Premium
Multiple drug intolerance syndrome and multiple drug allergy syndrome: Epidemiology and associations with anxiety and depression
Author(s) -
Blumenthal K. G.,
Li Y.,
Acker W. W.,
Chang Y.,
Banerji A.,
Ghaznavi S.,
Camargo C. A.,
Zhou L.
Publication year - 2018
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13440
Subject(s) - anxiety , depression (economics) , medicine , odds ratio , epidemiology , odds , psychiatry , logistic regression , drug , economics , macroeconomics
Background The epidemiology of multiple drug intolerance syndrome ( MDIS ) and multiple drug allergy syndrome ( MDAS ) is poorly characterized. We used electronic health record ( EHR ) data to describe prevalences of MDIS and MDAS and to examine associations with anxiety and depression. Methods Patients with ≥3 outpatient encounters at Partners HealthCare System from 2008 to 2015 were included. Patients with MDIS had intolerances to ≥3 drug classes, and patients with MDAS had hypersensitivities to ≥2 drug classes. Psychiatric conditions and comorbidities were defined from the EHR and used in multivariable logistic regression models to assess the relation between anxiety/depression and MDIS / MDAS . Results Of 746 888 patients, 47 634 (6.4%) had MDIS and 8615 (1.2%) had MDAS ; 3171 (0.4%) had both. Anxiety (adjusted odds ratio [ aOR ] 1.72 [1.65, 1.80]), depression ( aOR 1.46 [1.41, 1.52]), and both anxiety and depression ( aOR 1.97 [1.86, 2.08]) were associated with increased odds of MDIS . Depression was associated with increased odds of MDAS ( aOR 1.41 [1.28, 1.56]), but there were no clear associations with anxiety ( aOR 1.13 [0.99, 1.30]) nor both depression and anxiety ( aOR 1.13 [0.92, 1.38]). Conclusion While 6% of patients had MDIS , only 1% had MDAS . MDIS was associated with both anxiety and depression; patients with both anxiety and depression had an almost twofold increased odds of MDIS . MDAS was associated with a 40% increased odds of depression, but there was no significant association with anxiety. Psychological assessments may be useful in the evaluation and treatment of patients with MDIS and MDAS ; physiologic causes for MDAS warrant further investigation.