Chronic spontaneous urticaria (CSU) is linked with significant impairment of overall quality of life besides psychological distress. Accumulating evidence has shown significant comorbidity between CSU and an array of mental illnesses.

A recent study in Israel assessed the association between CSU and anxiety and depression, with the help of an optimized matched controlled design. This was a nationwide matched control study conducted using the Clalit Health Services (CHS) database. Overall, 12,539 CSU patients and 60,510 age and sex matched controls were included. Three multiple logistic regression models were conducted to dtermine the association between CSU and anxiety and depression, adjusting for age, sex, socioeconomic status (SES), diabetes, obesity, hypertension, and smoking status.

Investigators noted a higher frequency of anxiety and depression among CSU patients compared to controls (anxiety - 9.6% vs. 5.7%, p < 0.001; depression - 11% vs 7.9%, p < 0.001, respectively) after adjusting for demographic and clinical factors. The association of CSU with anxiety was found to be the strongest in the 18-29 age group, as well as in the high SES group. The association of CSU with depression was the highest in the 50-69 age group, and in the low SES group.

The study concluded that chronic spontaneous urticaria is associated with anxiety and depression. Authors stated that dermatologists should give due consideration to employing mental health screening procedures, particularly for patients from specific risk groups.Source: Tzur Bitan D, Berzin D, Cohen A. The association of chronic spontaneous urticaria (CSU) with anxiety and depression: a nationwide cohort study. Arch Dermatol Res. 2020 Apr 8.