Effect of Psychological Stress Intervention for Patients with Chronic Urticaria (CU)

Abstract

RATIONALE: Many patients with CU report heightened levels of psychological stress before and/or after the onset of urticaria, thus we observed the effect of psychological stress intervention on CU symptoms. METHODS: Participants met individually with a psychiatry resident once a week for a 6-week acceptance-based behavioral stress intervention. Each participant completed a packet of psychological and dermatological symptom questionnaires prior to the first session and after the final session. The urticaria activity score (UAS) was recorded daily to observe symptom trends. Medicines that would affect urticaria symptoms were recorded daily and each was given an arbitrary score (MS), based upon anticipated clinical impact, that was averaged over the period between visits to observe differences in drug use trends with intervention. RESULTS: Four participants were enrolled. Participants 1 and 4 completed the study (Participant 2 withdrew due to schedule conflicts and Participant 3 was removed after missing several sessions). Participant 1 exhibited little change in the UAS or MS after intervention. There was an increase in both parameters across the final two sessions, which corresponded to an increase in major life stressors. There was an improvement in 2 of 3 stress questionnaire scores. Participant 4 exhibited an improvement in UAS and MS trends until the final session when a significant life stressor was reported. There was improvement in 2 of 3 stress questionnaire scores. CONCLUSIONS: Psychological stress intervention may have treatment benefit for patients with CU and stress, but is likely limited by the time commitment required to learn the stress intervention techniques.