Managing Anxiety Related to Anaphylaxis in Childhood: A Systematic Review

Katharina Manassis

doi:10.1155/2012/316296

Abstract

Objectives. This paper reviews the relationship between anxiety and anaphylaxis in children and youth, and principles for managing anxiety in the anaphylactic child and his or her parents. Methods. A review of the medical literature (Medline) was done using the keywords “anxiety,” “anaphylaxis,” and “allergy,” limited to children and adolescents. Findings were organized into categories used in the treatment of childhood anxiety disorders, then applied to managing anxiety in the anaphylactic child. Results. Twenty-four relevant papers were identified. These varied widely in methodology. Findings emphasized included the need to distinguish anxiety-related and organic symptoms, ameliorate the anxiety-related impact of anaphylaxis on quality of life, and address parental anxiety about the child. Conclusion. Children with anaphylaxis can function well despite anxiety, but the physical, cognitive, and behavioral aspects of anxiety associated with anaphylactic risk must be addressed, and parents must be involved in care in constructive ways.

Highlights

Anxiety symptoms are common in children with anaphylactic conditions and in their parents
Children with anxiety disorders are at increased risk for allergies, including those associated with anaphylaxis [1], and anaphylaxis itself can provoke anxiety
A child with an insect sting allergy might completely avoid the outdoors; a child with a severe food allergy might follow an overly restrictive diet or avoid friends’ homes for fear of encountering an allergen; a young anaphylactic child might refuse to stay at school without a parent for fear of having a reaction there

Summary

Introduction

Anxiety symptoms are common in children with anaphylactic conditions and in their parents. Anxiety becomes debilitating and imposes unnecessary restrictions on the anaphylactic child’s life, preventing the child from engaging in important daily activities at home, at school, or socially. Anxiety associated with such daily impairment is not considered normative [3]. A child with an insect sting allergy might completely avoid the outdoors; a child with a severe food allergy might follow an overly restrictive diet or avoid friends’ homes for fear of encountering an allergen; a young anaphylactic child might refuse to stay at school without a parent for fear of having a reaction there. Prominent symptoms of anxiety (e.g., hyperventilation or blushing) may mimic anaphylactic reactions, often resulting in further anxiety and impairment [4,5,6]

Objectives

Methods

Results

Conclusion