Association of Chronic Urticaria with Psychological Distress: A Multicentre Cross-sectional Study

Chronic urticaria is a debilitating disease that affects health-related quality of life, but few studies have evaluated its impact on psychological wellbeing. The aim of this study was to evaluate the quality of life of patients with chronic urticaria and determine its impact on their emotional and psychological wellbe-ing. A cross-sectional multicentre study of a cluster of 264 Lebanese patients visiting dermatology/immu-nology clinics was conducted between July 2018 and June 2020. The impact of chronic urticaria on quality of life was assessed using the Chronic Urticaria Qua-lity of Life Questionnaire (CU-Q2oL) and Dermatology Life Quality Index (DLQI), as well as its consequences on mood changes using the Patient Health Questionn-aire-9 (PHQ-9) and Beirut Distress Score 22 (BDS-22) scores. A multivariable analysis of covariates was per-formed to determine the effect of the triggering fac-tors of urticaria on both CU-Q2oL and PHQ-9. A mode-rate negative correlation was found between Urticaria Control Test and quality of life scores as well as PHQ-9 and BDS-22 (p < 0.001). Patients with the lowest Ur-ticaria Control Test score had the highest impairment in quality of life and depression scores. In conclusion, chronic urticaria compromises patients' quality of life and emotional wellbeing. This distress is more pro-nounced when the disease is more severe.SIGNIFICANCEChronic urticaria is a dermatological disease that compro-mises the quality of life of patients, due to its debilitating symptoms. The recurrent pattern of this disease may have a detrimental effect on patients' psychology, and many stu-dies have demonstrated that patients may experience a prolonged psychological burden, such as depression. The evaluation of quality of life and psychological health is fun-damental for a better assessment of disease progression and treatment efficacy. The results of this study demon-strate that urticaria is associated with an impairment in quality of life, which emphasizes the need for evaluation of the psychological health of patients visiting tertiary clinics.