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Hereditary angiooedema and psychological stress: an exploratory study

Hereditary Angiooedema (HAE) is characterized by a deficit or by a malfunctioning of C1- 1nh; its symptoms vary greatly from one individual to another. Some studies suggest that some of the attacks of HAE may be triggered or affected by stress and emotional states (Zotter et al., 2014), however this link has never been examined in depth. Moreover, recent research has highlighted the influence of the neurological correlatives of stress in the activation of the compliment cascade, a system already compromised in those suffering from HAE [1] [2].

Aims

With this pilot study we intend to explore the connection between stress, emotional states and the variability of the attacks, in a sample of 11 individuals aged between 4 and 17 with HAE, together with their parents. It is a preliminary study, which aims to explore whether emotions have a direct or indirect influence on the development of HAE.

Methods

We adopt a multi method approach, using widely -used, internationally recognized tests, listed below:

  • Semi-structured interviews with parents to explore their interpretation on the variability of the attacks;

  • CBCL to exclude cases of psychopathology;

  • CLES to evaluate the perceived level of stress;

  • AQC on alexithymia;

  • LEAS-C on emotional awareness;

  • TEMAS on the functions of personality;

  • A diary of symptoms, noting the frequency, intensity and the location of the attacks.

Results

Although 92% of parents believed that emotional states played an important role in the triggering of attacks, the young patients were unable or had difficulty articulating their emotional states, more in general with their processes of emotion regulation (De Steno et al., 2013). This may well be connected to the high levels of stress experienced by nearly all the patients seen in the CLES test. These high levels of stress, in 9 out of 11 cases, correlated with the frequency of the attacks. Finally, from the CBCL results no personality disorder emerged connected to HAE.

Conclusions

We believe that by encouraging skills aimed at expressing emotions caused by stress, prove useful in the treatment and management of individuals suffering from HAE. The results of this pilot study highlighted the need for further research on the role of psychological factors connected to HAE.

References

  1. Burns V, et al: “Complement cascade Activation after an acute psychological stress task”. Psychosomatic Medicine. 2008, 70: 387-396. 10.1097/PSY.0b013e31816ded22.

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  2. De Steno D, Gross JJ, Kubzansky L: "Affective Science and Health:The Importance of Emotion and Emotion Regulation”. Health Psychology. 2013, 32 (5): 474-486.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Galante, A., Freda, M.F., Bova, M. et al. Hereditary angiooedema and psychological stress: an exploratory study. Clin Transl Allergy 5 (Suppl 1), O6 (2015). https://doi.org/10.1186/2045-7022-5-S1-O6

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  • DOI: https://doi.org/10.1186/2045-7022-5-S1-O6

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