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Psychiatric comorbidity in chronic urticaria patients: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Dermatological illness can affect the quality of life and may coexist with psychiatric disorders. OBJECTIVE: The aim of this review was to systematically evaluate the published evidence of any psychiatric disorders that may coexist with chronic urticaria (CU) and any effect psychiatric interventions may have on CU. METHODS: Following the Cochrane guidance, we conducted a systematic literature search using web-based search engines provided by PubMed (for Medline database), Google Scholar and Scopus for studies that have investigated the existence of psychiatric comorbidity in patients with CU. To be included, a study had to possess features, such as: (1) distinction between chronic urticaria and allergic conditions, (2) direct collection of diagnostic psychiatric data by using clinical interview and standardized questionnaires, (3) International Classification of Disorders criteria or the Diagnostic and Statistical Manual of Mental Disorders criteria for the diagnosis of mental disorders, and (4) manuscripts written or published in the English language. Unpublished research and research in progress were not included. All the eligible studies were scrutinized for any reported psychiatric interventions that had any effect on CU. The systematic review has been registered on PROSPERO (registration number CRD42019122811) and was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS: Twenty-five studies were identified. Almost one out of three CU patients have at least one underlying psychiatric disorder. None of the studies clarified whether the psychiatric disorders pre-existed the CU onset, and no association was found between CU severity and duration, and psychological functioning. Only one case report and two case series mentioned that treatment of psychiatric disorders with either anti-depressants, anti-anxiety drugs or psychological interventions might result in improvement of urticaria. CONCLUSIONS: Patients with CU frequently experience psychiatric disorders. This highlights the need for a multidisciplinary therapeutic approach involving prompt recognition and management of any potential psychiatric disorder in addition to urticaria treatment. Further studies are needed to assess whether psychiatric disorders coexist with CU independently or follow urticaria onset and whether any psychological or psychiatric intervention may help in CU control.
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“Psychotropic drugs (e.g., antidepressants and benzodiazepines) could have a positive effect on CSU treatment 11,31 .”
From Could distress tolerance levels be associated with the severity of chronic spontaneous urticaria? (2022) · cites this paper as [31]
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Chronic Urticaria Through the Prism of Psycho-Neuro-Immunology: Another “Gordian Knot” to Solve
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Impact of Chronic Urticaria and How to Measure It
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Grattan, C. E. H., Zuberbier, T., & Maurer, M. (2021) · Springer eBooks · doi:10.1007/978-3-030-84574-2_13
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Telia, Z., Machavariani, K., TELIA, A. Z., & TELIA, A. Z. (2022) · EXPERIMENTAL & CLINICAL MEDICINE GEORGIA · doi:10.52340/jecm.2022.07.19
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Grattan, C. E. H., & Sears, A. V. (2024) · doi:10.1002/9781119709268.rook042
Hindelang, M., Sitaru, S., Fischer, C., Biedermann, T., & Zink, A. (2025) · JDDG Journal der Deutschen Dermatologischen Gesellschaft · doi:10.1111/ddg.15557_g
Can, P. K., & Can, U. (2025) · Dermatology Practical & Conceptual · doi:10.5826/dpc.1501a4470
Zakaraya, D. (2025) · Egyptian journal of Immunology · doi:10.55133/eji.320212
de Souza, A. P. F. A., Bertoli, A. F., Pacheco, M. A., Martini, A. P. S., Crivelatti, I., & da Silva, J. (2024) · Arquivos Catarinenses de Medicina · doi:10.63845/wws86s38
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da Fonseca, J. T., de Figueiredo, J. P., Neves, L. V. B. T., de Oliveira, J. C. S., de Oliveira, J. S., Figueiredo, V. R., & Campos, R. A. (2026) · Anais Brasileiros de Dermatologia · doi:10.1016/j.abd.2025.501261
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Metadata
- Authors
- Konstantinou, G. N., & Konstantinou, G. N.
- Affiliations
- Hellenic Air Force (GR)
- Venue
- Clinical and Translational Allergy
- Publisher
- Wiley
- Published
- 2019-08-23
- Volume
- 9
- Issue
- 1
- Pages
- 42-42
- ISSN
- 2045-7022 (ISSN-L)
- PMC
- PMC6706894
- OpenAlex
- W2969929864
- Cited by
- 110
- References
- 66
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 16 · 2023: 16 · 2022: 18 · 2021: 18 · 2020: 9
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Clinical and Translational Allergy (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Urticaria and Related Conditions
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Keywords
- chronic urticaria, psychiatric comorbidity, mental illness, depression, anxiety, antidepressants, anxiolytics, psychological intervention, urticaria severity, multidisciplinary care
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