Associations of Disease Activity, Depression Severity, and Quality of Life in Chronic Spontaneous Urticaria.

INTRODUCTION

Chronic spontaneous urticaria (CSU) is often a psychophysiological comorbidity. Depression is believed to both cause and sustain CSU.

OBJECTIVES

We aimed to investigate the severity of depression in patients with CSU and the impact of CSU on quality of life.

METHODS

We enrolled 150 CSU and 75 healthy controls. We calculated the disease activity with Urticaria Activity Score 7 (UAS7) and divided the chronic urticaria patients into two groups as mild-moderate CSU (N=75) and severe CSU (N=75). We used the Patient Health Questionnaire-9 (PHQ-9) to measure the severity of depression in all patients and the Dermatology Life Quality Index (DLQI) to measure the quality of life in 150 CSU patients.

RESULTS

Significant main effects were observed for disease severity (P<0.001) and sex (P<0.001) on rank-transformed DLQI scores and PHQ-9 scores. Patients with severe CSU had substantially higher adjusted rank-transformed DLQI and PHQ-9 scores than those with mild-moderate CSU (P<0.001). Similarly, females exhibited higher rank-transformed DLQI and PHQ-9 scores compared to males (P<0.001). Among covariates, disease duration exerted a strong positive effect on rank-transformed DLQI and PHQ-9 scores (P<0.001). Additionally, the presence of angioedema was associated with increased depressive symptoms (P=0.042), whereas allergic comorbidities had a minor protective effect (P=0.001).

CONCLUSION

This multicenter study demonstrated that disease severity and duration are the primary determinants of elevated rank-transformed DLQI and PHQ-9 scores in patients with chronic spontaneous urticaria, while female sex contributes a modest but significant effect.