Sex Differences in Adults with Insect Venom Allergy regarding Psychological Distress, Attitudes toward the Emergency Medication, and Factual Knowledge about the Disease

Int Arch Allergy Immunol. 2020;181(7):529-535. doi: 10.1159/000507625. Epub 2020 May 27.

Abstract

Background: Hymenoptera venom allergy (HVA) has a prevalence of 3% in adults. Although patients have no ongoing symptoms, they often suffer from an impairment of their psychological well-being and quality of life.

Objective: The aim of this study was to analyze sex-specific differences regarding the psychological burden caused by this allergy and handling of the emergency medication.

Method: Study participants filled out a questionnaire including sociodemographic and disease-specific characteristics, the Hospital Anxiety and Depression Score (HADS), and theoretical knowledge about the emergency medication set (EMS). Additionally, an objective structured clinical examination was used to assess practical knowledge and handling of the EMS.

Results: Fifty-six patients were included (55.4% females). Female patients showed higher subjective anxiety levels due to HVA compared to men (mean 7.2 vs. 4.6, p = 0.0003). Furthermore, the HADS revealed that women had a significant higher anxiety level, especially after Mueller grade I-II anaphylactic reactions (mean 6.3 vs. 2.8, p = 0.0134). This was associated with a higher theoretical but not practical knowledge about their disease. On the other hand, males were less inclined to carry the emergency medication "always" or "almost always" (56 vs. 87.1%, p = 0.0015) but showed higher self-assurance in using it (mean 7.3 vs. 6.1, p = 0.0446).

Conclusions: This clinical study provides evidence for sex differences in coping with HVA. The results suggest that females should be monitored more closely for allergy-associated anxiety symptoms, while men need more encouragement to carry the emergency medication.

Keywords: Anaphylactic reaction; Emergency medication; Gender differences; Insect venom allergy.

MeSH terms

  • Adult
  • Anaphylaxis / etiology*
  • Anaphylaxis / prevention & control
  • Animals
  • Anxiety / etiology
  • Arthropod Venoms / adverse effects*
  • Arthropod Venoms / immunology*
  • Bronchodilator Agents / therapeutic use
  • Epinephrine / therapeutic use
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hypersensitivity / immunology*
  • Hypersensitivity / psychology
  • Insect Bites and Stings / complications*
  • Insect Bites and Stings / immunology
  • Male
  • Middle Aged
  • Psychological Distress
  • Sex Factors

Substances

  • Arthropod Venoms
  • Bronchodilator Agents
  • Epinephrine