{
  "abstract": "Background/Objective: The psychological impact of in vivo diagnostic procedures remains poorly understood. We assessed changes in psychological distress and drug hypersensitivity-related quality of life (QoL) throughout a diagnostic evaluation for suspected immediate drug hypersensitivity reactions (IDHRs) and aimed to identify predictors of persistent psychological burden. Methods: This single-center prospective observational longitudinal study included 100 consecutive adults undergoing evaluation for suspected IDHRs. Psychological distress and QoL were assessed using the Depression Anxiety Stress Scale-21 (DASS-21) and the Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q). Assessments were performed before and after each diagnostic phase, including skin tests (STs), placebo, and drug provocation tests (DPTs). Results: The mean age was 44.2 ± 12.5 years, and women comprised 72% of the cohort. Depression, anxiety, stress, and DrHy-Q scores significantly decreased after ST, placebo, and DPT compared with baseline measurements. Across diagnostic stages, depression, anxiety, stress, and DrHy-Q scores were significantly lower during the DPT phase than during the ST and placebo phase in both pre-test and post-test measurements (p < 0.01 for pairwise comparisons). The number of prior HSRs showed a weak but significant positive correlation with DrHy-Q scores. In multivariable linear regression analysis, the number of prior HSRs was the only independent predictor of post-DPT DrHy-Q scores (β = 3.43, 95% CI 1.36–5.50, p = 0.001). Patients who avoided the provoked drug despite a negative DPT had higher DPT-post depression, anxiety, stress, and DrHy-Q scores. Conclusions: Psychological burden progressively decreased over the course of the stepwise diagnostic evaluation for suspected IDHRs, although patients with repeated reactions may benefit from additional support.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Türkiye"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 19,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ayşe Feyza Aslan",
      "orcid": "0000-0001-5866-2646"
    },
    {
      "affs": [
        0
      ],
      "name": "Semra Demir"
    },
    {
      "affs": [
        0
      ],
      "name": "Pelin Korkmaz"
    },
    {
      "affs": [
        0
      ],
      "name": "İlkim Deniz Toprak"
    },
    {
      "affs": [
        0
      ],
      "name": "Nevzat Kahveci",
      "orcid": "0000-0001-7050-6101"
    },
    {
      "affs": [
        0
      ],
      "name": "Merve Hörmet İğde"
    },
    {
      "affs": [
        0
      ],
      "name": "Mehmet Emin Sezgin",
      "orcid": "0000-0002-7654-283X"
    },
    {
      "affs": [
        0
      ],
      "name": "Bircan Erden",
      "orcid": "0009-0003-2943-4697"
    },
    {
      "affs": [
        0
      ],
      "name": "Deniz Eyice Karabacak"
    },
    {
      "affs": [
        0
      ],
      "name": "Şule Çelik Kamacı",
      "orcid": "0000-0001-7132-2400"
    },
    {
      "affs": [
        0
      ],
      "name": "Andaç Karadeniz",
      "orcid": "0000-0002-4796-3328"
    },
    {
      "affs": [
        0
      ],
      "name": "Yavuz Erkam Kesgin"
    },
    {
      "affs": [
        0
      ],
      "name": "Selin Ece Güzel"
    },
    {
      "affs": [
        0
      ],
      "name": "Merve Dilşad Atasever"
    },
    {
      "affs": [
        0
      ],
      "name": "Leyla Bölek"
    },
    {
      "affs": [
        0
      ],
      "name": "Esra Kaya"
    },
    {
      "affs": [
        0
      ],
      "name": "Osman Ozan Yeğit"
    },
    {
      "affs": [
        0
      ],
      "name": "Derya Ünal"
    },
    {
      "affs": [
        0
      ],
      "name": "Aslı Gelincik"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2p2fmr7b09sdj.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15207964",
  "fulltext_url": null,
  "id": "2p2fmr7b09sdj",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/7964",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2736|Drug-Induced Adverse Reactions"
    ]
  ],
  "openalex": "W7221865317",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-15",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/2p2fmr7b09sdj.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15207964",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/7964"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2736|Drug-Induced Adverse Reactions",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Changes in Psychological Burden and Quality of Life During In Vivo Diagnostic Evaluation for Immediate Drug Hypersensitivity: A Prospective Stepwise Study",
  "title_text": "Changes in Psychological Burden and Quality of Life During In Vivo Diagnostic Evaluation for Immediate Drug Hypersensitivity: A Prospective Stepwise Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:00Z",
  "url": "https://research.draconitic.com/paper/2p2fmr7b09sdj",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}