Psychology Referrals Rose for Children with Food Allergies in the Past Decade

A new study found psychology referrals dramatically increased for children with food allergies in the past decade.¹ The findings will be presented at the 2024 American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting from October 24 – 28, 2024 in Boston.

In recent years, many patients and children have experienced anxiety surrounding food allergies. According to the Allergy & Asthma Network, food allergy-specific anxiety tends to focus on certain phobias and fears, including needle phobia, allergen safety, eating out, traveling, allergic reactions and anaphylaxis, using epinephrine, rejection, humiliation, exclusion, bullying, and death.²

Not only that but more and more children have developed food allergies in the past decade. Children with food allergies do not have greater rates of anxiety than their peers without a food allergy but they do have a greater level of distress and worry about their food allergies.

A recent study using a cross-sectional online survey design reported that 67.7% of adults, 77.2% of caregivers, and 51.6% of children experience psychological distress associated with allergies.³ The research indicated that allergy provider assessments of psychological distress are necessary.

Although many recognize the link between food allergies and anxiety, a lot of people have limited access to professional services that offer therapy due to geographic barriers.¹ Cognitive behavior therapy can especially be helpful for those with food allergy-related anxiety.² The tertiary care referral center at Nationwide Children’s Hospital in Columbus, Ohio, has increased psychology services in recent years, but investigators wondered if this increased visits for food allergy-related anxiety.1

“Our center has devoted significant resources to address the psychosocial support needed by many families who have children with food allergies,” said lead investigator Andriana La Mantia, MD, from the Nationwide Children’s Hospital, in a statement. “Our goal in this study was to characterize the use of these services for food allergy-related anxiety.”

The team conducted a retrospective chart review of outpatient pediatric psychology referrals at the team’s center between 2013 – 2023 due to food allergies or related conditions. They collected data on demographic information, medical history related to food allergy, and the number of psychology appointments between 2013 – 2023.

The study included 250 patients (141 males) who had a median age of 9.5 years. Most (88%) were referred for food allergy-related concerns, with an average of 2.1 allergens per patient. The sample included 53% with prior documented anaphylaxis, 69% with food-related anxiety, and 12% with quality-of-life impairment that led to the referral.

More than half of patients (60%) who received psychology referrals had ≥ 1 appointment. On average, patients had 5.5 follow-up appointments in the following year.

The team observed that, in the past decade, there was an 11-fold increase in food allergy referrals. The referrals had a > 50% increase in the year 2023 compared to yearly referrals from 2018 – 2022.

“Food allergy patients, particularly children, often suffer from anxiety related to potential accidental ingestion and anaphylaxis,” said investigator David Stukus, MD, an ACAAI member. “Expanding psychological services for these patients is an important part of how we try to support families to live normal lives while balancing food allergy management.”

References

1. ^{Need for psychology referrals increasing for children with food allergies. EurekAlert! October 24, 2024. https://www.eurekalert.org/news-releases/1061371. Accessed October 23, 2024.}
2. ^{Mental Health and Living with Food Allergies. Allergy & Asthma Network. https://allergyasthmanetwork.org/food-allergies/food-allergy-anxiety/. Accessed October 23, 2024.}
3. ^{Smith, T. Study Suggests Allergy Provider Assessments of Psychological Distress Necessary. HCPLive. July 3, 2024. https://www.hcplive.com/view/study-allergy-provider-assessments-psychological-distress-necessary. Accessed October 23, 2024.}