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Decline in Dehydroepiandrosterone Sulfate Observed in Chronic Urticaria is Associated With Psychological Distress

From the Chair and Clinical Department of Internal Diseases, Allergology and Clinical Immunology in Zabrze (Z.B., A.K.-Z., B.R.); and Chair and Clinical Department of Psychiatry in Tarnowskie Góry (K.B.-B., J.M., R.T.H.), Medical University of Silesia in Katowice, Poland.

Address correspondence and reprint requests to Zenon Brzoza, Chair and Clinical Department of Internal Diseases, Allergology and Clinical Immunology in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13–15, 41-800 Zabrze, Poland. E-mail: zbrzoza{at}mp.pl

Objective: Dehydroepiandrosterone sulfate (DHEA-S) decline in chronic urticaria (CU) may be involved in etiopathogenesis of the disease or is a secondary phenomenon resulting e.g. from psychological distress. The relation between mental stress and skin diseases is well documented, however not focused on urticaria. We sought to explore the association of mood disturbances and the sense of coherence (SOC), as psychological distress parameters, and DHEA-S decline in patients suffering from CU.

Methods: The patient sample included 54 subjects with active CU. Fifty-nine healthy subjects were enrolled in the control group. In all subjects DHEA-S serum concentration was measured and mental status analyzed using the State and Trait Anxiety Inventory, SOC Questionnaire and Beck Depression Inventory.

Results: Urticaria patients showed lower serum concentration of DHEA-S (p = .01) and lower level of the SOC (p = .009), as well as higher level of anxiety as a state (p < .001) and as a trait (p = .001), and higher level of depression (p = .003). DHEA-S concentration correlated negatively with the level of anxiety as a trait (p = .02) and the level of depression (p = .046), and positively with the SOC level (p = .03).

Conclusions: The results of the present study show that CU patients suffer from the psychological distress. We demonstrated for the first time that DHEA-S decline observed in CU patients might be a phenomenon secondary to psychological disturbances.

Key Words: urticaria • dehydroepiandrosterone sulfate • distress • sense of coherence • anxiety • depression

Abbreviations: ASST = autologous serum skin test; BDI = Beck Depression Inventory; CU = chronic urticaria; D = level of depression; DHEA = dehydroepiandrosterone; DHEA-S = dehydroepiandrosterone sulfate; SOC = sense of coherence; SOC-29 = Sense of Coherence Questionnaire; STAI = State-Trait Anxiety Inventory; X1 = level of anxiety as a state; X2 = level of anxiety as a trait.