Patients with food allergies may need mental health support

(Reuters Health) – Many patients with life-threatening food allergies can sometimes feel anxious or overwhelmed, but mental health professionals are rarely involved in their care, suggests a survey of cancer centers. American excellence in the treatment of allergy.

Allergy specialists and mental health professionals should work together to create easier ways to access mental health care for patients, the investigation team said in a "clinical communication" published in the Journal of Allergy and Clinical Immunology.

"Food allergy is a chronic, but unique disease because you do not suffer from pain every day, but every time you eat, you may be afraid that something serious will happen," said Dr. Marcus Shaker, a pediatric allergist. at the Dartmouth-Hitchbad Medical Center in Lebanon, New Hampshire, who did not participate in the newspaper.

According to the American Academy of Pediatrics, approximately 8% of American children have been diagnosed with food allergy.

"It depends on how this is formulated and addressed has profound implications, and it can start very early with the family or the doctors," Shaker told Reuters Health during a phone interview. "For some families, it does not affect them much, but for others, it's a completely different framing with constant vigilance and fear."

In the paper, a group of clinicians led by Linda Herbert of the National Medical Center for Children and the George Washington University School of Medicine in Washington, D.C., describes the results of her online survey. The authors were not available to comment on their report.

The survey interviewed site coordinators from 28 centers of excellence in the US Food Allergy Education and Research Clinical Network regarding the presence of psychiatrists, psychologists, social workers and other counselors in their practice. and the presence of mental health practitioners in the community through referrals.

The survey questions also focused on perceptions of patients' mental health issues in managing their food allergies, their allergy testing and problems, and their participation in clinical trials. .

A total of 22 centers of excellence were in hospitals, 16 of which were occupied only by children. Of the sites, five had a mental health professional in their division, either full-time or part-time. More than half of the sites had a professional in their facility to whom they could refer patients, but fewer had a professional in the community for referral purposes. In only four locations did students receive training on mental health issues related to a food allergy.

All but one participant reported having observed mental health issues related to food allergy in their patients, including the anxiety of children and parents. Site coordinators thought that mental health services could be very beneficial at the time of allergy diagnosis before significant developmental transitions in children and before feeding problems. The coordinators also reported having observed mental health issues related to dosage, allergic reactions, use of epinephrine in emergency and food aversions.

Eighteen participants stated that they did not have any mental health support, but that they would like to have it. They also indicated that they thought that few mental health professionals had sufficient knowledge of food allergy to be able to provide specialized care.

"We have seen children develop a complete anxiety disorder, and if they have a reaction, it can be traumatic and cause some degree of post-traumatic stress disorder that takes time to get back to the place. where they were, "said Dr. Amanda Cox of the Jaffe Food Allergy Institute in New York, who did not participate in the newspaper.

The allergy and mental health communities should work together to develop food allergy education programs for mental health professionals and primary care physicians, as well as expand the pool of professionals available for referrals, write the authors of the study.

"In any chronic health condition, it's important that parents and caretakers observe its impact on how a person works in the world," Cox said during a phone interview. "If this limits them and is stressful, it could be a problem that could benefit from good coping mechanisms."

SOURCE: https://bit.ly/30R3ZDH Journal of Allergy and Clinical Immunology: in Practice, Online May 14, 2019.