Associations of Disease Activity, Depression Severity, and Quality of Life in Chronic Spontaneous Urticaria

Abstract Introduction Chronic spontaneous urticaria (CSU) is often a psychophysiological comorbidity. Depression is believed to both cause and sustain CSU. Objectives We aimed to investigate the severity and presence of depression in patients with CSU and the impact of CSU on quality of life. Methods We enrolled 60 CSU and 30 healthy controls. We calculated the urticaria activity score with Urticaria Activity Score-7 (UAS-7) and divided the chronic urticaria patients into 2 groups as 30 CSU with UAS-7 below 28 (mild-moderate severity) and 30 CSU with UAS-7 28 and above (severe urticaria). We used the patient health questionnaire-9 (PHQ-9) to measure the severity of depression in all patients and the dermatology quality of life index (DQoLI) to measure the quality of life in 60 CSU patients. Results The percentages of mild depression in the mild-moderate CSU, severe CSU and healthy groups were 16.67%, 46.67%, 6.7%, respectively. The percentage of mild depression in the severe CSU group was statistically significantly higher than in the mild-moderate CSU group (p=0.0001). The number of patients with mild depression was higher in patients with mild-moderate CSU than in the healthy group, but this was not statistically significant (p=0.4238). There was a positive correlation between UAS-7 and PHQ-9, DQoLI values were r=0.545, p=0.000; r=0.941, p=0.000 respectively, and these were statistically significant. There was also a positive correlation between PHQ-9 and DQoLI, which was statistically significant (r=0.510, p=0.000). Conclusions Having severe CSU disease was closely associated with increased prevalence of depression and impaired quality of life.