The psychological impact of food allergy and undergoing a food challenge test in adult age

Makatsori, M. and Miles, Anne (2021) The psychological impact of food allergy and undergoing a food challenge test in adult age. European Annals of Allergy and Clinical Immunology 53 (6), pp. 252-262. ISSN 1764-1489.

Abstract

Introduction: Despite an increasing number of adults being affected by food allergy, there is currently limited research regarding the psychological impact of living with this condition in this age group and the effect of undergoing food challenge testing - the gold standard for diagnosis- on health-related quality of life (HRQoL). Objectives: To assess whether ruling out a food allergy using an open food challenge could improve HRQoL and emotional well-being. To evaluate whether HRQoL gains are higher among people testing negative for food allergy and whether people higher on health anxiety would be less reassured by a negative food challenge. Methods: A cross-sectional study (n=276) and a prospective study (n=53) were performed. Adults with a positive (n=34), or negative food challenge (n=34), or with an allergy confirmed via other means (No challenge, n=208), completed the Food Allergy Quality of Life Questionnaire-Adult Form, General Health Questionnaire-12, State-Trait Anxiety Inventory short form, Positive and Negative Affect Schedule, shortened version of the Health Anxiety Questionnaire in addition to clinical and demographic variables. A prospective study examined these measures before and three months after a food challenge (negative, n=45; positive, n=8). Results: Adults with a negative food challenge outcome had better HRQoL than those with a food allergy confirmed via other means (No challenge), with no differences between the two allergy positive groups (food challenge vs. no challenge). No group differences in emotional distress, health anxiety or mood were found. The prospective study showed HRQoL significantly improved following a food challenge (F(1,39) = 16.868; p<0.001; Intention-to-treat F(1,52) = 15.346; p<0.001). High health anxiety was not associated with lower reassurance following a negative test. Conclusions: People who have a food allergy excluded following a food challenge have better HRQoL. There was a significant improvement in HRQoL following an open food challenge which supports the need to increase provision of food challenge testing in this age group.

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