Changes in Psychological Burden and Quality of Life During In Vivo Diagnostic Evaluation for Immediate Drug Hypersensitivity: A Prospective Stepwise Study
- 1Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Türkiye
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.
Related
- Diagnostic Performance of Color Doppler Ultrasound for Detecting Nuchal Cord and Associated Immediate Neonatal Outcomes at Term in Uganda: A Prospective Diagnostic‐Accuracy Cohort Study
- Guidelines: Diagnosis and management of perioperative immediate hypersensitivity reactions 2025
- A prospective cross-sectional diagnostic feasibility study: musculoskeletal ultrasound for pediatric bone age evaluation
- Guidelines on the diagnosis and management of perioperative immediate hypersensitivity reactions 2025
- Validity and prognostic value of the University of California, San Diego dyspnea questionnaire in fibrotic hypersensitivity pneumonitis: a multicenter prospective study
BibTeX
@article{aslan2026changes,
title = {{Changes in Psychological Burden and Quality of Life During In Vivo Diagnostic Evaluation for Immediate Drug Hypersensitivity: A Prospective Stepwise Study}},
author = {Ayşe Feyza Aslan and Semra Demir and Pelin Korkmaz and İlkim Deniz Toprak and Nevzat Kahveci and Merve Hörmet İğde and Mehmet Emin Sezgin and Bircan Erden and Deniz Eyice Karabacak and Şule Çelik Kamacı and Andaç Karadeniz and Yavuz Erkam Kesgin and Selin Ece Güzel and Merve Dilşad Atasever and Leyla Bölek and Esra Kaya and Osman Ozan Yeğit and Derya Ünal and Aslı Gelincik},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207964},
url = {https://www.mdpi.com/2077-0383/15/20/7964},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Changes in Psychological Burden and Quality of Life During In Vivo Diagnostic Evaluation for Immediate Drug Hypersensitivity: A Prospective Stepwise Study
AU - Ayşe Feyza Aslan
AU - Semra Demir
AU - Pelin Korkmaz
AU - İlkim Deniz Toprak
AU - Nevzat Kahveci
AU - Merve Hörmet İğde
AU - Mehmet Emin Sezgin
AU - Bircan Erden
AU - Deniz Eyice Karabacak
AU - Şule Çelik Kamacı
AU - Andaç Karadeniz
AU - Yavuz Erkam Kesgin
AU - Selin Ece Güzel
AU - Merve Dilşad Atasever
AU - Leyla Bölek
AU - Esra Kaya
AU - Osman Ozan Yeğit
AU - Derya Ünal
AU - Aslı Gelincik
PY - 2026
DA - 2026/10/15
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207964
UR - https://www.mdpi.com/2077-0383/15/20/7964
AB - 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.
SN - 2077-0383
ER -