukeland University Hospital, University of Bergen, N-5021 Bergen, Norway. Tel.: +47 55 97 30 79; fax: +47 55 97 58 90.
Arnold Berstad, M.D., Ph.D.
- Institute of Medicine, University of Bergen, N-5021 Bergen, Norway
- Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
Ragna Lind, R.N., M.Sc.
- Institute of Medicine, University of Bergen, N-5021 Bergen, Norway
Erik Florvaag, M.D., Ph.D.
- Institute of Medicine, University of Bergen, N-5021 Bergen, Norway
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, N-5021 Bergen, Norway
Gülen Arslan Lied, M.D., Ph.D.
- Institute of Medicine, University of Bergen, N-5021 Bergen, Norway
- Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
Tone Tangen, M.D., Ph.D.
- Institute of Clinical Medicine, University of Bergen, N-5021 Bergen, Norway
- Department of Psychiatry, Haukeland University Hospital, N-5021 Bergen, Norway

Received 22 April 2009; accepted 31 August 2009. published online 05 October 2009.

Abstract

Objective

Self-reported food hypersensitivity (SFH) is common. Psychological factors are assumed to be associated. We assessed anxiety and depression in SFH patients, using both questionnaires and interview.

Methods

Consecutive patients (n=130) and randomly selected healthy volunteers (n=75) completed the Hospital Anxiety and Depression Scale (HADS), the neuroticism scale of the Eysenck Personality Questionnaire (EPQ-N) and the General Health Questionnaire (GHQ). Seventy-six of the patients were also interviewed by use of the Mini International Neuropsychiatric Interview and the Montgomery–Aasberg Depression Rating Scale. All patients underwent extensive allergological, gastroenterological and dietary examinations.

Results

According to interviews, 57% of patients fulfilled the DSM-IV criteria for at least one psychiatric disorder. Anxiety disorders (34%) and depression (16%) predominated. According to questionnaires, patients scored significantly higher than controls on all psychometric scales except for depression (HADS). We also found an underreporting of depression in HADS compared with interviews (2.5% vs. 16%, P=.001). Food hypersensitivity was rarely confirmed by provocation tests (8%). Eighty-nine percent of the patients had irritable bowel syndrome.

Conclusions

Anxiety and depression are common in patients with IBS-like complaints self-attributed to food hypersensitivity. Anxiety disorders predominate. In this setting, depression may be underreported by HADS.

Keywords: Anxiety disorders, Depression, Food allergy, Food hypersensitivity, Irritable bowel syndrome