Psychological aspects of food allergy

Food allergies may impact the emotions of patients through both direct and indirect mechanisms. Direct mechanisms include the effects on the central nervous system from biologic mediators released during an allergic reaction to food. Indirect mechanisms include the stress of coping with a food allergy-for example, food preparation and avoidance-as well as managing the fear of the potential consequences of ingesting the food. Indirect effects may also be mediated through family members-for example, the impact of a parent's stress on the child. These relationships are difficult to study, in part because many patients who report food allergy symptoms do not have objective symptoms when challenged with the offending food. Symptoms may be misinterpreted as food allergy more often by patients with certain psychological profiles. In this paper, relevant literature is reviewed, and clinical treatment designed to minimize the emotional suffering of patients and their families is presented through the description of a case vignette.